Uterine Fibroids

What are uterine fibroids?

Uterine fibroids are growths inside the uterus. They are non-cancerous, and they often occur in women of childbearing age (18 to 40). Fibroids are also called leiomyomas or myomas. Uterine fibroids rarely develop into cancer and having fibroids does not increase a woman’s risk of uterine cancer.

There are different classifications of uterine fibroids – intramural fibroids (developing in the uterine wall), submucosal fibroids (protruding into the uterine cavity), and subserosal fibroids (bulging outside of the uterus).

How big are uterine fibroids?

Uterine fibroids range in size from very small – so small they can’t be seen without magnification – to so large that they enlarge the size of the uterus. Women can have only one fibroid or multiple fibroids. 

What causes uterine fibroids?

The exact cause of uterine fibroids is not known. Experts believe that uterine fibroids begin in a stem cell in the myometrium, which is the smooth muscles of the uterus. As this cell divides, it creates a mass that is different from the nearby tissue. This mass is a uterine fibroid. 

There are some factors that seem to increase a woman’s risk for developing fibroids.

  • Hormones – two reproductive hormones, estrogen and progesterone, may promote the growth of uterine fibroids. This may have something to do with the fact that these hormones play a direct role in preparing the lining of the uterus for pregnancy each month. 
  • Genetic changes – Many uterine fibroids have genetic differences from the normal cells that make up uterine muscles.
  • Other growth factors – Some substances that help the body build and maintain tissue may contribute to fibroid growth.

How are uterine fibroids detected?

Some uterine fibroids may never be detected, but larger fibroids or those that cause symptoms are often felt during a pelvic exam or seen on an imaging test, like an ultrasound. 

What are some common symptoms of uterine fibroids?

Most fibroids don’t cause any symptoms, so they often go undetected. If you do have symptoms, you may experience:

  • Heavy bleeding during menstruation
  • Longer than normal menstrual cycles (more than a week)
  • Pelvic pain
  • Pelvic pressure
  • Urinary problems, like frequent urination or difficulty emptying the bladder all the way
  • Constipation
  • Back or leg pain

Women who bleed excessively from fibroids may become anemic due to blood loss. 

Who is at risk for developing uterine fibroids?

There are not many known risks for developing uterine fibroids. Any woman of reproductive age may develop them. It does seem that there are a few factors that may increase your risk. Those are:

Family history and heredity: If your mother or a sister has or had fibroids, your risk may be greater.

Race: African American women are at higher risk for developing uterine fibroids, and if they do develop them, they’re more likely to have larger fibroids or multiple fibroids. 

Other factors that may have an impact on developing fibroids:

  • Early onset of menstruation
  • Hormonal birth control use
  • Obesity
  • Vitamin D deficiency
  • Alcohol consumption
  • A diet high in red meat and low in fruit, green vegetables, and dairy

Is there a way to avoid uterine fibroids?

There is no known way to avoid developing uterine fibroids as long as you have your uterus. However, maintaining a healthy weight and making certain lifestyle choices (like eating a diet high in vegetables and fruits and low in red meat) may decrease your risk.

Treatment for uterine fibroids

Many women who have uterine fibroids do not need treatment. However, if you have fibroids, and they are causing concerning symptoms, you should talk with your doctor about a treatment plan. 

There are many treatment options. 

Medications

Medications can be used to affect estrogen and progesterone, which can help reduce symptoms like heavy menstrual periods and pressure or pain in the pelvic region. Medications do not remove fibroids, but they may reduce them in size. Medication options include:

  • Gonadotropin-releasing hormone (Gn-RH) agonists, which block the production of estrogen and progesterone and fool your body into thinking you’re in a postmenopausal state. When menstruation stops due to the medications, the fibroids tend to shrink. 
  • Progestin-releasing intrauterine device (IUD), which can reduce fibroid-induced bleeding. It does not shrink fibroids, and it has a sometimes unwanted effect of preventing pregnancy. 
  • Tranexamic acid, which helps ease heavy bleeding during menstruation. It is only taken on days when you experience heavy bleeding.
  • Other medications may be recommended to help control bleeding or reduce pain.

Non-invasive procedure

Focused ultrasound surgery (FUS) is a non-invasive, outpatient procedure offered to treat uterine fibroids without using a surgical incision or removing the uterus. It uses an MRI scanner to show the doctor where your fibroids are located. The doctor then uses ultrasound technology to deliver sound waves to the fibroids, which heats the tissue and destroys it.

Minimally invasive procedures

Minimally invasive procedures treat uterine fibroids by destroying or shrinking them, and they do not require traditional surgical incisions. They include:

  • Uterine fibroid embolization (UFE) (also known as uterine artery embolization or UAE) is a minimally invasive procedure done to block blood flow to fibroids with the goal of shrinking them and reducing or eliminating associated symptoms. It is performed by an interventional radiologist (a physician who specializes in using radiology to perform medical procedures without a surgical incision). 
  • Laparoscopic or robotic myomectomy
  • Hysteroscopic myomectomy
  • Endometrial ablation

Traditional surgical procedures

Some women may need to have traditional surgery to remove or otherwise treat uterine fibroids. The most common traditional surgical options are:

  • Abdominal myomectomy
  • Hysterectomy

Find an OB-GYN that treats uterine fibroids, call 800-633-7377, or make an appointment with an Interventional Radiologist.