Uterine Fibroids: What women should know

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What is a Uterine Fibroid?

A uterine fibroid is a noncancerous, or benign, tumor that grows in or around a woman’s uterus during the reproductive stages of her life. It may also be referred to as a myoma, fibromyoma, or leiomyoma.

How Do Uterine Fibroids Form?

Uterine fibroids can develop anywhere in the uterus, and even in the cervix. They can develop within the uterus and also outside of the uterus. The type of uterine fibroid a woman has depends on where in the uterus the fibroid has developed. There are three main types of uterine fibroids:

1. Intramural fibroid – develops in wall of the muscle within the uterus

2. Submucosal fibroid – develops and grows into the uterus’ inner cavity 

3. Subserosal fibroid – develops and grows outside of the uterus

Who is at risk for uterine fibroids?

Uterine fibroids are actually very common and are found in more than one-third of women during the reproductive stages of their lives, otherwise known as their childbearing years. They affect about 20 percent of women. Women are at a higher risk for uterine fibroids if they have the following risk factors:

  • African-American women are 2-3 times more likely than Caucasian women to develop uterine fibroids 
  • 30 years old or older
  • Overweight or obese
  • Have never given birth
  • Have a family history of uterine fibroids
  • Have been using birth control pills since an early age, such as 13-16 years old
  • Got their period at an early age, such as younger than 10 years old

What causes uterine fibroids?

The cause of uterine fibroids is unknown. However, they may be related to the amount of estrogen women have. When women have a high level of estrogen, such as during their childbearing years, fibroids tend to gradually increase in size. Afterwards, during a woman’s menopausal years, women have low levels of estrogen. During menopause, fibroids are not often found.

Uterine Fibroids Signs and Symptoms

Not all women will experience the same signs and symptoms of uterine fibroids. Some women may experience them more frequently or less frequently, while some women may have no symptoms at all. While as many as three out of four women have uterine fibroids, many are often unaware that they have them because they may not have any signs or symptoms. For the women that do experience signs and symptoms, these are the most common:

  • Heavy menstrual bleeding
  • Abdominal or pelvic pain
  • Abnormal vaginal bleeding, such as prolonged menstrual periods or irregular bleeding between periods
  • Pelvic pressure
  • Difficulty urinating and urinary frequency
  • Pain during sexual intercourse
  • Lower back pain
  • Complications with pregnancy, such as infertility, miscarriage, or early labor

Uterine Fibroids Diagnosis

Because not all women experience signs and symptoms of uterine fibroids, they may be detected otherwise, such as during a routine pelvic exam. The traditional ways to diagnose uterine fibroids include transvaginal ultrasound, sonohysterogram, MRI, hysterosalpingogram, hysteroscopy, or endometrial biopsy.

Treatment

The following options are available for treatment of uterine fibroids. Depending in the type of uterine fibroid and the severity of your condition, signs and symptoms, your doctor may recommend one of the following treatment options:

  • Watchful waiting

    • —This is for women with minimal or no symptoms or are close to menopause. Watchful waiting includes regular pelvic exams to monitor fibroid growth and symptoms. After menopause, the decrease in estrogen and progesterone levels will cause most fibroids to shrink and get rid of symptoms.

  • Medications

Oral contraceptives or progestins may be given to help control menstrual bleeding, but they don't reduce fibroid size. 

—Gonadotropin-releasing hormone agonist

—Progestin-releasing intrauterine device 

  • Noninvasive procedures

    —MRI-guided focused ultrasound surgery

    —Minimally invasive procedures

    —Uterine artery embolism

    —Myolysis

    —Laparoscopic or robotic myomectomy 

    —Hysteropscopic myomectomy 

    —Endometrial ablation and resection of submucosal fibroids

    —Standard surgical procedures

    —Abdominal myomectomy

        —Hysterectomy