Often the first time a woman learns she has uterine fibroids is during a pelvic exam or ultrasound. Whether you've just been diagnosed with fibroids or you've known for years that you have them, you may have some questions. Learning more about fibroids can help you explore your options.
What are fibroids?
Fibroids are growths in the uterus. They're made up of muscle cells and other tissues. Your doctor may call them fibroid tumors, but they are almost always benign (not cancerous) and they don't raise your risk for uterine cancer.
Who gets fibroids?
Fibroids are very common in women between the ages of 30 and 50. After menopause, fibroids usually shrink. It's estimated that as many as half of all women have fibroids, but most of them don't know it.
Experts are not sure what causes fibroids. They do know that they tend to run in families and they are more common in obese women. Women who eat red meat seem to have a higher risk of fibroids and women who eat a lot of green vegetables appear to have a lower risk.
For reasons that aren't known, African American women get fibroids much more often and at a younger age than women of other races.
What are the symptoms?
Fibroids don't usually cause any symptoms. When they do cause symptoms, though, some of the most common include:
- Heavy periods or bleeding between periods
- Pain, pressure, or fullness in the lower belly
- A frequent need to urinate
- Pain during sex
- Low back pain
Fibroids can cause infertility or pregnancy problems, such as miscarriage or premature labor. These problems are fairly rare, though.
Whether fibroids cause symptoms usually depends on:
- Where they are located. Fibroids grow in three different areas: on the inside of the uterus, in the walls of the uterus, and on the outside of the uterus.
- How big they are. Fibroids can range in size from as small as a seed to as large as a grapefruit.
For instance, a large fibroid on the outside of your uterus may press on your bladder and cause urinary problems. A fibroid inside your uterus, even if it's small, may cause heavy menstrual bleeding.
Many other conditions can cause symptoms like those of fibroids. A doctor may want to do some tests to be sure of the diagnosis. These might include ultrasound, MRI, CT scan, or laparoscopy.
Treatments for uterine fibroids
If you have no symptoms, you probably don't need any treatment. Your doctor can check your fibroids during your regular exams to see if they've grown. In most cases, fibroids grow slowly and stop growing or shrink after menopause.
In the past, many women with fibroids had hysterectomies to cure their symptoms. Fibroids are still one of the main reasons women have this surgery. Yet there are several other treatment options you can consider. Your doctor can help you understand your choices along with their risks and benefits.
- Over-the-counter pain relievers, such as ibuprofen (Motrin or Advil), which can reduce menstrual pain
- Birth control pills, which make periods lighter and relieve menstrual pain
- Hormone therapy, which may be used for a short while to shrink fibroids before hysterectomy
- Hysterectomy, which removes the whole uterus. This is the only sure way to get rid of fibroids, but it ends your ability to get pregnant.
- Myomectomy, which removes only the fibroids and spares the uterus.
Nonsurgical treatments include:
- Uterine fibroid embolization, which shrinks fibroids by blocking their blood supply.
- Endometrial ablation, which destroys a fibroid found inside the uterus as well as the lining of the uterus.
- Myolysis, which uses a laser or heat to destroy fibroids.
- MRI-guided focused ultrasound, which uses ultrasound to destroy fibroids. This newer technique shows promise but is not yet widely available.
As you consider your choices, think about:
- How severe your symptoms are
- Whether you hope to get pregnant
- How you would feel about having your uterus removed
- How close you are to menopause, when your symptoms may go away on their own
Created on 12/07/2007
Updated on 03/02/2011
- U.S. Food and Drug Administration. Fibroids.
- American College of Obstetricians and Gynecologists. Birth control pills.
- National Women's Health Information Center. Uterine fibroids.