Fibroids

Uterine fibroids are benign growths that develop from the muscle tissue of the uterus. They also are called leiomyomas or myomas. The size, shape, and location of fibroids can vary greatly. They may be inside the uterus, on its outer surface or within its wall, or attached to it by a stem-like structure. A woman may have only one fibroid or many of varying sizes. A fibroid may remain very small for a long time or grow slowly over a number of years. 

Fibroids

Uterine fibroids are benign growths that develop from the muscle tissue of the uterus. They also are called leiomyomas or myomas. The size, shape, and location of fibroids can vary greatly. They may be inside the uterus, on its outer surface or within its wall, or attached to it by a stem-like structure. A woman may have only one fibroid or many of varying sizes. A fibroid may remain very small for a long time or grow slowly over a number of years. 

Fibroids are most common in women aged 30–40 years, but they can occur at any age. Fibroids occur more often in African American women than in white women. They also seem to occur at a younger age and grow more quickly in African American women.

Frequently Asked Questions

Fibroids may have the following symptoms: 

  • Changes in menstruation
    • —Longer, more frequent, or heavy menstrual periods
    • —Menstrual pain (cramps) 
    • —Vaginal bleeding at times other than menstruation
    • —Anemia(from blood loss)
  • Pain
    • —In the abdomen or lower back (often dull, heavy and aching, but may be sharp) 
    • —During sex
  • Pressure
    • —Difficulty urinating or frequent urination 
    • —Constipation, rectal pain, or difficult bowel movements 
    • —Abdominal cramps
  • Enlarged uterus and abdomen 
  • Miscarriages 
  • Infertility 

Fibroids also may cause no symptoms at all. Fibroids may be found during a routine pelvic exam or during tests for other problems.

Fibroids that do not cause symptoms, are small, or occur in a woman who is nearing menopause often do not require treatment. Certain signs and symptoms may signal the need for treatment:

  • Heavy or painful menstrual periods that cause anemia or that disrupt a woman’s normal activities 
  • Bleeding between periods 
  • Uncertainty whether the growth is a fibroid or another type of tumor, such as an ovarian tumor 
  • Rapid increase in growth of the fibroid 
  • Infertility 
  • Pelvic pain 

Myomectomy is the surgical removal of fibroids while leaving the uterus in place. Because a woman keeps her uterus, she may still be able to have children. Fibroids do not regrow after surgery, but new fibroids may develop. If they do, more surgery may be needed.

Hysterectomy is the removal of the uterus. The ovaries may or may not be removed. Hysterectomy is done when other treatments have not worked or are not possible or the fibroids are very large. A woman is no longer able to have children after having a hysterectomy. 

Other treatment options are as follows: 

Hysteroscopy—This technique is used to remove fibroids that protrude into the cavity of the uterus. A resectoscope is inserted through the hysteroscope. The resectoscope destroys fibroids with electricity or a laser beam. Although it cannot remove fibroids deep in the walls of the uterus, it often can control the bleeding these fibroids cause. Hysteroscopy often can be performed as an outpatient procedure (you do not have to stay overnight in the hospital). 

Uterine artery embolization (UAE)—In this procedure, tiny particles (about the size of grains of sand) are injected into the blood vessels that lead to the uterus. The particles cut off the blood flow to the fibroid and cause it to shrink. UAE can be performed as an outpatient procedure in most cases.

Magnetic resonance imaging-guided ultrasound surgery—In this new approach, ultrasound waves are used to destroy fibroids. The waves are directed at the fibroids through the skin with the help of magnetic resonance imaging. Whether this approach provides long-term relief is currently being studied.

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