Uterine Fibroids

Uterine (YOU-ter-in) fibroids (FI-broyds) are growths that can form inside the uterus, on the outer surface of the uterus, or inside the wall of the uterus. They can grow alone or in clusters. Uterine fibroids can happen any time in a woman’s life. They are more common in African American women.

You may have fibroids and not be aware of them. They can stay very small for many years and not cause any problems. Sometimes, they can grow fast.

Most small fibroids do not cause problems. If the fibroids get larger, they may make your abdomen swell. Fibroids may cause you to have heavy periods. You also could have pain in your lower pelvic area. Fibroids may make it hard for you to become pregnant. In very rare cases, the fibroid tissue becomes cancerous and grows very fast.

What causes uterine fibroids?

Not much is known about what causes uterine fibroids. Some women may inherit genes that cause them. The hormone estrogen seems to make fibroids grow. The level of estrogen in a woman’s body rises or falls during natural events such as pregnancy (which causes an increase in estrogen) or menopause (which causes a decrease in estrogen).

 

How will I know if I have uterine fibroids?

In many cases, fibroids don’t cause any symptoms.When symptoms do happen, they usually include:

  • Changes in your period
  • Pain in your belly or lower back
  • Pain during sex
  • Pressure when you urinate or pressure in your rectal area
  • Several miscarriages or the inability to become pregnant
  • In rare cases, strong pain, nausea, and fever

 

Call your doctor if you have any of these symptoms.

How are fibroids diagnosed?

Most fibroids are found during a routine pelvic exam. If your doctor thinks you may have fibroids, she or he may use the following tests:

 

  • Ultrasound — a painless procedure that uses sound waves to create a picture of your
    organs
  • Laparoscopy (lap-ah-RAW-sko-pee) — a telescope-like instrument, called a laparoscope (LAP-er-ah-skope), is inserted through a small cut (incision) below the belly button to view the inside of the abdomen
  • Hysteroscopy (hiss-ter-OSS-sko-pee) — a slender instrument, called a hysteroscope (HISS-ter-ah-skope), is inserted through the vagina and cervix to view the inside of the uterus
  • Hysterosalpingogram (HISS-ter-ah-sal-PING-o-gram) — an x-ray test where dye is injected into the uterus and fallopian tubes so the doctor can see the size and shape of the fibroids

Will I need treatment for fibroids?

Treatment is not usually needed if fibroids are small or if a woman is nearing menopause. Certain conditions may require treatment:

  • Heavy vaginal bleeding or painful periods
  • Bleeding between periods
  • The doctor isn’t sure if the growth is a fibroid or another type of tumor (such as
     an ovarian tumor)
  • Rapid increase or growth of the fibroid
  • Infertility
  • Pain in the pelvic region
  • Problems with bladder control

If you have had fibroids in the past, you should have regular check-ups with your doctor.

Treatment of fibroids

Fibroids are usually treated by removing them surgically. Non-surgical treatments do not completely remove fibroids. In some cases, your doctor may prescribe medicine to shrink the fibroids temporarily and control bleeding. This medicine lowers the body’s level of estrogen. Doctors often order this medicine to treat heavy bleeding before surgery. This medicine will cause the fibroids to shrink, but they won’t go away completely.When you stop taking the medicine, the fibroids will probably grow back.

 

Surgical options include:

  • Myomectomy (my-oh-MECK-toe-me) — removes the fibroids but leaves the uterus in place. This may be done through the laparoscope, the hysteroscope, or through a cut (incision) in your belly. The procedure depends on the location and size of the fibroid.
  • Hysterectomy (hiss-ter-ECK-toe-me) — removes the uterus. The ovaries may or may not be removed.
  • Uterine fibroid embolization (em-bohliz-AY-shun) — blocks the blood flow to the fibroids. This is a newer procedure. When the blood flow is blocked, the fibroids shrink.With this procedure, the fibroids do not go away completely.

Fibroids during pregnancy

A few pregnant women have uterine fibroids. If you are pregnant and have fibroids, they were probably there before you became pregnant. They probably won’t cause problems for you or your baby. The fibroids may grow larger because your body produces more estrogen when you’re pregnant.

 

Usually, fibroids don’t need to be treated during pregnancy. If you are having pain or discomfort, your doctor may suggest bed rest. If your doctor thinks that you might go into labor before your due date, you may be admitted to the hospital early. The position of the fibroid may determine whether you have a vaginal delivery or a c-section delivery. Very rarely, a myomectomy may be performed during pregnancy. In most cases, fibroids become smaller after pregnancy.

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