Uterine fibroids are noncancerous growths. Fibroids may be discovered during a pelvic examination. If your doctor suspects a fibroid in your uterus, she will likely recommend an ultrasound. This painless test uses sound waves to create a picture of the uterus, and helps detect uterine growths. Fibroids are measured during the test, and their location in the uterus is determined. Uterine fibroids might be found unexpectedly if an ultrasound is performed for another medical reason.
Cause and Occurrence
While the cause of uterine fibroids is unknown, their growth seems to depend on the hormone estrogen. These tumors are rare in women under 20 years of age, and are most common in women over 30. They occur more often in African American women than in Caucasian women. Fibroids often get smaller and eventually go away after menopause. Fibroids can be so small that they need to be viewed through a microscope, and in other cases can fill the uterus entirely and weigh several pounds. Often more than one fibroid develops.
Symptoms
The symptoms of uterine fibroids include heavy bleeding during menstrual periods, periods that last longer than usual and painful periods. Bleeding between periods can occur as well. Less common symptoms include a feeling of pressure in the lower abdominal area, abdominal gas or constipation, and pain during intercourse. Sometimes there are no symptoms at all.
Nonsurgical Treatments
Treatment depends on your health, age, whether you are pregnant, if you plan to have children in the future, the type of fibroids and the severity of the symptoms. Some physicians may recommend a watch-and-wait approach to fibroids, because they often grow slowly and will usually shrink after menopause. Nonsurgical treatments include intrauterine devices to reduce pain and bleeding; nonsteroidal anti-inflammatories, such as ibuprofen, for pain; iron supplements to treat any anemia; and birth control pills, which help lighten heavy periods. Hormonal medications may be recommended to shrink the fibroids. This short-term treatment is often used if a patient is nearing menopause or before surgery.
Surgical Treatments and Procedures
Your doctor may recommend a uterine artery embolization as a means of stopping the blood supply to a fibroid. This procedure is not used to treat large fibroids, and is not used for women who want more children. Myomectomy is a surgical procedure to remove fibroids. It is often the choice of women who want to have children, because it is not likely to affect fertility. For an outpatient procedure called a hysteroscopic resection, the doctor uses instruments and a small camera inserted into the uterus through the cervix to remove fibroids. If medications are not effective and other procedures are not possible, a hysterectomy may be recommended. This is an invasive surgical treatment to remove the uterus. You may be offered the option of keeping your ovaries if you choose this procedure.
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