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Most women with uterine fibroids have no symptoms. However, fibroids can cause a number of symptoms depending on their size, location and their closeness to nearby pelvic organs.

Different types of fibroids develop in different locations in and on the uterus as follows:

Sub mucosal fibroids: They grow and bulge toward the inside of the uterus. They grow directly below the lining cells of the uterus and may lead to heavy or irregular bleeding.

Intramural fibroids: These stay mostly embedded within the middle of the wall of the uterus

Subserosal fibroids: They grow on the outside of the uterus and may be attached to it by a stalk

The definite cause of fibroids is not known, but each individual fibroid starts when a single cell starts to grow abnormally, and produce large amounts of collagen and other proteins. The female hormones estrogen and progesterone are necessary for fibroids to grow, so they usually do not occur before puberty when production of these hormones begins and shrink after menopause when hormone production drastically decreases.

A fibroid is an abnormal growth (a tumor) in the womb which occurs commonly in black women and can range in size from as small as 1cm to as big as 25cm. They can be big enough to make a woman look up to 8 months pregnant. One person can have only one fibroid or as many as fifty or sixty fibroids in the womb at a time. In most women, fibroids do not cause any problems and so a lot of people actually have fibroids and don’t even know it.

Today I will be sharing about uterine fibroids

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The symptoms of endometriosis include the following:

Painful menstrual periods – this pain is usually severe, starts some days before the period starts, and continues for some days after the period has ended. The pain sometimes extends from the lower abdomen to the back and thighs

Constipation, diarrhoea, pain on passing stool or urinating, which is related to the period, i.e it starts when the period starts or is about to start, and ends when the period ends or extends for a few days

Painful intercourse

Chronic pelvic pain

Cyclical pain in some parts of the body – the skin, chest (if it is located in the lungs; can also cause a cyclical cough)

Infertility

Some women with endometriosis will have no symptoms of pain even if the endometriosis is severe, while others with severe pain might not have much pain.

Endometrial tissue that is found outside the uterus is influenced by the female hormones, the same as inside the uterus. So, the tissue thickens during the cycle and is shed when menstruation begins. It is unable to flow out, and thus remains there and irritates the surrounding areas. This can cause scar tissue (called adhesions) to form, and make the organs stick to each other or stick to the walls of the abdomen and the pelvis. In the ovaries, endometriosis can cause a type of ovarian cyst called an endometrioma, which contains a thick, dark coloured fluid.

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It is not yet very clear why the endometrium is found outside the uterus in endometriosis, but there are a few likely reasons. When the endometrium is being shed during a period, it is possible that while the blood flows out through the vagina, some of it flows backwards through the tubes and ends up in the pelvic area, from where it can attach to the pelvic walls, organs, and even the bowel (retrograde menstruation).


Another possible reason is that the cells from the endometrium can be carried from the uterus to other parts of the body through the lymphatic or blood vessels. It has been shown that after one has any surgery involving the uterus (like a myomectomy or a Caesarean section), endometrial cells can be carried to the site of the skin incision and thus endometriosis develops on the surgical scar.

Endometriosis is a medical condition in which the endometrial tissue (i.e the lining of the womb which sheds off with every cycle at menstruation) is found in other places outside the uterus, like on the pelvic wall, the ovaries, and the bowel (the intestines).

Endometriosis most commonly causes severe menstrual pain (dysmenorrhoea), and is often underdiagnosed, because of a wrong assumption that it is normal for periods to be painful.

Endometriosis

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Intrauterine adhesions commonly cause the following symptoms:

Reduction in the amount of bleeding during menstruation

Reduction in the number of days of menstruation

Passing small amounts of dark blood during a period

Developing painful periods (dysmenorrhoea)

Recurrent early miscarriages

Difficulty in getting pregnant

Intrauterine adhesions usually occur after any procedure that can cause injury or damage to the endometrium, irrespective of the reason for which the procedure was done.

This includes the following:

Dilatation and Curettage (D&C)

Manual Vacuum Aspiration (MVA)

Caesarean section

Open myomectomy

Hysteroscopic surgeries


Manual removal of the placenta

Intrauterine adhesions are formed when there is an injury or a cut on the endometrium (the lining of the womb which sheds off with every cycle at menstruation) that does not heal properly and forms scar tissue, which is also called an adhesions.

These adhesions replace the normal endometrial lining and can cause a reduction in menstrual flow and difficulty getting pregnant because the fertilized egg is unable to implant on the abnormal endometrium. It also causes the walls of the uterus to stick together and distorts the shape of the cavity, or forms a band that can block the cavity. It is sometimes referred to as Asherman’s syndrome.

I will be sharing along the line of Intrauterine Adhesions today also known as asherman syndrome

I will be looking at answering some few questions based on some feedback i have gotten via mail and calls.


Feel free to drop your questions if you have anyone along this line of thoughts.

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Surgery: Pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. Cervical surgery can sometimes cause scarring or shortening of the cervix. The cervix is the neck of the uterus.


Submucosal fibroids: Benign or non-cancerous tumors occur in the muscular wall of the uterus. They can interfere with implantation or block the fallopian tube, preventing sperm from fertilizing the egg. Large submucosal uterine fibroids may make the uterus' cavity bigger, increasing the distance the sperm has to travel.


Endometriosis: Cells that normally occur within the lining of the uterus start growing elsewhere in the body.



Previous sterilization treatment: In women who have chosen to have their fallopian tubes blocked, the process can be reversed, but the chances of becoming fertile again are not high.

Medical conditions includes;

Ovulation disorders appear to be the most common cause of infertility in women.

Ovulation is the monthly release of an egg. The eggs may never be released or they may only be released in some cycles.

Ovulation disorders can be due to:

Premature ovarian failure: The ovaries stop working before the age of 40 years.

Polycystic ovary syndrome (PCOS): The ovaries function abnormally and ovulation may not occur.

Hyperprolactinemia: If prolactin levels are high, and the woman is not pregnant or breastfeeding, it may affect ovulation and fertility.

Poor egg quality: Eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. The older a woman is, the higher the risk.

Thyroid problems: An overactive or underactive thyroid gland can lead to a hormonal imbalance.

Chronic conditions: These include AIDS or cancer.

Problems in the uterus or fallopian tubes can prevent the egg from traveling from the ovary to the uterus, or womb.
If the egg does not travel, it can be harder to conceive naturally.

Causes;

Many physical and emotional factors can cause infertility. It may be due to problems in the woman, man, or both.

Physical causes can include:

Risk factors that increase the risk include:


Age: The ability to conceive starts to fall around the age of 32 years.


Smoking: Smoking significantly increases the risk of infertility in both men and women, and it may undermine the effects of fertility treatment. Smoking during pregnancy increases the chance of pregnancy loss. Passive smoking has also been linked to lower fertility.

Alcohol: Any amount of alcohol consumption can affect the chances of conceiving.


Being obese or overweight: This can increase the risk of infertility in women as well as men.

Eating disorders: If an eating disorder leads to serious weight loss, fertility problems may arise.

Diet: A lack of folic acid, iron, zinc, and vitamin B-12 can affect fertility. Women who are at risk, including those on a vegan diet, should ask the doctor about supplements.

Exercise: Both too much and too little exercise can lead to fertility problems.


Exposure to some chemicals: Some pesticides, herbicides, metals, such as lead, and solvents have been linked to fertility problems in both men and women. A mouse study has suggested that ingredients in some household detergents may reduce fertility.


Mental stress: This may affect female ovulation and male sperm production and can lead to reduced sexual activity.

It may be that one partner cannot contribute to conception, or that a woman is unable to carry a pregnancy to full term. It is often defined as not conceiving after 12 months of regular sexual intercourse without the use of birth control.

Though because of the topic of the trend i will be focusing on causes in female.

Infertility happens when a couple cannot conceive after having regular unprotected sex.

Infertility means you cannot get pregnant (conceive).

There are 2 types of infertility: Primary and Secondary infertility.

Primary infertility refers to couples who have not become pregnant after at least 1 year having sex without using birth control methods.

Secondary infertility refers to couples who have been able to get pregnant at least once, but now are unable.

For those trying to conceive i will be sharing on infertility today, though will be sharing on a generic way: specific answers will best be shared depending on individual history and needs.

Lifestyle/Home remedies: Different things have been found to help different people; you would need to discover what words for you. They include Exercise (or activity), Rest, Heat (using a hot water bottle, or soaking in a hot bath). The key is to find what works for you, that you can fit into your daily schedule or routine.

Pain relievers: For most people, the uses of easily available pain medications are enough to relieve the pain, on those two or three days when the pain is experienced. This is sufficient for primary dysmenorrhoea

Hormonal medications: For the treatment of endometriosis and adenomyosis, hormones can be given to disrupt the normal cyclical release of the hormones oestrogen and progesterone. This prevents the endometrium from growing and shedding both within and outside of the lining. The contraceptives can be in the form of pills, injections, and even intrauterine devices. This treatment is not permanent, but can provide relief from the pain

How can it managed or treated?


For most people, menstrual pain is something that is a cause for discomfort, but not necessarily a major discomfort. However, if the pain disturbs you significantly every month, if the pain and other symptoms are getting worse, or if you notice that you suddenly developed very painful cramps, you need to see a Gynaecologist.

Do not assume that it is a woman’s portion, or lot, or cross to bear, and so decide to remain in pain.

It also helps to track your periods (this might be difficult, if your periods are irregular), so that you can prepare.

Some other things that can also cause painful periods are:

Pelvic Inflammatory Disease (an infection of the female reproductive organs, usually caused by sexually transmitted infections)

Cervical stenosis – Sometimes after one has had a surgical procedure, scar tissue can form and block the cervix, which is the opening of the uterus, thus preventing the blood from flowing out during menstruation. This can cause pain during periods, and is usually associated with either reduction in or absence of blood flow.

The things that can cause secondary dysmenorrhoea are:

Endometriosis: This is a condition in which the lining of the womb is found in other places outside the uterus, like on the pelvic wall, the ovaries, and the intestines. Endometrial tissue that is found outside the uterus is influenced by the female hormones, the same as inside the uterus. So, the tissue thickens during the cycle and is shed when menstruation begins. It is unable to flow out, and so it remains there and irritates the surrounding areas. This pain is usually severe, starts some days before the period starts, and continues for some days after the period has ended. The pain sometimes extends from the lower abdomen to the back and thighs. There can be cyclical pain in other parts of the body like on the skin or the chest. Other symptoms include cyclical diarrhoea or constipation, pain on stooling or urinating, painful intercourse, and infertility. It can also cause a type of ovarian cyst called an endometrioma.


Adenomyosis: This is similar to endometriosis, where there is endometrium found in other places. However, here, the endometrium is found within the muscle of the wall of the uterus. It either appears as small deposits (like seeds), or it is diffuse, in which case it isn’t easily separable from the rest of the body of the uterus. It is another common cause of severe dysmenorrhoea, usually associated with heavy and prolonged bleeding, and a bloated feeling.


Fibroids: Fibroids are abnormal growths that occur in the uterus, which can cause periods to be heavier and more painful than usual. They can also cause pain in the abdomen or in the lower back.

These are the most common causes of secondary dysmenorrhoea

There are two types of dysmenorrhea

Primary dysmenorrhoea: Usually starts at the onset or a few months after the onset of menstruation, and is normal.

Secondary dysmenorrhoea – This is when painful periods start in a woman who never used to have pain before. The pain is caused by a problem within the female reproductive organs, and it is more likely to start earlier in the cycle and last longer than in primary dysmenorrhoea.

Why Painful Periods? These two actions (cutting off of blood supply and the contractions) can cause women to experience pain during menstruation – this is called primary dysmenorrhoea and is the most common, occurring in more than 50% of women. This type usually gets better as one grows older and for some people, improves after delivery.

Pain is the most common complaint during menstruation. This pain occurs in the lower abdomen and usually starts on the first day of the period, is worse on the first one to three days, and gests better after that.
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Some other symptoms you might feel are low back pain, nausea, vomiting, diarrhoea, irritability, dizziness, moodiness, headaches.

This does two things:
The blood supply to the endometrium is cut off and so more of it dies and is shed

The uterus squeezes out all the blood and the endometrium that was shed. By the time the lining is shed, a new cycle has begun and the level of the hormones begins to rise again, and so the functional layer starts to grow back.