Uterine Fibroids

(Fibroids; Leiomyoma; Myoma; Fibromyoma)
  • Definition

    Fibroids are benign (noncancerous) growths in the wall of the uterus. The uterus is the organ where a fetus grows during pregnancy.
    Fibroids are common. They may be very small or they could grow to eight or more inches in diameter. Most fibroids remain inside the uterus. Sometimes, they may stick out and affect nearby organs. It is common for there to be more than one fibroid.
    Uterine Fibroid
    IMAGE
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  • Causes

    The cause of fibroids is unknown.
    Fibroid growth is stimulated by female reproductive hormones. As a result:
    Genetics may make some women more prone to fibroids. Substances that control blood vessel growth may also affect fibroid growth.
  • Risk Factors

    African American women are at increased risk. Other factors that affect your risk of fibroids include:
    • Risk increases with age until menopause
    • Family history
    Obesity and high blood pressure may also be linked to fibroids.
  • Symptoms

    Symptoms range from none at all to mild or severe. This depends on the size and location of the growths.
    Symptoms may include:
    • Pelvic pain
    • Feeling of pelvic pressure
    • Heavy menstrual bleeding
    • Clots in menstrual flow
    • Long periods
    • Bleeding between periods
    • Increased cramping during periods
    • Pain during sex
    • Frequent need to urinate
    • Constipation
    • Bloating
    • Abdominal swelling
    • Low back or leg pain
    • Infertility by blocking the fallopian tubes
    • Miscarriage
    Iron-deficiency anemia may develop if bleeding is heavy. This is low levels of red blood cells. It will affect the amount of oxygen your blood can carry.
  • Diagnosis

    Most fibroids are found during routine pelvic exams.
    Images may be taken of your bodily structures. This can be done with:
  • Treatment

    Most women with fibroids have no symptoms and do not need treatment. Your doctor may recommend monitoring any changes on a regular basis. Treatment may be done later if needed.
    Treatments include:
    Pain Medication
    Your doctor may recommend:
    • Over-the-counter pain relievers to ease mild symptoms
    • Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and relieve cramping
    • Prescription pain medication—If pain cannot be managed with medications above
    • Tranexamic acid to control bleeding symptoms
    Hormonal Therapy
    Hormone medications may be an option if you are not trying to become pregnant. These drugs can shrink fibroids, reduce abnormal bleeding, and lessen pain. However, fibroids can return after you stop taking the drugs. These drugs may be used to make fibroids smaller just before surgery.
    Procedures
    Surgery may be considered if:
    • The uterus becomes extremely large
    • The fibroids are interfering with fertility
    • Symptoms are severe
    Surgical procedures include:
    • Myomectomy —An incision is made in the abdomen. The fibroids are removed from the uterus.
    • Hysterectomy —The entire uterus is removed. You will be unable to have children if you have this surgery.
    Other options include:
    Other options include:
    • Uterine fibroid embolization—This is a minimally invasive procedure. It blocks blood flow to the fibroids. This will make the fibroids shrink.
    • Focused ultrasound therapy—Energy is centered on the fibroid to destroy it. This procedure may not be ideal for patients who are very overweight, have very large fibroids, or have extensive scars from prior abdominal surgeries.
    If you are diagnosed with uterine fibroids, follow your doctor's instructions .
  • Prevention

    There are no guidelines for preventing fibroids.
  • RESOURCES

    The American Congress of Obstetricians and Gynecologists http://www.acog.org

    The International Council on Infertility Information Dissemination http://www.inciid.org

    CANADIAN RESOURCES

    The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org

    Women's Health Matters http://www.womenshealthmatters.ca

    References

    Fibroids. Healthy Women website. Available at: http://www.healthywomen.org/condition/fibroids. Updated August 9, 2011. Accessed January 7, 2014.

    Uterine fibroid embolization (UFE). RadiologyInfo.org website. Available at: http://www.radiologyinfo.org/en/info.cfm?pg=ufe. Updated August 5, 2013. Accessed January 7, 2014.

    Uterine fibroids. Focused Ultrasound Foundation website. Available at: http://www.fusfoundation.org/Uterine-Fibroids/uterine-fibroids. Accessed January 7, 2014.

    Uterine leiomyoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated November 7, 2013. Accessed January 7, 2014.

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