Fibroids: Signs, Symptoms and Treatments
A fibroid is a type of non-cancerous tumor that forms in the uterus. Fibroids — also called uterine fibroids — consist of smooth muscle cells and connective tissue and can range from pea-sized to grapefruit-sized. An estimated 20 to 80 percent of women in their childbearing years have fibroids, although many women do not know it.
The reason fibroids develop is still not fully understood. However, what is known are the types of women most at risk of developing them. Women most at risk are:
- Nearing menopause
Symptoms of Uterine Fibroids
Some women have no symptoms at all, while others’ symptoms are severe. And although every woman experiences a unique set of symptoms, some of the more common ones include:
- Abnormal bleeding
- Frequent need to urinate
- Heavy or prolonged menstrual periods
- Lower back pain
- Painful intercourse
- Pelvic pain
Fibroids Are Usually Found During a Pelvic Exam
Fibroids are most often discovered during routine pelvic exams. However, only about one-third of fibroids are large enough to be detected during an exam. If a gynecologist believes a woman may have fibroids but does not detect them during a pelvic exam, the doctor may schedule an imaging test such as an x-ray, ultrasound or MRI.
Examples of other possible tests a gynecologist may recommend are:
- Hysteroscopy: A procedure in which an instrument called a hysteroscope is inserted into the vagina so the gynecologist can see the canal of the cervix and the inside of the uterus.
- Endometrial Biopsy: A procedure in which the doctor numbs the cervix, inserts a thin tube into the cervix and gently suctions out a tissue sample from the uterine lining.
- Hysterosalpingography: A type of x-ray exam that uses dye and records images of the uterus and fallopian tubes.
Deciding to Treat Fibroids or Wait
Most fibroids stop growing or may even shrink as a woman approaches menopause, so a gynecologist may recommend waiting and monitoring fibroids versus treating them. However, if a woman has fibroids that are very large or are causing pain and severe symptoms, a gynecologist may recommend treatment.
When deciding whether or not to treat fibroids, it’s important for a woman to communicate closely with her doctor and discuss things such as:
- Overall health
- Severity of symptoms
- Available medications, procedures or therapies
- Plans for future pregnancies
Types of Treatment
If the gynecologist and patient decide to move forward with treatment, there are surgical, minimally invasive and non-surgical options that can include:
- Hysterectomy: Surgical removal of the uterus, which also removes the fibroids
- Myomectomy: Removes the fibroids, but leaves the uterus intact so a future pregnancy is possible
- Uterine artery embolization: A process in which the arteries supplying blood to the fibroids are identified and then embolized (blocked). Because the blood supply to the fibroids is blocked, the fibroids shrink.
- Endometrial ablation: The lining of the uterus is removed or destroyed.
- Anti-hormonal agents: A gynecologist may prescribe an anti-hormonal agent, like progestin, or a gonadotropin-releasing hormone (GnRH) agonist. These medications cause estrogen and progesterone levels to fall, which stops menstruation. This in turn causes fibroids to shrink. Additionally, it can improve associated anemia. While these prescriptions can help reduce symptoms of fibroids, they are often used temporarily or prior to surgery or embolization to help with pain or symptom relief.
For More Information
Visit womenshealth.gov to read frequently asked questions and to learn more about fibroid treatment methods. If you are experiencing any symptoms, schedule an appointment with one of our physicians today.