Fibroids And Infertility
A uterine fibroid is a growth of smooth muscle and fibrous tissue which develops in the uterus. Fibroids usually occur in women of reproductive age and are sensitive to female hormones such as oestrogen and progesterone. For this reason, when a woman with uterine fibroids has high oestrogen levels (for example during pregnancy) her fibroids may increase in size. Many women with fibroids find that their fibroids shrink and their symptoms improve after menopause, due to the decrease in female hormones in their bodies.
Essentially, uterine fibroids are non-cancerous tumours. Very rarely, a fibroid may become cancerous. If you know that you have uterine fibroids, you should make sure to attend your appointments with the gynaecologist and keep your doctor informed about any changes in your symptoms.
Many women with uterine fibroids experience only mild symptoms or perhaps none at all. Others suffer discomfort and pain and may even have difficulty getting pregnant. Symptoms of uterine fibroids include:
Changes in menstrual bleeding – bleeding may become heavier, last for longer and be more painful. Bleeding may occur between periods.
Pain and swelling – depending on the size and location of a uterine fibroid, a woman feel pain and/or pressure in her pelvic or abdominal area. For example, a fibroid which presses against the rectum or bowel may cause changes in bowel movements, and a fibroid which presses against the cervix could cause pain during sex. Therefore, frequent urination and constipation can also be fibroid symptoms.
Backache – pain in the back and legs has also been reported by women with uterine fibroids.
If you are experiencing any of these symptoms you should speak to your doctor.
Infertility is another symptom or complication of uterine fibroids. Pregnant women who have uterine fibroids also have an increased risk of miscarriage or premature birth. Fibroids can cause infertility in a number of ways. A large fibroid may, for example, force the uterus cavity or fallopian tubes into an unnatural position. This means that a woman’s egg cannot travel down the tubes to meet her male partner’s sperm and, even if the egg does get fertilised, the resulting embryo may not be able to implant properly in the lining of the uterus. It is also thought that infertility in women with fibroids may be caused by an insufficient blood supply to the endometrial lining, which interferes with implantation. Fibroids may also cause inflammation in the uterus, which again creates an unsuitable environment for an embryo.
A range of treatments are available for women with uterine fibroids depending on the severity of their symptoms and their plans for getting pregnant. Some women who are menstruating normally manage to control their discomfort by taking anti-inflammatory painkillers when they have their periods. Other women may require hormone treatment to reduce the size of their fibroids, or surgery to remove the fibroids, before pregnancy is possible. Surgery is generally recommended only after all other types of treatment have failed. Many hormone treatments do stop menstruation but not permanently. Contraception should be used while the treatment is in progress. The aim of hormone treatment is to temporarily reduce the body’s levels of female hormones and shrink the fibroids, giving the patient a better chance of getting pregnant when the treatment is over.