Facts About Uterine Fibroids

Fibroids are fleshy tumors that can grow in a woman's uterus. Fibroids are almost always benign (not cancerous).

Types of Fibroids

There can be a single fibroid growing or multiple fibroids throughout the uterus. Most fibroids grow in the wall of the uterus and are classified by their location.

1. Submucosal - grow into the uterine cavity.
2. Intramural - grow within the wall of the uterus.
3. Subserosal - grow on the outside of the uterus.
4. Pedunculated - grow on stalks out from the surface of the uterus

Risk Factors for Developing Fibroids

Up to 80% of women develop fibroids by age 50; fibroids are most common in women in their 40's and early 50's.

Factors that can increase a woman's risk of developing fibroids are:

1. Age - fibroids become more common as women age, especially during the 30's and 40's through menopause. After menopause, fibroids usually shrink.
2. Genetics - having a family member with fibroids increases your risk. If a woman's mother had fibroids, her risk of having them is about three times higher than average.
3. Ethnic origin - African-American women are more likely to develop fibroids than other ethnicities.
4. Obesity - women who are overweight are at higher risk for fibroids, the risk can be three times greater than average.
5. Diet - eating a lot of red meat and ham is linked with a higher risk of fibroids. Eating plenty of green vegetables seems to protect women from developing fibroids.

Symptoms of Fibroids

Most fibroids do not cause any symptoms, and a woman can have fibroids her whole life and not know it.

Here is a list of symptoms that could possibly indicate uterine fibroids:

1. heavy vaginal bleeding
2. painful periods
3. bleeding between periods
4. pain during sex
5. feeling of fullness in the lower stomach area
6. enlargement of the lower abdomen
7. frequent urination, pressure on bladder
8. constipation, pressure on bowels
9. lower back pain
10. reproductive problems, such as infertility (very rare)

Diagnostic Testing for Fibroids

Your doctor may find that you have fibroids when you see her for a regular pelvic exam to check your uterus, ovaries, and vagina. The doctor can feel some fibroids with her fingers as a lump on your uterine wall. Doctors often describe the size of the fibroids by comparing their size to the size your uterus would be if you were pregnant. (For example, you may be told that your fibroids have made your uterus the size it would be if you were 16 weeks pregnant.) Alternatively, the fibroid's size might be compared to everyday objects that you can easily understand, such as an orange, a walnut, or a tennis ball.

Besides a pelvic exam, most doctors diagnose fibroids using an ultrasound. An ultrasound uses sound waves to produce a picture of your uterus. Many women are familiar with ultrasounds as they are often done during pregnancy. Pelvic ultrasounds are usually done while the patient has a full bladder in order to create a clearer picture of the uterus.

Occasionally, a doctor will need to employ a surgical technique to discover if you have uterine fibroids. A laparoscopy is when the doctor inserts a long, thin scope into your abdomen through a tiny incision near your belly button. The scope has a miniscule camera on the end that can take pictures of your uterus.

Treatment for Uterine Fibroids

Most women with fibroids do not have any symptoms. For women who do have symptoms, there are treatments that can help relieve the pain and excessive bleeding.

Talk with your doctor about the best way to treat your fibroids.

Some questions you and your doctor will need to consider are:

1. Are the fibroids causing pain?
2. Do you want to become pregnant in the future?
3. Are the fibroids very large? Are they in a dangerous position in the uterus?
4. Are the fibroids and their symptoms interfering with normal life?
5. How old are you and how close are you to menopause?
6. Do you have other illnesses or diseases that could cause complications?

If your fibroids are only causing you mild symptoms, your doctor may suggest taking medication. Over-the-counter drugs such as ibuprofen (Advil) or acetaminophen (Tylenol) can be used for mild pain. If you have heavy bleeding during your period, taking an iron supplement can keep you from getting anemia or correct it if you already are anemic.

Several drugs commonly used for birth control can be prescribed to help control the symptoms of fibroids. Low-dose birth control pills do not make fibroids grow and can help control heavy bleeding.

Another drug used to treat fibroids is Lupron, which is a gonadotropin releasing hormone agonists (GnRHa). This drug can shrink your fibroids, but the side effects can include hot flashes, insomnia, depression, decreased sex drive, and joint pain. GnRHa's can also cause bone thinning, so generally you would only use it for six months or less. Once you stop taking the drug, the fibroids often grow back quickly.

If you have fibroids with moderate or severe symptoms, surgery may be the best way to treat them. Here are the options:

1. Myomectomy - surgery to remove fibroids without taking out the healthy tissue of the uterus.
2. Hysterectomy - surgery to remove the uterus.
3. Endometrial Ablation - the lining of the uterus is removed or destroyed to control very heavy bleeding.
4. Myolysis - A needle is inserted into the fibroids, usually guided by laparoscopy, and electric current or freezing is used to destroy the fibroids.
5. Uterine Fibroid Embolization (UFE) - A thin tube is thread into the blood vessels that supply blood to the fibroid and tiny plastic or gel particles are injected into it. This blocks the blood supply to the fibroid, causing it to shrink.

Talk to your doctor about all of your options before making any choice about treatment for uterine fibroids.