Doctors flag concerns over recurrence of uterine fibroids in young women

Young women are at an increased risk of recurrence of uterine fibroids majorly due to lifestyle habits and genetics, said experts on Thursday.

Uterine fibroids are benign tumours of the uterus that frequently occur in women during their childbearing years. They are usually not malignant; however, they cause many problems, such as pain, heavy menses, and sometimes even infertility.

While myomectomy surgically removes fibroids by preserving the uterus, the fibroids tend to recur.

“In India, around 15-33 per cent of fibroids recur after myomectomy. There are many reasons for the recurrence of fibroids but importantly the main reasons are: genetic tendency and lifestyle habits,” Ila Jalote - Consultant, Obstetrics and Gynecology, Manipal Hospital, Gurugram, told.

“Uterine fibroids are becoming a major gynaecological concern. Although the precise cause of uterine fibroids is still unknown, the factors that are frequently associated with the condition include genetics and certain lifestyle factors,” added Madhuri Vidyashankar P, Consultant Gynaecologist, Hysteroscopic & Laparoscopic Surgeon, Motherhood Hospitals, Bengaluru.

The actual causes of fibroids remain unknown; however, several studies suggest a combination of factors.

Fibroid growth is induced by hormones like oestrogen, which stimulate lining growth in the uterus. Genetics also plays a role since those whose families have had previous cases of fibroid development stand at higher risk. Other things that increase one’s chances of having this disease include the early onset of menstruation, obesity, and a lack of vitamin D.

“The symptoms of fibroids depend on their size, number, and position. Some women never experience any symptoms at all, while others can go through a lot of discomfort, like excessive menstrual bleeding, pain or pressure in the pelvis, frequent urination, difficulties during defecation, painful sexual intercourse,” Jalote said.

Fibroids can also impact conception and pregnancy. Depending on their size and location, they physically block fallopian tubes, preventing sperm from reaching the egg or a fertilised egg from implanting in the uterus, the doctor said.

Fibroids can also increase the risk of miscarriage, especially in the first trimester, and also affect the baby by leading to preterm labour and breech position (feet or buttocks first).

“Fibroids can interfere with placental development or cause the placenta to detach from the uterine wall (placental abruption), both of which can be dangerous for the baby,” Jalote said.

Vidyashankar said that uterine fibroids can occasionally present without any symptoms, which makes them very harmful to reproductive health if not identified early on. “At least 50 per cent of fibroids are thought to be asymptomatic, however, this number is probably underestimated because it is based on women whose fibroids are unintentionally discovered during pelvic exams, ultrasounds, or cervical screenings,” the doctor said emphasising the need for early screening and annual physical examinations.