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Case Study Analysis: Uterine Fibroids
Victoria Moss
David Mumford

Case Study Analysis: Uterine Fibroids
Uterine fibroids develops in the muscular wall in the uterus are not malignant tumors or growth. Fibroids are found in women and are a type of growth not cancer. It is common in women who are between the ages of 25-45. Uterine fibroids are also called leionyomas or myomas. Fibroids do not cause problems when they remain small. They can grow inside and outside the uterus. Once the fibroids grow larger in size they can cause complications. Sometimes fibroids have grown large enough to fill the whole abdomen.
In African American women uterine fibroids exist more than in White women. Researching upon uterine fibroids it is not understood the causes and fibroids grow quicker in African American women. The female hormones estrogen and progesterone can increase or decrease throughout women's life. When a woman goes through menopause it decreases estrogen. When going through menopause fibroids tend to shrink. Birth control pills can cause fibroids to grow because it is a hormonal drug that contains estrogen.
Fibroids may cause some of these symptoms like changes in menstruation, heavy periods, and cramps. Vaginal bleeding other than menstrual cycle can cause anemia. Causes pain in the abdomen or lower back. It may inquire pain while acquiring sex or pressure when urinating. The uterus is enlarged, miscarriages, and infertility are other symptoms. When other symptoms occur you may have other problems. Sometimes fibroids may not show any signs. Fibroids can be found during yearly examination or during other tests.
A large fibroid can cause the abdomen to swell. When the abdomen is swollen it is hard to receive a complete pap smear. Fibroids in women can cause infertility. Sometimes women can become pregnant after their treatment. Not all women who have fibroids will get treated. If fibroids are not causing any problems why bother them. The doctor may recommend more exams to make sure the fibroids are not growing fast. There are medical treatments available to reduce heavy menstrual bleeding and often recommended before surgery.
Hormonal birth control includes the pill, the patch, the shot, vaginal ring, IUD, and implant. Using these treatments reduce cramping and bleeding. It may take a few months until the body adjusts. Some doctors advise women with heavy bleeding to take the hormonal pill. Hormonal intrauterine device (IUD) releases a hormone called progestin in a form of progesterone hormone into uterus. It prevents pregnancy and reduces menstrual bleeding up to five years. IUD is placed in the uterus. Implants prevent pregnancy and reduce menstrual bleeding up to three years. It is placed under the skin in upper arm. The shot called Depo-Provera is given once every three months to prevent pregnancy. The side effect is spotting during the first few months. Antifibrinolytic medicines work by helping blood to clot. The advantage of this medicine slows down bleeding quickly, but only take medicine a few days each month, and it does not keep a woman from conceiving. Nonsteroidal antiinflammatory drugs, such as Motrin or Alleve can be purchased over-the-counter, and do not need a prescription. Gonadotropin-releasing hormone agonists (GnRH) is an injection temporarily to shrink fibroids given once every three months.
Some women refuse treatment because of their age. There are limited treatment options for women with the symptoms of pain and heavy bleeding. Fibroids can get smaller, grow at different growth rates and are exposed to the same hormones in the blood. For women with uterine fibroids they have an option of choosing between three different treatments and have improvements in their life.
The treatment options to choose from are hysterectomy, uterine artery embolization, and MRI-guided focused ultrasound is called noninvasive procedure; no incision required. The patient lies on her stomach for this procedure with the MRI machine, ultrasound waves pass through the skin creating heat to destroy the fibroids.
Fibroids lead to hysterectomy, which is a remedy of a surgical procedure to remove altogether or part of uterus. Hysterectomies in women occur in about 80% of women there are about 50% in African American women and about 30% in White women. Women with fibroids from the ages of 25 and 45 is 20% at risk of a hysterectomy 7% for black women.
The impact of health resources for fibroids has inquired controversy about the treatments for fibroids by using vaginal hysterectomy. The removal of the uterus and the ovaries partial or total is called a hysterectomy. The size of the fibroids depends on what method can be used. Hysterectomy is needed if pain continues, heavy bleeding, and large fibroids. When a woman gets a hysterectomy, she can no longer have children. Hysterectomy might be an option for a woman who is at the end of her reproductive years. It is also considered when the fibroids cause complications or uncomfortable symptoms. Hysterectomy is a permanent procedure. When a woman has not gone through menopause there is a risk of osteoporosis and heart disease.
Uterine artery embolization is a small incision in groin area where a catheter is passed through the arteries it reaches the blood supply through the uterus. Small fragments are inserted into the uterine arteries. The particles cause the fibroids to shrink and cut off blood flow. This method works when having more fibroids present. The symptoms women have after the procedure cramping, nausea, or fever. It includes infections and uterine injury. Most women menstrual cycle resumes regular after the procedure. Menstrual periods do not return for 40% of women over 50. Women who have the UAE are at risk for placenta problems. If considering children you may consider other forms of treatment. Uterine fibroid embolization or uterine artery embolization blocks off the blood supply to arteries feeding the fibroids nonsurgical procedure.
Noninvasive magnetic resonance is used to demolish the fibroids with ultrasound waves. The magnetic resonance imaging helps the waves to apply heat to the fibroids through the skin. After the procedure women tends to have symptoms of improvement at least for the first year. Uterine artery embolization is a new nonsurgical treatment. It allows the fibroids to grow and stop the blood flow. This procedure blocks the blood vessels to the uterus. MRI guided focus ultrasound surgery no incision is required. The use of MRI helps to ensure the correct temperature at the targeted site. The ultrasound surgery takes about three hours and is done as an outpatient procedure. Most women return to daily activities after a day or two.
The outpatient procedure can be done in certain situations. The woman may stay at the hospital in other cases. The case analysis show experiences were close linking the development of fibroids. The risk of fibroids decreased with the increased number of pregnancies; women with five pregnancies had 1/4 of a risk than women who had none. The risk of fibroids was reduced in women who used oral contraceptives.
Uterine fibroids are classified by their location submucosal fibroids is the least common they are associated with heavy menstrual periods and miscarriages, they may have prolapsed into the cervix. Intramural fibroids grow within the uterine wall because of urinary frequency due to bladder compression.
Fibroids are measured by analysis of MRI scans. Fibroids range from one to thirteen cm in diameter from premenopausal women. The average growth of fibroids was 9%, but the difference among women from -89% to 138% they shrink >20%. The growth rates are similar in black and white women younger than 35. The rates declined for white women than black women. The growth rate is not dependent on size, location in uterus, weight, or number of children. Most fibroids do not grow and if so they grow or get smaller.
The study provides measurements that help assist in cost analysis of treatment for uterine fibroids to become helpful to make decisions regarding the treatments. The magnetic resonance imaging is rarely used but used to keep track of the growth of fibroids. About 40% of fibroids are abnormal; the other 60% are undetected a change. Most fibroids have no impact on fertility but fibroids that distort the uterine cavity decrease fertility; removing them increase fertility.
Conclusion: The evidence of managing fibroids is poor. Patients do not have the information needed to make decisions about appropriate treatment. Given the condition and the impact on women's lives obtaining this information should be top priority for research. In most women uterine fibroids, often exists they may not have any symptoms or need treatment. Fibroids may have no symptoms and require no treatment. On the other hand you may have a case in which they may need treatment. If you have been diagnosed with uterine fibroids in the past, you should have a regular checkup. It helps to pay attention to changes and warning signs that may encounter treatment. Maintaining a healthy diet and experiencing active lives helps to avoid serious diseases and complications. Pelvic examinations are used to study, confirm, and diagnose uterine fibroids. To decide on the best treatment for women there is not sufficient evidence about uterine fibroids. When diagnosed with uterine fibroids make sure her diet is high in fiber.

Carlson, KJ, Miller BA, Fowler FJ Jr. The Maine Women’s Health Study: I, Outcomes of hysterectomy. Obstetrics and Gynecology. 1994
InSightec. MR guided focused ultrasound surgery: A patient’s guide to a non-invasive surgery treatment for uterine fibroids. InSightec, Dallas, U.S.S.; 2004.
Malvasi, A. ”A three-dimensional morphological reconstruction of uterine leiomyoma pseudocapsule vasculature by the Allen-Cahr mathematical model”, Biomedicine and Pharmacotherapy, Volume 65, Issue 5. August 2011.
Mayo Clinic: Uterine Fibroids; June 2011
National Institute of Child Health and Human Development. Uterine Fibroids. September 6, 2011.
Stewart, EA. Uterine Fibroids: The Complete Guide, Johns Hopkins University Press, Baltimore MD 2007.…...

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