Anna Liew, 36, mum to Laurel, 3, used to suffer bad menstrual cramps as a teen. But while she thought it was common, or even “natural” for women to experience bad period pains, she only got a check-up when she started trying for a baby.
“We had been trying for a year. It then occurred to me that something may be wrong with my plumbing ― because of all the menstrual cramps I had experienced,” she recalls. Her gynae revealed that she had several fibroids, one of which was rather large (about 5cm) and located near her tubes, where the baby would implant. Removing it surgically would give Liew a higher chance at conceiving.
Liew says, “I was hesitant because I didn’t want to wait anymore to conceive, and I knew I had to recover after the surgery. But my doctor said that we could start trying three to six months after the surgery and my husband and I decided that was okay.”
Three months after Liew and her husband started trying for a baby again, she conceived her daughter. She adds that since the surgical procedure, her “menstrual cycles are regular and periods are lighter with less cramping”.
“It then occurred to me that something may be wrong with my plumbing ― because of all the menstrual cramps I had experienced.”
What are fibroids?
Fibroids are tumours in the uterus, explains obstetrician and gynaecologist Dr Tony Tan. They may either be:
* Intramural Found in the muscle layer of the uterus;
* Subserosal Sticking out of the external layer of the uterus;
* Submucosal Located within the cavity of the uterus.
* Or a combination of the above.
Around 50 per cent of women have had fibroids at any one time in their life, Dr Tan notes. “It’s unclear what causes them, but a family history of fibroids, obesity, and being aged between 35 and 50 predisposes a woman to having fibroids.” However, past pregnancies and the previous use of oral contraceptive pills may reduce their risk of such tumours.
While most fibroids are benign and do not cause symptoms, they may put pressure on the bladder and if they are large, cause frequent urination. They may also cause constipation if pressure is applied on the intestines. “If the fibroids are within the cavity of the uterus, they may also cause painful and heavy periods,” Dr Tan explains. Fibroids are usually detected via an ultrasound scan of the pelvis.
Fibroids may cause severe pain (though rarely) if they degenerate spontaneously ― this means that the fibroid collapses on itself and either hardens or liquefies (usually because it has outgrown its blood supply).
Fibroids and fertility
If the fibroid is located within the cavity of the uterus and interferes with the implantation of the embryo, it can affect a woman’s fertility, says Dr Tan. “Fertility is also affected if they obstruct the fallopian tubes directly, though this is rare.” He adds, “However, it is less clear why patients with fibroids in other locations also seem to have slightly decreased fertility when compared to others without fibroids.”
If you are pregnant and find out that you have fibroids, don’t fret. It is rare for fibroids to pose any problems to your pregnancy. However, in rare complications, these tumours may degenerate during pregnancy, which can cause acute pain, miscarriage or preterm labour.
“Fibroids should be removed if they are very big, or if they cause symptoms like heavy or painful menses.”
If the fibroid is not submucosal (within the cavity of the uterus) and not too big, the woman can go ahead to try to conceive, though she should watch out for complications. However, if it is submucosal or too large, it can be removed via a process called myomectomy.
“Fibroids should be removed if they are very big, or if they cause symptoms like heavy or painful menses,” says Dr Tan. However, if you are not looking to conceive, you can remove your entire uterus via a process called a hysterectomy. “These options should be discussed with your doctor.”
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