Determining the Risk: What Size of Fibroid is Considered Dangerous?

Fibroids are noncancerous growths that develop in the uterus, affecting millions of women worldwide. While most fibroids are benign and don’t cause noticeable symptoms, some can lead to complications, prompting the need for medical intervention. One crucial factor in assessing the risk associated with fibroids is their size.

Understanding Fibroids:

Fibroids are abnormal growths of muscle tissue in the uterus. They can vary in size, ranging from as small as a seed to as large as a grapefruit or more. Fibroids can develop inside the uterus, on its outer surface, or within the uterine wall. Although the exact cause of fibroids remains unclear, factors such as genetics, hormonal fluctuations, and pregnancy can contribute to their formation.

After diagnosing fibroids, the first thing a doctor discusses is the size of the fibroids. Why is the size of fibroids important to know? There are multiple reasons for it.

• The course of treatment for fibroids depends on their size.
• The location and size of fibroids are also crucial in predicting potential complications. For instance, there has been a reported case where emergency surgery was required for a woman with a large fibroid causing respiratory problems.
• Additionally, the size of the fibroid can serve as an alarm for determining when treatment should be initiated. It plays a significant role in guiding healthcare professionals toward the most appropriate and timely interventions.

Assessing Fibroid Size:

The fibroid size chart varies globally, with different centers employing diverse methods to characterize uterine size. Physicians may measure fibroids in centimeters, categorizing them as small, medium, or large.

• Small fibroid: Less than 3 cm in length (Comparable to the size of a pea or cherry)
• Medium fibroid: 3 to 6 cm (Similar in size to a plum or large orange)
• Large fibroid: 6 cm or more (Resembling the size of a grapefruit and beyond)

Some physicians define fibroid size based on obstetric weeks, where a small fibroid corresponds to the 4th obstetric week, a medium fibroid to weeks 10 to 11, and a large fibroid to weeks 12 to 16.

Which size of fibroid is dangerous in mm?

A common misconception is that the larger the fibroids, the more serious complications they will cause. However, it’s important to note that while larger fibroids can cause discomfort, they are not always guaranteed to pose problems. Similarly, a smaller fibroid doesn’t automatically signify any cause for concern. So, there is no straight forward answer to this question: which size of fibroid is dangerous.

How much does a 7 cm fibroid weigh?

While fibroids don’t directly cause weight gain, they contribute to overall body weight due to their mass. The weight of a 7 cm fibroid can vary, but generally, larger fibroids, including those over 6 cm, can weigh up to 25 pounds. Consequently, women with larger fibroids may experience heaviness in the lower abdomen and a protruding belly due to the presence of a substantial fibroid in the uterus.

When should you be concerned about fibroid size?

While many women with fibroids never experience any symptoms, the size of a fibroid can become a concern when it leads to the following issues:

Symptoms: Larger fibroids can cause symptoms such as heavy menstrual bleeding, pelvic pain or pressure, frequent urination, and backache. The size and location of the fibroid play a role in the severity of these symptoms.

Complications during Pregnancy: Depending on their size and location, fibroids can lead to complications during pregnancy and childbirth. Larger fibroids may obstruct the birth canal or interfere with the optimal positioning of the baby.

Impact on Fertility: In some cases, larger fibroids can affect fertility. They may block the fallopian tubes, interfere with the implantation of the embryo, or disrupt the blood flow to the uterus.

Degeneration: Larger fibroids are more prone to degeneration, a process in which the central part of the fibroid outgrows its blood supply, causing pain and sometimes requiring medical attention.

Rapid Growth: If a fibroid undergoes rapid growth, it may indicate malignancy, although fibroids are overwhelmingly benign. Any sudden increase in size should be thoroughly evaluated by a healthcare professional.

What is the solution?

The treatment of fibroids depends on the location and size of fibroids. Doctor can recommend one of the following:

Watchful Waiting:

Small, asymptomatic fibroids may not require immediate treatment. Regular monitoring through pelvic exams or imaging studies (ultrasound, MRI) can be done to track any changes.

Surgery:

For larger and heavier fibroids causing significant symptoms, surgery is often recommended. The two primary surgical options are myomectomy and hysterectomy.

Myomectomy is a uterus-saving procedure in which only the diseased part, typically the fibroids, is removed, leaving the rest of the uterus intact. On the other hand, hysterectomy involves the complete removal of the uterus. This procedure is considered more extensive, as it eliminates the entire uterus, preventing the possibility of future pregnancies.

The choice between myomectomy and hysterectomy depends on various factors, including the severity of symptoms, the desire for future fertility, and the overall health of the patient. This decision is typically made in consultation with the patient and their healthcare provider.

Uterine Artery Embolization:

This is a minimally invasive procedure initially used for the smaller fibroids but now also for the large ones. During the procedure, a catheter is guided through blood vessels to the uterine arteries, where small particles are injected to block blood flow to the fibroids. This process aims to reduce the size of the fibroids and alleviate associated symptoms, offering an alternative to surgical options.

Dr. Imtiaz Ahmed is the pioneer of this procedure in Pakistan. Email now at info@drimtiazahmad.com. Follow us on Instagram @Profdr_imtiaz_ahmad for daily updates.