What are uterine fibroids?
Fibroids are benign growths (not cancer) in the muscular wall of the uterus. These growths can be very tiny or as large as a cantaloupe.
Fibroids are very common. Between 20% and 80% of women develop fibroids by the time they reach 50 years of age. Most women get uterine fibroids in their 40s and 50s, and many women have them without knowing it.
Once a fibroid is formed, it tends to grow larger until menopause. After menopause, fibroids tend to shrink because women have less estrogen at that stage of their lives.
Symptoms of uterine fibroids
Many women who have fibroids don’t have symptoms. In other women, fibroids can cause heavy bleeding during the menstrual period. Periods may last much longer than usual. Fibroids may also cause pain or a feeling of pressure or heaviness in the lower pelvic area (the area between the hip bones), the back or the legs. Some women have pain during sexual intercourse. Others have a constant feeling that they need to urinate. There may also be a feeling of pressure in the bowel. Some women have constipation or bloating. Uterine fibroids can also cause infertility as well as complications during pregnancy and labor.
What causes uterine fibroids?
Doctors do not know what causes uterine fibroids. Some researchers believe they may be genetic (run in families). Other researchers think they could be related to hormone levels.
Other factors that can increase a woman’s risk of developing uterine fibroids include:
- Fibroids are common as women age, especially as they approach menopause.
- Ethnic origin.Black women are more likely to develop fibroids than white women.
- Women who are overweight are at higher risk for fibroids. For heavy women, the risk is two to three times greater than average.
- Eating habits.Eating a lot of red meat (e.g., beef) and ham is linked with a higher risk of fibroids. Eating plenty of green vegetables seems to protect women from developing fibroids.
How are uterine fibroids diagnosed?
Even if you have no symptoms, your doctor may discover that you have fibroids during a routine pelvic exam. They may be able to feel the fibroids during the exam and even estimate the size.
Your doctor also may order imaging tests to confirm the diagnosis. Or they may suggest looking inside you with a scope. This can be done through laparoscopy or hysteroscopy. In laparoscopy, your doctor will make a small incision (cut) near your navel and insert the scope. In hysteroscopy, your doctor will insert the scope into your vagina and cervix (no incision needed).
Can uterine fibroids be prevented or avoided?
Because doctors don’t know for sure what causes them, uterine fibroids cannot be completely prevented or avoided. However, lifestyle changes, such as losing weight and eat less red meat, can help reduce your risk.
Uterine fibroid treatment
There are many treatment options for women who have fibroids. Fibroids that don’t cause any symptoms may not need treatment. For fibroids that do cause symptoms, treatment options include medicine, noninvasive or minimally invasive procedures, or traditional surgery. Your doctor will help you figure out the best treatment option for your fibroid.
Your doctor will consider many things before helping you choose a treatment. Some of these things include:
- Whether or not you are having symptoms from the fibroids
- If you might want to become pregnant in the future
- The size of the fibroids
- The location of the fibroids
- Your age and how close to menopause you might be
How is medicine used to treat fibroids?
Medicines don’t get rid of fibroids, but they can help control symptoms and make fibroids smaller.
What procedures are used to treat fibroids?
Your doctor may recommend a noninvasive or minimally invasive procedure to remove or destroy the fibroid.
A noninvasive procedure means that your doctor does not have to make an incision (cut your skin) to destroy or remove the fibroid. MRI-guided focused ultrasound therapy is a new, noninvasive way of treating fibroids. During this procedure, you lie in a magnetic resonance imaging (MRI) scanner while it takes pictures of your uterus. The scanner shows your doctor exactly where the fibroid is. Your doctor then points ultrasound (sound waves) at the fibroid. The ultrasound waves heat up and destroy the fibroid. This is the least invasive procedure for treating fibroids but not every patient is a candidate for it. Your doctor can help you determine if it would work for you.
A minimally invasive procedure means that your doctor makes only a very small incision (cut) in your skin to destroy or remove the fibroid. Minimally invasive procedures include the following:
- Uterine fibroid embolization(also called uterine artery embolization): Fibroids will shrink or go away completely if their blood supply is stopped. During uterine fibroid embolization, the doctor injects tiny particles into the arteries that supply blood to the fibroids. These particles stop the blood flow to the fibroid. Over time, the fibroid will shrink. The procedure works even if you have several fibroids.
- Myomectomy: During this procedure, your doctor surgically removes the fibroids from your uterus. The surgical tools are inserted in the body either through very small cuts in the abdomen, or through the vagina and cervix.
What about hysterectomy?
If you have a number of fibroids or fibroids that are very large, your doctor may recommend a hysterectomy. During a hysterectomy, your doctor removes the entire uterus from your body. A hysterectomy can be done through an abdominal incision (cut) or through a vaginal incision.
Living with uterine fibroids
It is very possible to live your life without even knowing you have uterine fibroids. If you have symptoms, you and your doctor can discuss a treatment plan to manage symptoms or remove the fibroids.
If you are planning to become pregnant, talk to your doctor. Uterine fibroids can cause problems during pregnancy and delivery for some women. Other women experience no problems with it.
Questions to ask your doctor
- What could have caused my uterine fibroid(s)?
- How large is/are my uterine fibroid(s)?
- Does my uterine fibroid require treatment?
- Could I choose not to have the fibroid removed?
- I’d like to spare my uterus. Is uterine fibroid embolization a good treatment option for me?
- Do uterine fibroids put me at risk for any other health conditions?
- Is it safe for me to exercise? What about sexual activity?
