What Are Uterine Fibroids
Uterine fibroids are benign or not cancerous growths in the uterus.
They occur in about 20-25 percent of women. Fibroids are most common
in women between 30-40 years age but can occur at any age. Many
women who have fibroids are unaware of them because the growths
can remain small and not cause a problem. Fibroids however can cause
problems due to their size, number and location.
Types of Fibroids
Uterine fibroids are growths that develop from the cells that make
up the muscle of the uterus. The size, shape and location of the
fibroids can vary. They may occur inside the uterus, on its outer
surface or within the walls. Fibroids can range in size from pea-sized
growths to large melon sized growths. As fibroids grow they can
distort the inside as well as the outside of the uterus and can
completely fill the pelvis and abdomen. Fibroids can occur singly
or in multiples of varying sizes. Whether they will occur singly
or in groups, fibroid growth is unpredictable. They may remain very
small for a long time, suddenly grow rapidly, or grow slowly over
a number of years.
Causes of Fibroids
Although fibroids are quite common, little is known about what causes
them. The female hormone estrogen seems to increase their growth.
Symptoms of Fibroids
Often fibroids, even large ones, produce no symptoms. However when
symptoms do occur the following are most often seen:
- Heavy Periods
- Longer and More Frequent Periods
- Vaginal Bleeding Between Periods
- Menstrual Pain or Cramps
- Abdominal, Pelvic or Back Pain
- Pain During Sex
- Difficulty Urinating or Frequent Urination
- Constipation, Rectal Pain or Difficult Bowel Movements
- Abdominal Cramps
Diagnosis of Fibroids
Most fibroids may not have symptoms. Routine pelvic exam can be
the first detection of fibroids. Other tests that can be used to
obtain more information about the fibroid include the following:
- Ultrasound uses sound waves to create a picture of the
uterus or of the pelvic organs. It can identify the size and number
or fibroids as well as checking the growth.
- Hysterosalpingogram is a special x-ray test that can
detect abnormal changes in the size and shape of the uterus and
- Computed Tomography (CT) Scan and Magnetic Resonance Imaging
(MRI) are special imaging techniques that may also be used
to help visualize the fibroids but are rarely needed.
Complications of Fibroids
Although most fibroids do not cause problems, there can be complications.
Fibroids that are attached to the uterus by a stem may twist which
can cause pain, nausea or fever. Fibroids may become infected but
usually occurs only when there is an infection already in the area.
In very rare cases (much less than 1 percent) changes occur which
cause it to become malignant or cancerous. Very rapid growth of
the fibroid may signal this type of change. Fibroids may also cause
infertility by distorting the uterus and fallopian tubes If fibroids
are the cause of infertility, the treatment of the fibroid will
often result in pregnancy.
Treatment of Fibroids
Fibroids that do not cause symptoms or women nearing menopause often
do not require treatment. Certain signs and symptoms, however, may
signal the need for treatment.
- Heavy or painful menstrual periods
- Bleeding between periods
- Uncertainty about whether the growth is a fibroid or another
type of tumor.
- Rapid increase in growth of the fibroid
- Pelvic pain
Treatment for fibroids usually involves removing them with surgery.
Drugs, such as gonadotropin - releasing hormone (RnRH) agonist,
may be used to shrink the fibroids temporarily and to control bleeding.
The fibroids may be removed with myomectomy or hysterectomy. The
choice usually depends on patients wishes and desire to preserve
fertility as well as medical advice about size and location of the