Understanding Uterine Fibroids
Uterine fibroids are non-cancerous growths that develop from the muscle tissue of the uterus. These growths vary in size, from a pea to a melon. Fibroids are common, affecting an estimated 20% to 80% of women by age 50.
Fibroids can grow in various locations within or on the uterus. Intramural fibroids are the most common, growing within the muscular wall. Subserosal fibroids develop on the outer surface, sometimes attached by a stalk, while submucosal fibroids protrude into the uterine cavity. Fibroid presence and location can lead to a range of symptoms depending on their size and number.
Common symptoms include heavy or prolonged menstrual bleeding, which can lead to anemia. Pelvic pain or pressure can also occur due to fibroids pressing on surrounding organs. This pressure may cause frequent urination (if pressing on the bladder) or constipation (if pressing on the rectum). An enlarged abdomen is another symptom, particularly with larger fibroids.
How Fibroids Can Cause Shortness of Breath
Uterine fibroids can contribute to shortness of breath primarily through their impact on red blood cell count. The most frequent mechanism involves heavy or prolonged menstrual bleeding. Excessive blood loss over time can deplete the body’s iron stores, leading to iron-deficiency anemia.
Iron is a component of hemoglobin, the protein in red blood cells responsible for transporting oxygen from the lungs to the body’s tissues. When iron levels are low, the body cannot produce enough red blood cells, reducing its oxygen-carrying capacity. This diminished oxygen supply to organs and muscles can result in fatigue, weakness, and exertional dyspnea (shortness of breath during physical activity). The body attempts to compensate by increasing breathing rate, leading to breathlessness.
A less common mechanism involves large fibroids exerting physical pressure. In rare instances, large fibroids can press on the diaphragm, the muscular wall separating the chest and abdominal cavities. This pressure can impede the diaphragm’s movement, making it harder for the lungs to fully expand and contract. This physical restriction on lung function can lead to breathlessness, even at rest in some cases.
When to Consult a Doctor
Consult a doctor if you experience persistent or worsening shortness of breath, especially if you have been diagnosed with fibroids or suspect you might have them. Shortness of breath that occurs suddenly or severely requires immediate medical attention. Such symptoms could indicate anemia or, in rare cases, direct physical impingement on respiratory function.
You should also consult a healthcare provider if shortness of breath is accompanied by other symptoms. These may include dizziness, lightheadedness, chest pain, or an unusually fast or irregular heartbeat. Fatigue, pale skin, and cold hands and feet are additional indicators that might suggest iron-deficiency anemia as the underlying cause of your breathlessness. An accurate diagnosis is important to determine if fibroids are contributing to your shortness of breath and to rule out other potential causes.
Treatment Approaches for Fibroids
Treatment approaches for fibroids aim to alleviate symptoms, including those that might contribute to shortness of breath. For individuals experiencing heavy bleeding and resulting anemia, medical management often includes iron supplementation to restore iron levels and improve red blood cell production. Hormonal therapies, such as birth control pills, progestin-releasing intrauterine devices (IUDs), or GnRH agonists, can help reduce menstrual bleeding and sometimes shrink fibroid size.
Minimally invasive procedures provide symptom relief without major surgery. Uterine artery embolization (UAE) involves blocking the blood supply to fibroids, causing them to shrink. Myomectomy is a surgical procedure to remove fibroids while preserving the uterus, performed through various approaches including hysteroscopy, laparoscopy, or open surgery, depending on the fibroid’s size and location.
For some individuals, particularly those with significant symptoms or who have completed childbearing, a hysterectomy may be considered. This surgical procedure involves the removal of the uterus, which effectively treats fibroids and their associated symptoms. The choice of treatment depends on the fibroid’s size, location, symptoms, the individual’s age, and their desire for future fertility.