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Gynecology

Uterine Fibroids

The Facts about Uterine Fibroids.

Uterine Fibroids Causes & Symptoms Diagnosis Treatment

What are Uterine Fibroids?

Also called leiomyomas—or myomas for short—uterine fibroids are muscular tumors in the smooth wall of the uterus. You may have one or several. They may stay the same size, grow slowly or expand quickly.

Fibroids can grow in the lining of the uterus (submucosal fibroid), within the muscular wall (intramural fibroid), on the outside of the uterine wall (subserosal fibroid) or on mushroom-like stalks that extend outside the wall or into the cavity (pedunculated fibroid).

The Facts About Uterine Fibroids

Although mostly benign, these growths can cause troublesome symptoms and problems

Learning you have a fibroid tumor in your uterus is rarely cause for any alarm. Between 20 to 80 percent of all women will develop one or more by the time they reach 50, according to the Office on Women’s Health.

Some tumors are smaller than a fruit seed, and you may have no symptoms at all. Others become so large your belly area becomes distended. Regardless of the size, you may experience pain, pressure, heavy bleeding and other symptoms that can interrupt your daily activities.

Fortunately, some treatments can help.

Causes and Symptoms

Why do fibroids grow?

Although the cause of fibroids is still unknown, there are risk factors, including:

    • Age - You’re more likely to get them in your 30s and 40s. After menopause, they tend to shrink.
    • Hormones - Estrogen and progesterone, your female hormones for the menstrual cycle, help fibroids grow. Hormone production decreases after menopause, which is why fibroids should stop growing and possibly shrink.
    • Family history - If your mother had fibroids, you are at a higher risk of getting them.
    • Race - African-American women are at a higher risk of developing fibroids, leading researchers to believe ethnicity and genetics have a role
    • Lifestyle - Your risk can increase with alcohol consumption and a diet that’s high in red meat and low in green vegetables. Women who are overweight are at a higher risk
    What are the symptoms of fibroid tumors?

    Many women experience no symptoms. For others, the symptoms can be annoying, painful and disruptive to daily life. You may experience:

      • Heavy menstrual bleeding
      • Menstrual bleeding that lasts longer than seven days
      • Painful periods
      • Persistent pelvic pain
      • Distension of the lower stomach
      • A feeling of pressure on the bladder or rectum
      • Frequent urges to urinate
      • Low back pain or leg pain
      • Painful sex

      How Are Fibroids Diagnosed?

      • Your health care provider may detect fibroids during a routine pelvic exam. Other diagnostic procedures include:
      • An ultrasound, which uses sound waves to create an image of the uterus. During a transvaginal ultrasound, a small tool (transducer) is placed in the vagina.
      • Magnetic resonance imaging (MRI) for a more in-depth look. An MRI is usually only required if surgery is indicated.
      • Laparoscopy and hysteroscopy. These minimally invasive surgical procedures can be used to diagnose and treat fibroids. During the laparoscopy, a scope with a camera is inserted near the umbilicus to look inside the pelvis at the outside of the uterus. During a hysteroscopy, the scope enters the vagina and cervix and looks at the lining or inside of the uterus

      What Are The Treatments for Uterine Fibroids?

      If you’re not experiencing uncomfortable symptoms or problems, treatment is rarely required. Your doctor will monitor the fibroids if needed. If you are having pain, pressure or heavy bleeding, your doctor may talk to you about options to alleviate the symptoms. Treatment will depend on the location and the size of the fibroids, as well as whether or not you plan to get pregnant in the future.

      Treatments include:

      • Lifestyle changes - Maintain a healthy weight and follow a low-fat diet
      • Medications - Over-the-counter pain anti-inflammatories can ease the discomfort. Hormones or hormone-blocking medications. Examples include birth control pills, progesterone intrauterine devices and Gonadotropin-releasing hormone agonists
      • Uterine fibroid embolization or uterine artery embolization. Both of these minimally invasive surgeries block the blood supply to the fibroid to shrink it.
      • Hysterectomy - In this surgical procedure, the uterus is removed, which prevents fibroids from growing in the future. Again, the surgical approach will depend on the fibroid’s size. Surgeons at ChristianaCare perform both myomectomies and hysterectomies.

      Are Fibroids Cancerous?

      The chance of having a cancerous fibroid, known a leiomyosarcoma, is exceedingly rare—less than one in 1,000, according to the Office on Women’s Health.

      What Happens if I Want to Get Pregnant?

      If a woman has trouble getting pregnant, submucosal fibroids might be the cause. However, many women with fibroids have normal pregnancies. The chance of needing a caesarian for delivery is higher in women with fibroids. Most obstetricians are well-versed in the best way to care for pregnant women with fibroids.

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