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Fibroids
Fibroids,ormyomas,aregrowthsorbenigntumoursthatforminsidetheuterus(womb).Around fourin10womenovertheageof40willhavefibroids.Nooneknowswhyfibroidsdevelop,butitis suspectedthatthesexhormonesoestrogenandprogesteroneplaysignificantroles.Thisis becausefibroidsrarelygrowinprepubescentgirlsandpostmenopausalwomen.Pre-existing fibroidsstopgrowing,andmayevenshrink,onceawomanpassesthemenopause. Fibroidsoftencausenoproblems,butmayoccasionallybeassociatedwithinfertility,miscarriage andprematurelabour.Otherpossibleproblemsincludeheavy,lengthyandpainfulperiods. Treatmentdependsonthesize,numberandlocationofthefibroids,butmayincludedrugs, proceduresperformedunderlocalanaestheticandsurgery.Fibroidsrarelyturncancerous. Symptoms Mostwomenwithfibroidshavenosymptoms.Whenpresent,symptomsmayinclude: Heavyperiods Lengthyperiods Periodpain Spottingbetweenperiods Painfulintercourse Asensationofheavinessorpressureintheback,bowelandbladder Frequenturination Alumporswellinginthelowerabdomen.

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Different types Fibroidsarecategorisedbytheirlocation,whichincludes: Intramuralgrowingintheuterinewall.Intramuralfibroidsarethemostcommon variety. Submucosalgrowingintheuterinelining(endometrium).Thistypetendstocause excessivemenstrualbleedingandperiodpain. Subserosalgrowingontheexteriorwalloftheuterus.Thesesometimesappearlike longstalks.

Common complications Fibroidscancauseavarietyofcomplications,including: Anaemiaexcessivemenstrualbloodlosscancauseanaemia,adisordercharacterisedby thebodysinabilitytocarrysufficientoxygenintheblood.Symptomsofanaemiainclude breathlessness,fatigueandpaleness. Urination problemslargefibroidscanbulgetheuterusagainstthebladder,causinga sensationoffullnessordiscomfortandtheneedtourinateoften. Infertilitythepresenceoffibroidscaninterferewithimplantationofthefertilisedeggin anumberofways.Forexample,theeggmaytrytoburrowintoafibroid,orfibroidsclose totheuterinecavitymaypropopentheuterus,makingsuccessfulimplantationdifficult. Miscarriage and premature deliveryfibroidscanreducebloodflowtotheplacentaor maycompeteforspacewiththedevelopingbaby.

Diagnosis Fibroidscanbedetectedusinganultrasound,wheresoundwavescreateatwo-dimensional picture.Theinsideoftheuteruscanbeexaminedwithahysteroscope,whichisathintubepassed throughthecervix(neckofthewomb).Asmallcameramaybeplacedatthetipofthe hysteroscope,sothattheinterioroftheuteruscanbeviewedonamonitor.

Fibroids

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Treatment Treatmentdependsonthelocation,sizeandnumberofthefibroids,butmayinclude: Monitoringifthefibroidsarecausingnosymptomsandarenotlarge,awaitandsee approachisusuallyadopted. Drugs suchashormones,usedincombinationtoshrinkthefibroidspriortosurgery. Arterial embolisation underlocalanaesthetic,afinetubeispassedviaanarteryinthe armorlegintothemainarterysupplyingthefibroidwithblood.Thewholeprocessis monitoredbyx-ray.Fineparticles(likesand)aretheninjectedintothearterytoblockthe bloodsupplytothefibroid.Thefibroidslowlydiesandsymptomsshouldsettleoverafew months. Hysteroscopythefibroidsareremovedviathecervix,usingahysteroscope. Laparoscopyorkeyholesurgery,whereathintubeisinsertedthroughtheabdomento removethefibroids. Open surgerylargerfibroidsneedtoberemovedviaanabdominalincision.This procedureweakenstheuterinewallandmakesCaesareansectionsforsubsequent pregnanciesmorelikely. Hysterectomythesurgicalremovalofsome,orall,oftheuterus.Pregnancyisno longerpossibleafterahysterectomy.

Where to get help Yourdoctor Gynaecologist

Things to remember

Fibroids,ormyomas,arebenigngrowthsthatforminsidetheuterus(womb). Around30to40percentofwomenovertheageof40yearshavefibroids. Commonproblemsincludeheavyandpainfulperiods,infertilityandanincreasedriskof miscarriage. Treatmentoptionsincludetheuseofdrugstoshrinkthefibroids,embolisationorsurgical removal.

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FamilyPlanningVictoria

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Fibroids

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