Hidden Away: Uterine Fibroids

Uterine fibroids are noncancerous growths of the uterus that nevertheless can become painful. They often appear during child-bearing years. Doctors still do not know what causes them.

The growths develop from the myometrium – the muscular tissue of the uterus. Their size varies from seedlings undetectable by the human eye up through masses so large that they can distort and enlarge the uterus – in extreme cases expanding the uterus so much that it reaches the rib cage.

As many as 75 percent of the female population have uterine fibroids at one point in their lives, but remain unaware because there are often no symptoms. Often times doctors will discover fibroids incidentally during a pelvic exam or prenatal ultrasound.

If you are symptomatic, expect one or more of the following:

·         Heavy menstrual bleeding

·         Prolonged menstrual periods — seven days or more of menstrual bleeding

·         Pelvic pressure or pain

·         Frequent urination

·         Difficulty emptying your bladder

·         Constipation

·         Backache or leg pains

Fibroids can cause acute pain when they outgrow their blood supply. Byproducts from a degenerating fibroid can seep into surrounding tissue, causing pain and, rarely, fever. A fibroid that hangs by a stalk inside or outside the uterus can trigger pain by twisting on its stalk and cutting off its blood supply. It is also possible, although uncommon, that fibroids could cause infertility or pregnancy loss.

Your doctor will likely prescribe an ultrasound scan or magnetic resonance imaging to confirm your condition, as well as map and measure the fibroids. Other tests may include:

·         Hysterosonography, also called a saline infusion sonogram, uses sterile saline to expand the uterine cavity, making it easier to get images of the uterine cavity and endometrium.

·         Hysterosalpingography uses a dye to highlight the uterine cavity and fallopian tubes on X-ray images.

·         Hysteroscopy, in which your doctor inserts a small, lighted telescope called a hysteroscope through your cervix into your uterus. Your doctor then injects saline into your uterus, expanding the uterine cavity and allowing your doctor to examine the walls of your uterus and the openings of your fallopian tubes.

Many women find they can live with uterine fibroids, which usually grow slowly and tend to shrink after menopause, when levels of reproductive hormones drop. But treatments are available.

·         Medications called Gn-RH agonists treat fibroids by blocking the production of estrogen and progesterone, putting you into a temporary postmenopausal state. As a result, menstruation stops, fibroids shrink and anemia often improves.

·         A progestin-releasing intra-uterine device can relieve heavy bleeding caused by fibroids. Note that this option provides symptom relief only and does not shrink fibroids or make them disappear.

Focused ultrasound surgery can destroy small areas of fibroid tissue through the use of ultrasound. This procedure in completely non-invasive. 

A myomectomy may also be performed t remove the fibroids. Depending upon their size and configuration, this surgery can be performed laparoscopically, with minimal invasion.