Uterine Fibroids

Uterine fibroids at a glance

  • Uterine fibroids are common benign (noncancerous) tumors that develop in the uterus.
  • If fibroids bulge into the uterine cavity or are located inside the uterus, they can impair fertility or cause miscarriages.
  • Depending on the severity of the fibroid and rate of growth, some women may only need pelvic exams or ultrasounds once in a while to monitor the fibroid’s growth; however, surgery may be needed to remove the fibroid, especially if it is hampering fertility.

What are uterine fibroids?

Uterine fibroids are benign (noncancerous) tumors that develop in the uterus. Fibroids are fairly common – up to one in five women may develop fibroids during their fertile years, and up to 50 percent of women have fibroids by age 50 (fibroids are rare in women under age 20, and are more common in African Americans). As long as a woman is menstruating, a fibroid can grow slowly over time. Fibroids are generally so tiny only a microscope can detect them. However, they can grow very large, sometimes weighing several pounds.

If fibroids bulge into the uterine cavity or are located inside the uterus, they can impair fertility or cause miscarriages. Fibroid location may vary in the uterus, but fibroids that affect fertility are typically those that grow so large they distort the shape of the uterine cavity or are within the cavity itself.

The cause of uterine fibroids is unknown, but their presence has been linked to the estrogen hormone. A physician may detect them during a physical exam, ultrasound, or magnetic resonance imaging (MRI); however, fibroids can be difficult to diagnose, especially if the woman is extremely overweight.

Symptoms

Uterine fibroids often do not have accompanying symptoms, but the more common symptoms are:

  • Heavy menstrual bleeding, sometimes with the presence of blood clots
  • Longer than normal menstrual periods
  • Pelvic cramping or pain during periods
  • Bleeding between periods
  • Frequent urination
  • Sensation of fullness or pressure in lower abdomen
  • Pain during intercourse

Uterine Fibroids Treatment

Treatment depends on several things, including:

  • Age
  • General health
  • Severity of symptoms
  • Type of fibroids
  • If the woman is pregnant
  • If the woman wants children in the future

Depending on the severity of the fibroid and rate of growth, some women may only need pelvic exams or ultrasounds once in a while to monitor the fibroid’s growth. Fibroids symptoms can be treated by:

  • Birth control pills (oral contraceptives) for heavy periods
  • Iron supplements, which prevent or treat anemia due to heavy periods
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) for cramps or pain, such as ibuprofen or naprosyn
  • Intrauterine devices (IUDs) that can reduce heavy bleeding and pain by releasing the progestin hormone
  • Short-term hormonal therapy injections to help shrink the fibroids

If a physician deems it necessary, the following four main surgical procedures are used to remove fibroids:

  • Hysteroscopic resection of fibroids: an outpatient procedure that removes fibroid tumors growing inside of the uterine cavity.
  • Uterine artery embolization: a procedure that causes the fibroid to die and shrink by cutting off the blood supply. Women who may want to become pregnant in the future should probably avoid this approach.
  • Myomectomy: removes the fibroid, often in an attempt to restore or preserve fertility. However, more fibroids can develop after the procedure. Myomectomy may preserve or restore fertility, but all options should be discussed with the consulting fertility specialist.
  • Hysterectomy: an invasive surgery to remove the uterus. This is used when medicines do not work and other procedures are not a viable option.