Knowledge of how your reproductive system functions is essential to keep it healthy. The ability to identify the symptoms of fibroids, for instance, can facilitate early medical intervention and treatment.

What are uterine fibroids?

Smooth muscle tissue growths found in and around the womb (the uterus) that are not cancerous are known as uterine fibroids. The size and shape of fibroids can differ significantly, with some being less than 1cm in diameter while others exceeding 15cm.

Fibroids are also known as:

• Myomas
• Uterine myomas
• Leiomyomas

What are symptoms of uterine fibroids?

Most women with fibroids do not present with symptoms right away. Hence, they might not even know that they have these growths. Nevertheless, those who experience symptoms might encounter the following:

• Menstrual periods characterised by heavy or painful bleeding
• Bleeding or spotting between periods
• Abdominal pain
• Sensation of fullness
• Pain in the lower back and pelvis
• Frequent urge to urinate
• Pain or discomfort during sexual intercourse
• Infertility or pregnancy complications in severe cases

What are the risk factors of developing uterine fibroids?

Some factors that have been associated with developing uterine fibroids are:

• Research indicates that oestrogen may contribute to the formation of fibroids. These growths tend to emerge during a woman’s reproductive years, when oestrogen production is at its peak. They then reduce in size following menopause.
• Between ages of 30 to 50
• Being overweight

How are uterine fibroids diagnosed?

Fibroids are often detected incidentally during routine gynaecological visits as they usually do not cause noticeable symptoms in most women. However, a pelvic or abdominal ultrasound scan will be conducted upon referral by a doctor to confirm the diagnosis.

The location of the fibroid determines its classification: 

• Intramural fibroids: Grow within the muscular wall of the uterus. They are the most prevalent type. 
• Subserosal fibroids: Develop outer wall of the uterus. They can grow to large sizes. 
• Submucosal fibroids: Grow beneath the inner lining of the uterus. 
• Pedunculated fibroids: Attached to the uterus with stem-like tissue. They can either be subserosal or submucosal. 

How are uterine fibroids treated?

If you do not have symptoms, you may not necessarily need treatment since fibroids tend to shrink on their own post-menopause. 

However, if symptoms manifest, your physician may draw up a treatment plan considering the following aspects:

• Your age
• Your overall health
• The severity of your symptoms
• The location and size of your fibroids
• Your plans for pregnancy (if any)

Medications are typically prescribed to manage symptoms the patient is experiencing. 

Additional treatment techniques include: 

1. Myomectomy: A surgical procedure to remove fibroids without affecting fertility. However, there is a possibility of regrowth, leading to further surgery.
2. Hysterectomy: A surgery that removes the whole uterus. This option is only suggested for women with large fibroids, severe symptoms, and do not intend to get pregnant.
3. Magnetic Resonance Imaging (MRI) guided procedures: Guided ultrasound waves are used to eliminate fibroids.
4. Uterine artery embolisation (UAE): A procedure where a special solution is injected through a tube in your leg. This procedure obstructs blood flow to the fibroids, leading to their shrinkage. Women who want to conceive need to consult their physician before undergoing UAE.

What are ovarian cysts?

Cysts are sacs of fluid that form within your body. Ovarian cysts refer specifically to growths that form on one or both of your ovaries. Most ovarian cysts are non-cancerous, but a medical examination is required to rule out ovarian cancer.

What are symptoms of ovarian cysts?

In most cases, ovarian cysts do not present symptoms. However, they may cause symptoms if they are large and block blood flow to the ovaries.

Symptoms may include:

• Abdominal pain
• Feelings of fullness
• Irregular or light periods
• Frequent urination
• Pain during sexual intercourse
• Pelvic pain may also occur

If you experience sudden, sharp pain, please seek immediate medical intervention.

What are the risk factors of developing ovarian cysts?

Some ovarian cysts are associated with underlying medical conditions such as endometriosis or polycystic ovary syndrome (PCOS). Others, such as pathological cysts, result from anomalous cell proliferation, increasing the risk of ovarian cancer in postmenopausal women.

Most cysts, though, form as a natural part of the menstrual cycle. For example, functional cysts grow and develop when the follicle of an ovary fails to discharge its fluid and contract after releasing an egg.

How are ovarian cysts diagnosed?

Ovarian cysts are typically detected during routine pelvic exams, as most are asymptomatic. However, further examinations are required to verify the diagnosis once they are discovered. This may include:

1. Transvaginal ultrasound: Sound waves are used to create an image of the ovaries on a special screen. Doctors can then identify the cyst with more precision. However, while an ultrasound can determine the size of the cyst, it cannot tell whether the cyst is cancerous or non-cancerous. 
2. Blood tests: Performed if the cyst is suspected to be cancerous.

How are ovarian cysts treated?

The first stages of treatment usually involve monitoring the cysts via follow-up ultrasound scans. The scans may be conducted again after a few weeks or months to check if the cyst is growing. Postmenopausal women may require ultrasound scans and blood tests every four months for a year.

While there are times when cysts disappear on their own without medical intervention, surgery might be necessary if symptoms are present, the cyst is large or suspected to be cancerous.

There are two types of surgeries to remove ovarian cysts:

1. Laparoscopy: This is the most common surgical procedure for removal of ovarian cysts. It utilises a laparoscope, a tube-shaped microscope with a light, to remove the cyst via small incisions in the skin. This is a minor surgery, so patients are often discharged on the same or the next day. 
2. Laparotomy: May be necessary for cysts that are large or cancerous. During the procedure, a larger incision is made in the abdomen to remove the cyst altogether. The doctor will take care to preserve the ovaries as much as possible.

FAQs for uterine fibroids vs ovarian cysts

1. Can I have both uterine fibroids and ovarian cysts together?
   It is possible to have both conditions concurrently. This is because fibroids and ovarian cysts develop in different areas of the reproductive system.
2. Which is more dangerous - a uterine fibroid or an ovarian cyst?
   Fibroids are generally non-cancerous. While cancer cells can develop in fibroids, this is an uncommon occurrence. On the contrary, while most ovarian cysts are benign, some may be malignant, and surgery may be required for their removal. Therefore, ovarian cysts are often seen as more dangerous compared to uterine fibroids.
3. Do I need to remove my fibroids and/or cysts?
   These growths are usually asymptomatic and typically do not need to be removed. Please seek medical attention if you experience any of the abovementioned symptoms for fibroids and/or cysts.
4. Can uterine fibroids be mistaken for ovarian cysts?
   A healthcare professional can differentiate between fibroids and cysts with a pelvic examination or ultrasound. However, mistaking a fibroid for a cyst can happen when self-diagnosing, so it is always best to see your doctor for medical advice.
5. Will uterine fibroids go away on their own?
   Asymptomatic fibroids generally decrease in size over time, particularly after menopause. Thus, it is possible for them to resolve on their own. Please seek medical attention if you experience any of the abovementioned symptoms for fibroids and/or cysts.
6. Can exercise shrink uterine fibroids?
   Exercise alone cannot shrink or reduce fibroids if you have them. Specialised medical treatment, as suggested by your doctor is needed.
7. What happens if uterine fibroids are left untreated?
   Without medical intervention, fibroids may reduce one’s likelihood of getting pregnant or carrying a child to term. This may be true if the fibroid is large. It is also possible for fibroids to cause anaemia, and abdominal pain if the fibroid is pedunculated and submucosal. Please seek medical attention if you experience any of the abovementioned symptoms for fibroids.

Make an appointment at Pantai Hospitals

Understanding the differences between uterine fibroids and ovarian cysts is important to ensure your reproductive well-being. Despite their similarities, they have distinct differences, including distinct indications and developing in different parts of the body. Medical assessment is the most reliable approach for precise diagnosis. 

A dedicated and expert team of Obstetrics & Gynaecology specialists at Pantai Hospital is available for consultation to provide the best care and assistance. 

Get in touch with us to book an appointment today if you have concerns or questions regarding fibroids and cysts. We assure you the best possible care tailored to your specific needs.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.