Uterine Fibroids

Uterine fibroids (also called uterine myomas or fibroid tumors) are benign growths within the uterus, occurring in 80% of women. For most women they are small and cause no symptoms, but sometimes they can get bigger and need treatment.   Although fibroids are not cancer and do not cause cancer, you should be aware of the problems they can cause so that you know when to seek help from your doctor.
Fibroids grow from the muscle layer in your uterus. They can vary in number, size, shape, and location (inside, within, or outside the uterus). They range from smaller than pea-sized to larger than grapefruit-sized - 6 inches across or more. 
Fibroids can occur in any age woman, but usually they occur when you are 30-40 years old. They are more common in African American women, and tend to occur at a younger age, than in white women. 
The cause of fibroids is not known, but they may be linked to changing levels of the female hormones estrogen and progesterone. They often shrink after menopause.
Although fibroids may cause no symptoms, some of the following can occur with fibroids:
  • heavy menstrual periods with bad cramps
  • spotting in between periods
  • anemia (low iron levels) due to the heavy blood loss
  • regular pain or cramping in the abdomen or lower back
  • pressure that seems to be causing urination or bladder problems
  • constipation or rectal pain
  • fertility problems or miscarriages
  • enlarged or odd-shaped uterus  
Many of these symptoms are similar to symptoms from other conditions, such as endometriosis, so it is important to see your doctor who will do tests to find out what is causing your problems.
There are several tests your doctor can do to find out if your symptoms are caused by fibroids. These can include:
  • ultrasound imaging which uses sound waves to make a picture of your abdominal organs
  • hysteroscopy, in which your doctor inserts a special scope through the vagina and cervix to look at the inside of your uterus
  • laparoscopy, in which a slender camera is inserted through a small cut near your navel to look inside your abdomen 
Usually you are treated for fibroids only when they are causing bothersome symptoms. Your choice of treatment depends on your symptoms, and whether or not you wish to get pregnant in the future. Treatments of symptoms and the fibroids themselves include:
  • hormone medications which help reduce the menstrual symptoms
  • medicines which help blood clot, and so slow menstrual bleeding
  • painkillers such as ibuprofen for cramps
  • surgical removal of the fibroids while leaving the uterus in place (myomectomy)
  • uterine artery embolization (UAE), in which blood vessels supplying the fibroids are blocked, causing the fibroids to shrink
  • endometrial ablation, which does not affect fibroids but helps decrease or stop heavy bleeding
  • hysterectomy, or surgical removal of the entire uterus
  • ultrasound surgery, in which the fibroids are destroyed with ultrasound waves.  
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