ibroids are a health issue that many women have, though they often go unnoticed or cause minimal symptoms. Uterus or the womb is a small, pear-shaped organ where a baby grows during pregnancy. Sometimes, small lumps called fibroids can grow inside or on the surface of the uterus. These fibroids are made up of muscle and fibrous tissue. They can vary in size from as small as a pea to as large as a grapefruit. While they are usually harmless, they can sometimes lead to bothersome symptoms or complications.

Fibroids are quite common, especially among women in their 30s and 40s. Factors like family history, early onset of periods, hormonal changes, no previous pregnancies or birth and being overweight can sometimes increase the chances of developing fibroids. Symptoms depend on fibroid size, number and location. Many women may have fibroids and not even know it, because they often don’t cause any symptoms. Some fibroids respond to oestrogen and progesterone, making their growth unpredictable.

Fibroids can be divided into various types based on their location, which can influence the severity of symptoms. For example, within the wall of the uterus (intramural), submucosal fibroids are close to the lining of the uterus which sheds every month during menses, or they can be within the cavity of the womb itself.

The major take home points are that there can either be bulk-related symptoms, abnormal bleeding and iron deficiency anaemia, pain or fertility concerns. Some women with fibroids might experience heavier or longer periods than usual, every month. Furthermore, they can sometimes cause pain in the lower belly or pressure on the bladder or bowel, leading to discomfort or a feeling of fullness. In some cases, fibroids can cause pain or discomfort during intercourse. Submucosal and intramural fibroids can interfere with pregnancy, affecting fertility and potentially causing complications during gestation.

Equally important, though infrequent, are the larger fibroids that can press on the bladder, causing more frequent urination or difficulty emptying the bladder completely. They tend to shrink or stay about the same size after menopause.

In women with symptoms, they can often be detected through routine screening, which is the pelvic exam or ultrasound. It is important to regularly monitor any changes in the size or symptoms of fibroids. Occasionally, other imaging tests like MRI may be needed to get a clearer picture of the fibroids.

While fibroids can be a concern for many women, they are usually harmless and manageable. By understanding the symptoms and treatment options available, women can take charge of their health and work with their doctors to find the best approach for their individual situation.

Treatment for fibroids depends on their size, number, location, whether they’re causing symptoms and the desire for pregnancy. If fibroids are small and not causing any issues, the first and foremost thing to do is eating a balanced diet, maintaining a healthy weight and staying active. Stress can sometimes make symptoms worse, so finding ways to relax and manage stress can be helpful. In some cases, medications can help manage symptoms like heavy bleeding or pain.

For small fibroids, treatment might include hormonal treatments or pain relievers. If fibroids are large or causing significant symptoms, surgery may be needed. This could involve removing the fibroids (myomectomy) or, in more severe cases, removing the entire uterus (hysterectomy). Other treatments involve shrinking fibroids using focused ultrasound or blocking the blood supply to the fibroids. Long-term medical treatment for fibroids is also now possible, particularly for premenopausal women. Progesterone receptor modulators such as Urlipristal acetate, offering improved management and symptom relief.

While fibroids can be a concern for many women, they are usually harmless and manageable. By understanding the symptoms and treatment options available, women can take charge of their health and work with their doctors to find the best approach for their individual situation. With the right information and support, managing fibroids can be a part of maintaining overall health and well-being.

The gaps in fibroid research, clinical care and federal policy need urgent attention. Key areas of improvement include boosting research funding, enhancing fibroid assessment with advanced pelvic imaging and implementing long-term studies. Addressing health disparities, especially for women of ethnic minorities, developing treatments that preserve fertility and expanding education beyond gynaecologic specialists are also crucial. Furthermore, advancing personalised patient care through shared decision-making is essential. Immediate action in these areas will improve outcomes for women suffering from fibroids.

The writer is a family physician