Singapore Vascular and Interventional Centre
Causes, symptoms, and prevention of uterine fibroids, explained.
How to tell if you need uterine fibroid embolisation (UFE, Singapore).
CAUSES
Uterine fibroids are common benign tumours that develop in women. These are some of the common causes of uterine fibroids, Singapore:
- High levels of oestrogen and progesterone: This is the first major cause of uterine fibroid development. Levels of these hormones tend to be higher in pregnant, breastfeeding, and perimenopausal (time period approaching menopause) women.[1] One’s diet can also increase the levels of oestrogen and progesterone. Higher levels of these 2 hormones stimulate the growth of uterine fibroids.
- Vitamin D deficiency: Studies on an Asian demographic have shown that there is a greater prevalence of uterine fibroids among women who have deficient (65.57%) or insufficient (55.73%) vitamin D levels, as compared to among women who have sufficient levels (42.24%). Hence, it has been concluded that vitamin D deficiency increases the risk of a person developing uterine fibroids. [11]
- Excessive alcohol consumption: Alcohol has been found to increase the risk of uterine fibroids in a few ways. Firstly, alcohol can increase the level of oestrogen, which as mentioned earlier, tends to stimulate the growth of uterine fibroids. Secondly, Vitamin D levels are decreased upon consumption of alcohol, which is an important regulator of uterine fibroids. The levels of growth factors TGF-β3 and IGF-1 as well as cytokines also increase with alcohol consumption, and together they raise the risk of developing uterine fibroids.[4]
- Heredity: certain genotypes (referring to the genetic makeup of a person) are more prone to developing. An indicator of your risk would be whether your mother or sisters have had a history of fibroids. Very often, uterine fibroids run in the family.
RISK FACTORS
Risk factors refer to some common observations that have been associated with a higher risk of uterine fibroid development. Many of these factors have been determined by correlation in studies
- Older age: As women become older, the risk of developing uterine fibroids becomes higher. During the time period approaching menopause and through menopause, fibroids tend to grow more quickly. This generally happens between 30 years to 40 years old.[2]
- Onset of menstruation at an early age: In a previous study done, a relationship between the age at menarche (first menstrual period) and the risk of uterine fibroids was discovered. They determined that an increased risk of uterine fibroids is associated with a young age at menarche that is 11 years old and below, as compared to the mean age at menarche (12–13 years). When the age at menarche is above 13 years old, the risk of developing fibroids is lower. This same relationship was observed for the risk of developing multiple uterine fibroids versus a single fibroid.[3] Essentially, the risk of developing fibroids of a greater number is higher when the onset of menstruation has occurred at an early age.
- No pregnancy history/Not having children: Nulliparous individuals (person who has never had a live delivery) would have experienced more uninterrupted menstrual cycles. As a result, the female hormone levels are more optimal for fibroid growth as compared to women who have given birth before.[5]
- Obesity and higher body weight: A person is considered obese if they’re more than 20% over the healthy body weight. People who are obese tend to have a higher circulating level of oestrogen, which then stimulates the growth of uterine fibroids.[6]
SYMPTOMS OF UTERINE FIBROIDS
Sometimes, even when you do have fibroids, you may have little to no symptoms. However, should you have any of the symptoms below, you should seek fibroids treatment, Singapore, to allow yourself to continue living with quality of life.
- Abnormal menstrual cycle (heavy or frequently occurring): As a result of excessive bleeding, iron deficiency anaemia can be caused. This can in turn cause the presence of symptoms like extreme tiredness, dizziness, fainting, headaches, chest pain and shortness of breath (non-exhaustive). [7] Although doctors have not confirmed how fibroids cause excessive bleeding (Menorrhagia), there are a few theories behind this common symptom. Fibroids can cause abnormal production of hormones, which affects the action of the uterus’ smooth muscles, therefore changing blood flow. Submucosal fibroids (embedded in the wall of the uterus) also cause the endometrium (wall of the uterus) to have a greater exposed surface area, which causes increased bleeding.
- Painful bleeding during menstrual periods: Fibroids place pressure on the uterine lining, which presses on nerves and hence causes pain. Additionally, fibroids caused heavier periods as mentioned above, and hence with every contraction is stronger to expel more blood through the narrow cervix.[8]
- Pain and bleeding during or after sexual intercourse: This occurs especially if the fibroids are located near the cervix. Fibroids alter the shape of the uterus and distort it, which makes the woman more prone to pain when pressure is applied.10 Such pressure is present during sexual intercourse, which can cause mild discomfort to intense pain depending on the individual.[9]
- Bloating: Especially when fibroids grow in clusters, they cause the expansion of the abdominal cavity resulting in swelling that is visible. This can also cause weight gain which cannot be lost by exercise, and hence unexplained weight gain is also a symptom of fibroids.
- Acute or severe pelvic and lower back pain: Fibroids may press or pinch the nerves around these two areas, especially since fibroids extending from the uterus can be quite close to the spinal cord, a central nervous system of the body.
- Constipation, frequent urination: Fibroids pressing on your bladder reduce its capacity to hold urine, hence leading to more frequent urination and urinary incontinence. When the fibroids press on the colon from the back of the uterus, they affect the normal movements of the bowel, which then causes constipation and more painful passing of stool.[10]
PREVENTION OF UTERINE FIBROIDS
In reality, there is no guaranteed method to prevent uterine fibroids, however there are some diet and lifestyle changes that can be made to reduce the risk of uterine fibroids. These are some ways that this can be done:
- Maintain healthy weight through regular exercise. This reduces the chances of obesity which has been determined as a factor increasing the risk of uterine fibroids.
- Eat vitamin D and fibre-rich foods. Vitamin D supplementation decreases the size of the fibroids should they develop, also decreases the risk of the fibroids developing in the first place. Cruciferous vegetables are examples of foods that are vitamin and fibre-rich. Broccoli, Brussels sprouts, cabbage, cauliflower, collard greens, kale, and turnips are all cruciferous vegetables.
- Reduce sugar in your diet, and eat high sugar foods in moderation. This is because simple carbohydrates like sugar can potentially trigger the growth of fibroids.
- Cut down alcohol consumption.
- Avoid oestrogen increasing/mimicking foods in high amounts. Foods like red meat, soybeans, soy milk, tofu, and flaxseed can have negative effects when too much is consumed.[11]
For all things related to uterine fibroids, Singapore Vascular and Interventional Centre can provide for you. If you are concerned about and identify with any of the above symptoms, feel free to book an appointment with our doctors, Dr Benjamin Chua and Dr Manish Taneja, so that we can conduct a comprehensive check on you. Fibroids treatment, Singapore, is very much available and uterine fibroid embolisation (UFE, Singapore) has been proven effective, so do not worry.
Contact us with the details below:
+65 6694 6270 (Call)
+65 9898 3595 (WhatsApp)
[email protected] (Email)
Novena Specialist Centre #06-08, 16-19
8 Sinaran Drive, Singapore 307470
REFERENCES
[1]https://www.osmosis.org/answers/leiomyoma-of-uterus
[2]https://www.womenshealth.gov/a-z-topics/uterine-fibroids#:~:text=There%20are%20factors%20that%20can,After%20menopause%2C%20fibroids%20usually%20shrink.
[3]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3727338/
[4]https://www.researchgate.net/publication/336548122_Alcohol_Consumption_and_Risk_of_Uterine_Fibroids
[5]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4793163/
[6]https://pubmed.ncbi.nlm.nih.gov/1802214/#:~:text=Obesity%20is%20associated%20with%20many,to%20be%20influenced%20by%20estrogens.
[7]https://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/symptoms-causes/syc-20355034
[8]https://www.everydayhealth.com/womens-health/free-yourself-from-fibroid-pain.aspx
[9]https://www.usafibroidcenters.com/uterine-fibroid-symptoms/pain-during-sex/#:~:text=Why%20Do%20Fibroids%20Cause%20Pain,can%20also%20be%20a%20factor.
[10] https://fibroids.com/fibroid-symptoms/
[11]https://journals.sagepub.com/doi/full/10.1177/0300060520923492