Fibroids are abnormal
growths that develop in or on a woman’s uterus. Sometimes, these tumors become
quite large and cause severe abdominal pain and heavy periods. In other cases,
they cause no signs or symptoms at all. The growths are typically benign (noncancerous).
The cause of fibroids is unknown.
According to the National
Institutes of Health (NIH), about 70 to 80 percent of women have them by the age of 50.
Different fibroids develop
in different locations in and on the uterus.
Intramural fibroids are
the most common type of fibroid. These types appear within the lining of the
uterus (endometrium). Intramural fibroids may grow larger and actually stretch
Subserosal fibroids form
on the outside of your uterus, which is called the serosa. They may grow large
enough to make your womb appear bigger on one side.
When subserosal tumors
develop a stem (a slender base that supports the tumor), they become
These types of tumors
develop in the inner lining (myometrium) of your uterus. Submucosal tumors are
not as common as other types, but when they do develop, they may cause heavy
menstrual bleeding and trouble conceiving.
It is unclear why fibroids
develop, but several factors may influence their formation.
Estrogen and progesterone
are the hormones produced by the ovaries. They cause the uterine lining to
regenerate during each menstrual cycle and may stimulate the growth of
Fibroids may run in the
family. If your mother, sister, or grandmother has a history of this condition,
you may develop it as well.
Pregnancy increases the
production of estrogen and progesterone in your body. Fibroids may develop and
grow rapidly while you are pregnant.
Is at Risk for Fibroids?
Women are at greater risk
for developing fibroids if they have one or more of the following risk factors:
- a family history of fibroids
- being over the age of 30
- being of African-American descent
- having a high body weight
Are the Symptoms of Fibroids?
Your symptoms will depend
on the location and size of the tumor(s) and how many tumors you have. If your
tumor is very small, or if you are going through menopause, you may not have
any symptoms. Fibroids may shrink during and after menopause.
Symptoms of fibroids may
- heavy bleeding between or during your periods
that includes blood clots
- pain in the pelvis and/or lower back
- increased menstrual cramping
- increased urination
- pain during intercourse
- menstruation that lasts longer than usual
- pressure or fullness in your lower abdomen
- swelling or enlargement of the abdomen
Are Fibroids Diagnosed?
You will need to see a
gynecologist to get a pelvic exam. This exam is used to check the condition,
size, and shape of your uterus. You may also need other tests, which include:
An ultrasound uses high frequency
sound waves to produce images of your uterus on a screen. This will allow your
doctor to see its internal structures and any fibroids present. A transvaginal
ultrasound, in which the ultrasound wand (transducer) is inserted into the
vagina, may provide clearer pictures since it is closer to the uterus during
This in-depth imaging
testing produces pictures of your uterus, ovaries, and other pelvic organs.
Are Fibroids Treated?
Your doctor will develop a
treatment plan based on your age, the size of your fibroid(s), and your overall
health. You may receive a combination of treatments.
Medications to regulate
your hormone levels may be prescribed to shrink fibroids. Gonadotropin-releasing hormone (GnRH)
agonists, such as leuprolide (Lupron), will cause your estrogen and
progesterone levels to drop. This will eventually stop menstruation and shrink
Other options that can
help control bleeding and pain, but will not shrink or eliminate fibroids,
intrauterine device (IUD) that releases the hormone progestin
anti-inflammatory pain relievers, such as ibuprofen
- birth control
Surgery to remove very
large or multiple growths (myomectomy) may be performed. An abdominal
myomectomy involves making a large incision in the abdomen to access the uterus
and remove the fibroids. The surgery can also be performed laparoscopically,
using a few small incisions into which surgical tools and a camera are
Your physician may perform
a hysterectomy (removal of your uterus) if your condition worsens, or if no
other treatments work. However, this means that you will not be able to bear
children in the future.
Minimally Invasive Procedures
A newer and completely noninvasive
surgical procedure is forced ultrasound surgery (FUS). You will lie down inside
a special MRI machine that allows doctors to visualize the inside of your
uterus. High-energy, high-frequency sound waves will be directed at the
fibroids to destroy (ablate) them.
shrinks fibroids using an electric current or laser, while cryomyolysis freezes
the fibroids. Endometrial ablation involves inserting a special instrument into
your uterus to destroy the uterine lining using heat, electric current, hot
water, or microwaves.
Can Be Expected in the Long Term?
Your prognosis will depend
on the size and location of your fibroids. Fibroids may not need treatment if
they are small or do not produce symptoms. If you are pregnant and have
fibroids, or become pregnant and have fibroids, your physician will carefully
monitor your condition. In most cases, fibroids do not cause problems during
pregnancy. Speak with your doctor if you expect to become pregnant and have