Uterine fibroids are common, normally non-cancerous, tumors that develop in or around the uterus. Affecting an estimated 20-40% of women of reproductive age in Hong Kong , these growths can vary in size and may not always cause symptoms. However, for some women, fibroids can lead to significant health issues, including heavy bleeding, pain, and even fertility challenges.
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The awareness of women’s health in Hong Kong is growing, and understanding the causes, symptoms, and treatment options for uterine fibroids has become an important aspect of maintaining overall reproductive health. For women in Hong Kong, where busy work schedules often overlap with family responsibilities, early awareness and timely treatment are crucial for preventing complications.
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What are Uterine Fibroids?
Uterine fibroids are benign growths that develop in the uterus, typically made of muscle and fibrous tissue. They can appear anywhere within the uterus, classified based on their location:
Intramural fibroids | These grow within the uterine wall and are the most common type. |
Submucosal fibroids | These are located just beneath the inner lining of the uterus and can affect menstrual cycles significantly. |
Subserosal fibroids | These grow on the outer surface of the uterus and can cause pain or pressure on nearby organs. |
Pedunculated fibroids | These grow on a stalk-like structure, either inside or outside the uterus. |
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Though most fibroids do not lead to major health concerns, they can cause significant discomfort and complications in some women. It’s essential to be aware of the symptoms, especially if they significantly impact your daily life.
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What are the Causes of Uterine Fibroids?
The exact cause of uterine fibroids remains unclear , but several factors are believed to contribute to their development.
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1. Hormonal Imbalance: The growth of fibroids is heavily influenced by the hormones estrogen and progesterone. These hormones stimulate the growth of the uterine lining during each menstrual cycle, and when fibroids are present, they respond similarly, growing in size. This explains why fibroids are more common in women of reproductive age.
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2.Genetic Factors: Family history plays a significant role in the development of fibroids. If your mother or sister had fibroids, your risk of developing them increases. Certain genetic mutations have also been linked to fibroid growth.
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3.Other Risk Factors: Several other factors can increase the likelihood of developing uterine fibroids, including:
○Obesity: Higher body fat levels can contribute to higher estrogen levels, which may increase the likelihood of fibroid development.
○High blood pressure: Women with hypertension may be at higher risk for fibroids.
○Pregnancy: The hormonal changes that occur during pregnancy can sometimes encourage the growth of fibroids.
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Understanding these risk factors can help you take preventative measures, such as maintaining a healthy weight and seeking early medical advice if you have a family history of fibroids.
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Why do Uterine Fibroids Cause Bleeding?
One of the most common symptoms of uterine fibroids is abnormal bleeding, which can range from heavy periods to prolonged bleeding. But why do fibroids cause such bleeding?
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1. How Fibroids Affect Menstrual Cycles: Fibroids, particularly submucosal fibroids, can cause heavy menstrual bleeding because they interfere with the normal contraction of the uterine muscles during menstruation. This can lead to a buildup of the endometrial lining, causing prolonged and heavier periods.
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2. Impact on the endometrial shedding: The presence of fibroids can also disrupt the normal shedding of the uterine lining. Fibroids may cause an irregular blood flow and prevent the proper shedding of the lining, which results in heavier and longer periods.
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Women with fibroids often report not only heavier periods but also blood clots and prolonged bleeding that can last several days longer than normal. If these symptoms interfere with daily life, it's important to consult a doctor for an evaluation.
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Common Symptoms of Uterine Fibroids
Uterine fibroids often don’t cause noticeable symptoms, but when they do, they can significantly impact a woman's quality of life. Some of the most common symptoms include:
Heavy menstrual bleeding | This is one of the most common signs of fibroids, often leading to anemia due to excessive blood loss. |
Pelvic pain or pressure | This can be due to the size of the fibroid or its position within the uterus. |
Frequent urination | Large fibroids can put pressure on the bladder, causing the need to urinate more often. |
Lower back pain | Fibroids that press on the spine or nearby muscles can lead to chronic back pain. |
Pain during intercourse | Some women may experience pain during sex, especially if the fibroid is located near the cervix. |
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If you experience any of these symptoms, it’s important to speak with your doctor. Though they may not always indicate fibroids, they could point to other health concerns that require medical attention.
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How are Uterine Fibroids Diagnosed?
Diagnosing uterine fibroids typically begins with a pelvic exam, during which your doctor may feel for any abnormal growths in the uterus. If fibroids are suspected, further diagnostic tests may be required, such as:
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●Ultrasound:The most common method used to identify fibroids, ultrasound uses sound waves to create an image of the uterus and any growths inside it.
●MRI: For more detailed images, an MRI may be used to assess the size, location, and number of fibroids.
●Hysteroscopy: In some cases, a small camera is inserted through the cervix to directly observe the inside of the uterus.
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Early diagnosis is crucial, as untreated fibroids can lead to complications, such as infertility or severe anemia from excessive bleeding.
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How to Remove Uterine Fibroids
There are several treatment options available to manage uterine fibroids, ranging from non-surgical methods to surgery, depending on the severity of the symptoms.
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Non-surgical Treatments | Medications | Hormonal treatments, such as birth control pills or GnRH agonists, can shrink fibroids by reducing estrogen levels. Over-the-counter pain relievers may help manage mild symptoms. |
MRI-guided focused ultrasound | A non-invasive treatment that uses high-frequency sound waves to destroy fibroid tissue without the need for surgery. | |
Surgical Treatments | Myomectomy | This procedure involves the removal of fibroids while preserving the uterus, making it an option for women who wish to retain fertility. |
Hysterectomy In | severe cases, a hysterectomy may be recommended. This is the removal of the uterus and is typically considered when fibroids are large, or other treatments have failed | |
Uterine artery embolization (UAE) | This procedure involves blocking the blood vessels that supply the fibroids, causing them to shrink over time. |
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Empowering Your Uterine Fibroid Management
Uterine fibroids are common, but they can cause discomfort and affect daily life if left untreated. Understanding the causes, symptoms, and treatment options available can help you make informed decisions about your health.
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If you suspect you may have fibroids or are experiencing symptoms, consult a healthcare provider for a thorough diagnosis and personalized treatment plan. With the right care, fibroids can be effectively managed.
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Sources:
1.The Hong Kong College of Obstetricians and Gynaecologists. (2009). Guidelines for the Management of Uterine Leiomyoma. Number 13. Published by The Hong Kong College of Obstetricians and Gynaecologists, a Foundation College of Hong Kong Academy of Medicine. Available at: https://www.hkcog.org.hk/hkcog/Download/Guidelines_for_the_Management_of_Uterine_Leiomyoma_2009.pdf
2.Johns Hopkins Medicine. (n.d.). Uterine Fibroids. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/uterine-fibroids
