Pregnancy Week by Week

Fibroids and Pregnancy

The exact causes of fibroids are unknown. It occurs when cells grow over the extent of the uterine muscle layer. Once fibroids start to develop, estrogen and progesterone appear to influence its growth. The highest amount of these hormones is secreted during pregnancy. After menopause, when secreted amount of hormone decreases, fibroids usually shrink or disappear.

Estrogen plays a major role in the development of fibroids because they:

Tend to rise more when the female body produces more estrogen (during pregnancy)
Usually shrinks when less estrogen is secreted (after menopause).

Progesterone also seems to stimulate the growth of fibroids, even in the absence of estrogen.

Symptoms

The symptoms of fibroids may develop slowly over several years or rapidly in a few months. Most women with fibroids are asymptomatic or experience mild symptoms and will never need treatment. For some patients, the symptoms of fibroids become a problem. In some cases, the first sign may be a difficult pregnancy.

Symptoms and problems caused by uterine fibroids are:

Abnormal menstrual bleeding, up to 30% of patients experience changes in menstrual cycle, for example:

Prolonged menstrual cycles that can cause anemia
Dysmenorrhea
Bleeding before or after the menstrual cycle
Bleeding between menstrual periods

Pelvic pain or pressure, for example:

Pain in the abdomen, pelvis or lower back
Pain during intercourse
Abdominal distension and pressure

Urinary problems, for example:

Frequent urination
Urinary incontinence
Kidney failure appeared after urethral blockage (rare)

Other symptoms:

Difficult bowel movements
Infertility
fibroids sometimes make it difficult to get pregnant
Problems in pregnancy such as premature labor detachment of the placenta
Miscarriage.

Risk factors

Factors that increase the risk of developing a uterine fibroids are:

Age: With age, women have higher predisposition to uterine fibroids, especially from 30 or 40 years old until menopause (around age 50). Until the age of 50, 80% of women experience uterine fibroids. When menopause occurs, fibroids usually shrink
Cases of uterine fibroids in the family: the presence of a fibroid at close family members increases the risk of its appearance
Ethnicity/race: black women are more prone to develop fibroids that Caucasian ones
Obesity.

Medical consult

You must immediately consult with a specialist in case you notice any of the following symptoms:

Heavy menstrual periods
Cycles that have evolved from a non-painful character to a painful one in the last 3-6 months
Frequent urination, pain, hematuria or inability to control urine flow
Any changes during the last 3 to 6 menstrual cycles
New or persistent pain sensation of heaviness in the lower abdomen or pelvis.

Infertility and problems arising during pregnancy

Experts are still studying the mechanism by which fibroids cause complications during pregnancy. It is known that fibroids may prevent implantation of a fertilized egg in the uterus, sometimes even increases the risk of miscarriage and in vitro fertilization is less likely to succeed in women with fibroids. Yet, when the fibro is already present, specialists cannot tell for sure whether it affects fertility or not. Surgical removal of fibroids, called myomectomy, is the only treatment known to improve the chance of pregnancy. Because fibroids may recur, a pregnancy is indicated as soon as possible after the myomectomy. 60% of women who had myomectomy as a treatment for infertility (and not other causes of infertility) get pregnant. Experts say that myomectomy may decrease the risk of miscarriage in patients with fibroids.