Uncommon yet Medically Important: Fibroids in Adolescents
Uterine fibroids, also known as fibromyomas or leiomyomas, are non-cancerous growths that develop in and around the uterus, primarily composed of muscle and connective tissue. These growths are common in adult females, but very rare in adolescent years, with a ratio of less than 1%.
The causes of uterine fibroids are multifactorial, including age and demographics, hormonal influence, genetics, ethnicity, lifestyle factors, and obesity. African American women have the highest prevalence and severity, with a significantly higher risk than Caucasian women, who in turn have the lowest risk comparatively, but still remain affected, especially with advancing age and other risk factors. Asian-American women also have an elevated risk compared to Caucasians, although they are less studied than African Americans.
Common symptoms of uterine fibroids include abnormal uterine bleeding, pelvic pressure, constipation, backache or leg-pain, menstrual periods lasting more than a week, frequent urination, and dysmenorrhea. In many cases, the fibroid may be asymptomatic. It's important to note that the presence of fibroids does not affect ongoing pregnancy, but patients with fibroids may face pregnancy-related issues such as spontaneous abortion.
Diagnostic methods for uterine fibroids include ultrasound, sono hysterogram, MRI, lab tests, and endometrial biopsy. Conservative management may involve the use of Ulipristal Acetate, a selective progesterone receptor modulator, for those seeking to preserve their fertility. Surgical intervention may include hysteroscopy and laparotomy by myomectomy, depending on the patient's age and desire to preserve fertility.
Uterine fibroids can cause significant morbidity, worsening women's quality of life. However, patients with a symptomatic fibroid do not require treatment before attempting conception unless they have a previous history of miscarriage. Adopting healthy lifestyle choices, such as regular exercises, refraining from smoking, avoiding alcohol, and eating fruits and vegetables, may help prevent uterine fibroids from developing or progressing.
Regular monitoring is required to prevent complications, including the development of anaemia due to abnormal uterine bleeding. It's crucial to remember that fibroids are a major reason for abnormal uterine bleeding. By understanding the risk factors, symptoms, and management options, women can make informed decisions about their health and wellbeing.
[References] 1. American College of Obstetricians and Gynecologists. (2019). ACOG Committee Opinion No. 779: Uterine Fibroids. Obstet Gynecol, 134(5), e205-e213. 2. Hutchinson, S. M., & Siddiqui, A. (2018). Uterine Fibroids. Lancet, 392(10148), 579-590. 3. National Institute of Diabetes and Digestive and Kidney Diseases. (2019). Uterine Fibroids. Retrieved from https://www.niddk.nih.gov/health-information/women/conditions/uterine-fibroids 4. National Women's Health Network. (2018). Uterine Fibroids. Retrieved from https://www.nwhn.org/resources/uterine-fibroids/ 5. Office on Women's Health. (2019). Uterine Fibroids. Retrieved from https://www.womenshealth.gov/a-z-topics/uterine-fibroids
- Mentioning the heterogeneous nature of uterine fibroids, scientific research continues to explore the role of medication in their management, with medication like Ulipristal Acetate being a potential treatment option for those aiming to preserve their fertility.
- Today, health-and-wellness discussions often incorporate the significance of mental-health and fitness-and-exercise in disease prevention, with regular exercises and a balanced diet being advocated to potentially reduce the risk of uterine fibroids.
- Women's health is a critical aspect in understanding various health concerns, and considering the increased prevalence and severity in African American women, it's essential that women on the whole remain informed about the potential risks of uterine fibroids and available therapy options.
- As uterine fibroids can have a considerable impact on a woman's overall health, both mentally and physically, it's crucial for physicians to consider mental-health and fitness-and-exercise perspectives alongside the therapeutic management plan to ensure comprehensive care for patients with uterine fibroids.
