UTERINE FIBROIDS AND INFERTILITY 2

Hello steemians,todays post will be a continuation of what I started yesterday. To those who haven't read it yet, you can follow this link.Today's post will contain how uterine fibroids are diagnosed,different modalities for treating, prognosis of the condition and if I don't get tired of typing, it's relationship with infertility will be discussed.

HOW ARE UTERINE FIBROIDS DIAGNOSED

In the last post we mentioned that women are usually symptomless,in other words diagnosis are made during routine check up. When a women presents to the hospital with symptoms, the health care practitioner will discuss her medical history and conduct a physical examination that includes a pelvic exam.
If further studies are indicated, one of the following tests can be done to help exclude other serious conditions
1).An abdominal,pelvic or transvaginal scan can help identify the location,size,shape and number of most fibroids. I won't bore you with mechanisms of action.
ultrasound

2).Laparoscopy: a surgical procedure to view internal organs
3). Hysteroscopy : to look into the uterus/womb
4). Hysterosalpingography

TREATMENT FOR UTERINE FIBROIDS

The treatment depends on the presenting complains of the individual. The treatment could range from doing absolutely nothing to medical or surgical.

MEDICAL TREATMENT

MIFEPRISTONE: A antihormonal drug that has been shown to reduce fibroid size by almost half. The drug also works for pelvic pain,bladder pressure and lower back pain. Low doses can help reduce the size in preparation of surgery to remove them. This drug in particular can induce miscarriage, therefore it's not advisable to use in women trying to conceive.

GnRH Agonist: These drugs acts on the pituitary gland to reduce the estrogen production in the body, this will then reduce the size of fibroids. Treatment course is usually for three months and can regrow once treatment is stopped. Side effects are: reduced bone density,osteoporosis,and vaginal dryness.

DANAZOL(Danocrine):They help reduce bleeding in women with fibroids. They have no effects whatsoever in the shrinking of the fibroids.

SURGICAL TREATMENT

Risks and benefits associated with these procedures are best discussed with your physician.

MYOMECTOMY:This is a surgical removal of fibroids. The uterus is left intact and the woman may be able to get pregnant .

HYSTERECTOMY : Surgical removal of the uterus(fibroids ). It's the most common and also considered as a cure. A salpingo-oophorectomy can be indicated if there's suspicion of cancer.

PREVENTION AND PROGNOSIS
Try to avoid weight gain, although not been proven to have any direct link onset or increase in size of fibroids,quitting smoking will improve general health of women who have this condition.
Prognosis depends on treatment success and the future outcome depends on the severity of the fibroid. It can affect fertility.

EFFECTS OF FIBROIDS ON REPRODUCTION

Mostly, fibroids that impinge on the endometrial cavity(submucosal) affects fertility. Some large fibroids especially the intramural types can occlude the openings of the the fallopian tube into the uterus with multiple fibroids causing abnormal uterine contractions that could lead to spontaneous abortion.
Surgical scars or adhesions which could prevent the release of the eggs or block the ends of the fallopian tubes,or otherwise interfere with the normal functioning and relationships of the pelvic organs. In some cases, multiple fibroids deprive the endometrium of blood flow,this in turn affects the delivery of estrogen to the uterine wall and thickening of the wall cannot occur to support pregnancy. This can result in first trimester miscarriages .

NOTE: Fibroids rarely undergo malignant change. However, when growth occurs rapidly over a month,especially in older women who have fibroids,it should raise suspicion and a clinician should be seen immediately.

Pls take note that all drugs and medical procedures stated in this article should be confirmed with your physician before taking any action. Thanks steemit.