Fibroids are abnormal growths of the uterus. They are also called uterine leiomyomas or myomas. They grow from the special muscle cells of the uterus.
(last reviewed January 24, 2008)
Where do fibroids grow?
They can grow within the wall of the uterus, inside the cavity of the uterus, or on the outside surface of the uterus.
(last reviewed January 24, 2008)
How common are fibroids?
Approximately 25-40% of women have fibroids. However, only a small percentage of these women have symptoms from the fibroids that require treatment.
(last reviewed January 24, 2008)
What causes fibroids to grow?
There are many theories about the origin of fibroids, but the exact cause is not clear. Their growth seems to be related to the hormonesestrogen and progesterone. When the levels of these hormones decrease at menopause, many of the symptoms of fibroids begin to resolve.
However, there is also evidence that hormones do not actually cause fibroids. For example, women who have had high levels of both of these hormones as a result of pregnancy or birth control pills have a lower incidence of fibroids later in life.
(last reviewed January 24, 2008)
Are there any factors that put someone at risk for getting fibroids?
Ethnic background — Fibroids are three times more common in black women as compared to white, non-Hispanic women.
Number of pregnancies — The more pregnancies a woman has that she carries to term, the less likely she is to have fibroids.
Use of birth control — Women who use birth control pills have a lower risk of developing fibroids, although women who use the pill at an early age (between age 13 and 16) may have an increased risk. Similar to the birth control pill, women who use using continuous progestin contraceptives (for example, Depo Provera®) have a lower risk of fibroids.
Smoking — Women who smoke have a decreased risk of fibroids. However, it is very clear that the health risks of smoking far outweigh any small benefit of the decreased incidence of fibroids.
Diet — Significant consumption of beef, ham, or other red meats does seem to increase the risk of fibroids, while consumption of green vegetables decreases risk. Alcohol, especially beer, also increases the risk for fibroids.
(last reviewed January 24, 2008)
How will my doctor figure out if I have fibroids?
There are several ways they can be diagnosed:
Physical exam - this is usualy the first step, and many fibroids can easily be found by your doctor during a physical exam.
Ultrasound - uses sound waves to visualize the uterus, this is the preferred imaging modality to diagnose fibroids.
Hysterosalpingogram (HSG) — This is often recommended for a woman who is trying to become pregnant. During this test, an x-ray of the uterus and tubes is taken after dye is inserted through the cervix. This test can show if the tubes are open, but it also may demonstrate oif fibroids are present.
Sonohysterogram — This is a type of ultrasound in which a saline solution is inserted through the cervix. This test also may show a fibroid in the uterine cavity
Other imaging such as CT or MRI can also show fibroids
(last reviewed January 24, 2008)
Do all fibroids cause symptoms?
No. The majority of fibroids are small and do not cause any symptoms at all.
(last reviewed January 25, 2008)
What are the symptoms that can be caused by fibroids?
Some of the possible symptoms that can be caused by fibroids are as follows:
Increased uterine bleeding — This can mean both longer and/or heavier periods
Pelvic pressure and pain — The larger the fibroid is, the more likely that it will cause these types of symptoms.
Frequent urination or difficulty emptying the bladder - this would be only if the locaton of the firoid was pressing on the bladder.
Painful intercourse - especially if located near the cervix
Abdominal Pain - in rare cases, fibroids can cause sudden and severe pain if the fibroid begins to break down (degenerate) or twist.
Problems with pregnancy and fertility — In women with very large fibroids, or one's located in the cavity oif the uterus, there might be some difficulty in getting pregnant, carrying a pregnancy, or other complications such as breech presentation, premature rupture of membranes, premature labor, and placental abruption
(last reviewed January 24, 2008)
Why do some women have symptoms of fibroids, and some not?
The severity of symptoms depends on several factors. These include:
Is bleeding between periods a symptom of fibroids?
In general, bleeding between periods is not a symptom of fibroids.
(last reviewed January 24, 2008)
How are fibroids treated?
There are several ways in which fibroids can be treated. It is important to have a detailed discussion with your doctor to decide which route would be right for you. The following are many of the ways to treat fibroids:
Medical treatment — Medications called Gonadotropin-releasing hormone (GnRH) agonists are the most common medical treatment for fibroids. One common example is Leuprolide (Lupron Depot®). Most women who use GnRH agonists temporarily stop having menstrual periods and have a significant reduction in the size of their fibroid(s).
Hysterectomy — Hysterectomy is surgical removal of the uterus through the abdomen or vagina.
Abdominal myomectomy — Myomectomy is surgical removal of a fibroid.
Laparoscopic myomectomy — In this procedure, fibroids are removed through a laparoscope, a thin tube inserted through a small incision in the abdomen. A surgeon uses the laparoscope to visualize and remove the fibroids.
Hysteroscopic myomectomy — In this procedure, a telescope-like instrument (hysteroscope) is placed into the vagina, through the cervix and into the uterus. Fibroids may be seen through the hysteroscope and removed.
Uterine artery embolization — In uterine artery embolization (UAE or UFE), a small catheter is inserted in a large blood vessel and threaded up to blood vessels near a fibroid. Tiny particles are injected into the blood vessel, which stops blood flow to the fibroid.
(last reviewed January 24, 2008)
Do I definitely need to be treated for the fibroids?
No, most women with fibroids never require treatment. You will only need treatment if the symptoms are severe enough.
(last reviewed January 24, 2008)
How do I decide what type of treatment is right for me?
This requires a very detailed discussion of your problem with your doctor.
The first and most important question should be whether you desire any future pregnancies. Several procedures such as hysterectomy and embolization would be inappropriate for someone who is considering having children in the future.
There are many other factors that are also important to discuss with your doctor. These include your medical and surgical history, and the size and location of your fibroids. With a thorough discussion, you should be able to decide what is right for you.
