Uterine fibroids are non-cancerous growths that develop in or around the uterus, the muscular organ where a fetus grows. Also known as uterine leiomyomas, fibromyomas, or myomas, these growths are composed of muscle and fibrous tissue. They can vary significantly in size, from a seed to a watermelon.
Visualizing a 7 cm Fibroid
A 7 cm fibroid is considered a medium-sized growth. To visualize this, it’s comparable to a large plum, a small orange, a standard lime, a peach, or a large lemon. While the measurement of 7 cm refers to its maximum diameter, the actual shape of a fibroid can vary, influencing how it occupies space.
Clinical Significance of a 7 cm Fibroid
A 7 cm fibroid is medically categorized as medium to large. While some individuals with this size fibroid may be asymptomatic, others experience noticeable effects. Common symptoms include heavy menstrual bleeding, sometimes with clots, or prolonged periods. This excessive bleeding can lead to anemia and iron deficiency.
A fibroid’s location within the uterus significantly influences symptoms, often more than its exact size. Intramural fibroids, which grow within the muscular wall, are the most common type. They can expand the uterus, potentially causing a feeling of fullness or pressure in the lower abdomen. Submucosal fibroids, located just beneath the inner lining, can lead to heavy bleeding and may also impact fertility. Subserosal fibroids, found on the outer surface, can grow quite large and may press on nearby organs.
Pressure on the bladder from a large fibroid can result in frequent urination or difficulty fully emptying the bladder. Pressure on the rectum may cause constipation. Some individuals may also experience pelvic pain or discomfort during intercourse.
Management and Treatment Approaches
Management of a 7 cm fibroid depends on the presence and severity of symptoms, the fibroid’s location, and the individual’s desire for future fertility. For those who are asymptomatic or have only mild symptoms, watchful waiting, involving regular monitoring with pelvic exams or ultrasounds, may be recommended. Fibroids often shrink after menopause due to lower estrogen levels, potentially alleviating symptoms.
Medical options can help manage symptoms, particularly heavy bleeding. Gonadotropin-releasing hormone (GnRH) agonists and antagonists can temporarily shrink fibroids by reducing estrogen and progesterone levels, inducing a menopause-like state. These medications, such as leuprolide or elagolix, are sometimes used before surgery to reduce fibroid size or improve anemia. Other medications, including tranexamic acid, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, and hormonal birth control, can help control heavy bleeding and pain.
Minimally invasive procedures offer alternatives to traditional surgery. Uterine artery embolization (UAE) involves injecting small particles into the arteries supplying the fibroids, blocking their blood flow and causing them to shrink. This procedure preserves the uterus and has a shorter recovery time than surgery. Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) is another non-invasive option, which uses high-frequency sound waves guided by MRI to heat and destroy fibroid tissue.
Surgical interventions include myomectomy, which removes only the fibroids while preserving the uterus, making it suitable for those who wish to maintain fertility. Myomectomy can be performed through abdominal incision, laparoscopically (small incisions), or hysteroscopically (through the vagina and cervix), depending on the fibroid’s size and location. Hysterectomy, the removal of the entire uterus, offers a permanent solution to fibroid issues and is typically considered when other treatments are ineffective or for individuals who do not desire future pregnancies. Consult a healthcare professional to discuss personalized treatment plans.