The HEALTH : October 2018 | Page 13

column OCTOBER, 2018 | The HEALTH 13 O B - GYN Non-cancerous growths in or around the womb WOMEN & INFANTS’ FERTILITY CENTRE F ibroids is an overgrowth of the muscle of the womb which is non-cancerous. It is manifest as small bumps – small tumours on the uterus. It can vary in its position, and essentially can be on the surface, within the uterus, can be pedunculated – meaning it has a stalk and a growth. This is depending on where it is. Symptoms Symptoms may vary according to each individual. However, the most common would be heavy and painful periods. At other times, the patient may feel pres- sure if the fibroid is more than five centimetres. If it’s like a small little lemon and it is in the front – it could press on the bladder so that would cause urinary incontinence. At other times, very huge fibroids can block the urinary pas- sage, resulting in severe pain. This is when intervention is required where a tube is inserted to relieve the patient. Some may also feel a hard firm growth in the tummy. Sometimes, outsides of periods, there may be on and off pain. Most women would not know that they have fibroids as it does not exhibit any symptoms. They would probably learn about it during a routine medical check-up or when they are pregnant. Who are at risk It essentially affects women of reproductive age – young ladies around the age of 20’s to 40’s. This may continue to grow as fibroids derives its growth from hormones. However, once a woman attains menopause, it will shrink. Genetics is a predominant factor. If a patient’s mother or grandmother has it – then there is a likelihood of that person being more at risk. There are some racial ethnicity predominance as well where fibroids are commonly seen in African women. Nevertheless in Malaysia, we see it all across the board. BY DR PATRICIA LIM SU LYN When fibroids become dangerous RF123 A female’s reproduction can be affected if the fibroids are inside the uterus. This can cause miscar- riage or if pregnant can constrict the baby from turning or result in premature delivery. Intervention There a few ways of managing fibroids. Firstly, if the lady has no symptoms at all, the fibroids are left and monitored. There are also medications available, but unfortunately the medications are hormone based and it doesn’t allow pregnancy. The other option; surgery known as a myomectomy involves remov- ing the fibroids. The risk involved with this surgery is bleeding. When the fibroids are removed, a cavity is created which is later closed up. In the process, if the womb continues to bleed – there’s a small percentage that the patient may suffer from loss of blood and in severe cases, the whole womb would need to be removed. Dr Patricia Lim Su Lyn is a consultant obstetrician and gynae- cologist at KPJ Tawakkal Specialist Hospital. She can be contacted at drpatricia@kpjtawakkal.com “Most women would not know that they have fibroids as it does not exhibit any symptoms. They would probably learn about it during a routine medical check- up or when they are pregnant.” Does soya cause fibroids? SOY is rich in phytoes- trogens or plant estrogens called isoflavones, which are similar in structure to human estrogen but not as potent. Because they’re weaker, it’s believed these plant estrogens could act as anti-estrogens and serve as a potential protection against several hormonal diseases. Uterine fibroids, although non-cancerous, are tumors thought to respond to estrogen and progesterone levels. For this reason, many question whether soy intake will protect or worsen the condition. KPJ Tawakkal Specialist Hospital Consultant Obste- trician and Gynaecologist Dr Patricia Lim Su Lyn explains that based on scientific evi- dence, there is no foods that are known to cause fibroids. “Some school of thoughts have been to avoid soya based foods as it contains natural estrogen. However, it is not really proven. Scien- tifically, there are no specific food that a person need to avoid.”