What are the causes & risk factors of fibroids?

The exact cause of fibroids is unknown, but several factors may influence their development:

• Hormonal Factors: Estrogen and progesterone, hormones that stimulate the development of the uterine lining during each menstrual cycle, seem to promote the growth of fibroids.
• Genetic Changes: Many fibroids contain alterations in genes that differ from those in normal uterine muscle cells.
• Other Growth Factors: Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth.
• Risk Factors: Being of reproductive age, family history, ethnic background (African-American women are more likely to develop fibroids), obesity, and certain dietary habits.

Impact on Pregnancy

Fibroids can affect fertility and pregnancy. They may cause complications such as infertility, pregnancy loss, preterm delivery, and complications during labor. However, many women with fibroids can still become pregnant and have successful pregnancies.

What are the treatment options for fibroids?

Here are the primary treatment methods:

1. Uterine Fibroid Embolization (UFE)

• Procedure: UFE, also known as uterine artery embolization (UAE), involves injecting small particles into the arteries supplying the fibroids, cutting off their blood supply. This causes the fibroids to shrink and die.
• Benefits: Minimally invasive, shorter recovery time compared to surgery, preservation of the uterus, and symptom relief for many patients.

2. MRI-Guided Focused Ultrasound (MRgFUS)

• Procedure: This non-invasive treatment uses high-intensity focused ultrasound waves, guided by MRI, to heat and destroy fibroid tissue.
• Benefits: Non-invasive, no incisions, quick recovery, and minimal risk of complications.

3. Endometrial Ablation

• Procedure: Although primarily used for treating heavy menstrual bleeding rather than fibroids themselves, endometrial ablation can be effective for small fibroids that are within or close to the uterine lining.
• Benefits: Minimally invasive, quick recovery, and can reduce menstrual bleeding.

4. Radiofrequency Ablation (RFA)

• Procedure: Radiofrequency energy is used to destroy fibroid tissue by heating it.
• Benefits: Minimally invasive, targeted treatment, and short recovery time.

5. Hysteroscopic Myomectomy

• Procedure: Though typically performed by gynecologists, this can also be facilitated by interventional radiologists for targeted fibroid removal.
• Benefits: Minimally invasive, preserves the uterus, and can improve symptoms rapidly.

Follow-Up and Recovery

• Monitoring: Regular follow-up appointments to monitor the effectiveness of the treatment and check for any recurrence of symptoms.
• Recovery Time: Recovery times vary depending on the procedure, with UFE and MRgFUS generally requiring shorter recovery periods compared to surgical options.

When to Consider These Treatments

• Symptomatic Relief: When fibroids cause significant symptoms such as heavy menstrual bleeding, pelvic pain, or pressure.
• Desire to Preserve Uterus: When the patient wishes to avoid a hysterectomy and preserve the uterus.
• Minimally Invasive Options: Preference for less invasive procedures with quicker recovery times and fewer complications compared to traditional surgery.