Uterine fibroids are benign growths that are made up of the muscle and connective tissue from the wall of the uterus (womb). Fibroids may grow as a single nodule or in clusters and may range in size from 1 mm to more than 20 cm (8 inches) in diameter. They may grow within the wall of the uterus or they may project into the interior cavity or toward the outer surface of the uterus. In rare cases, they may grow on stems projecting from the surface of the uterus. Each patient with fibroids may have varying symptoms, sizes, number, and location. Each fibroid is unique and one of a kind, which requires individualization of therapeutic options.
What causes uterine fibroids?
The causes of fibroids are not known. Most fibroids occur in women of reproductive age, and according to some estimates, they are diagnosed in black women 2-3 times more frequently than in white women. They seldom are seen in young women who have not begun to menstruate. The symptoms of uterine fibroids usually stabilize or go away in women after menopause.
According to the U.S. National Institutes of Health (NIH), at least 25%-80% of women suffer from uterine fibroids.
Are fibroids cancer?
It is extremely rare for a fibroid to undergo malignant or cancerous changes. In fact, one out of 350 women with fibroids will develop malignancy. There is no test that is 100% predictive in detecting rare fibroid related cancers. However, patients who have rapid growth of uterine fibroids, or fibroids that grow during menopause, should be evaluated immediately.
Who is at risk for uterine fibroids?
Risk factors for uterine fibroids include obesity, family history, not having children, early onset of menstruation, and late age for menopause. (A person is considered obese if he or she is more than 20% over his or her ideal body weight.)
What are the symptoms of uterine fibroids?
Most fibroids do not cause any symptoms and do not require treatment other than regular observation by a doctor. Fibroids may be discovered during routine gynecologic examinations or during prenatal care. Some women who have uterine fibroids may experience the following symptoms:
- Excessive or painful bleeding during menstruation
- Bleeding between periods
- A feeling of fullness in the lower abdomen
- Frequent urination resulting from a fibroid that compresses the bladder
- Pain during sexual intercourse
- Low back pain
- Chronic vaginal discharge
- Inability to urinate
- Severe menstrual cramps
How are uterine fibroids treated?
More and more, doctors are beginning to realize that uterine fibroids may not require any intervention or, at most, limited treatment. For a woman with uterine fibroids that are not causing symptoms, the best therapy may be watchful waiting. Periodic pelvic examination and ultrasound may be recommended by your physician, depending on the size or symptoms of the fibroid. Some women never exhibit any symptoms nor have any problems associated with fibroids, in which case no treatment is necessary.
If a woman is experiencing anemia caused by heavy, prolonged menstrual bleeding; moderate to severe pain; infertility; or urinary tract or bowel problems; then she will require evaluation. The type of treatment offered is determined by the number, size, location, and symptoms related to fibroids. Additionally, the desire for fertility will also determine whether certain options are feasible. Treatment options include:
- Laparotomy, which involves an abdominal incision to remove all fibroids, no matter the size or location of the tumors. Today, laparotomy is more often used when the fibroids are too numerous to be removed with minimally invasive technology.
Uterine Fibroid embolization. This procedure is performed by an interventional radiologist who works in collaboration with your gynecologist. A small catheter is placed in the uterine artery and small particles are used to block the flow of blood from the uterine artery to the fibroids. Loss of blood flow, shrinks the fibroids and thus improves symptoms. The procedure is performed with mild sedation and takes 60-90 minutes. Patients are typically able to return home the day after the procedure and back to work and activity in 10-14 days. This treatment is not offered to women who want children.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/5/2017…#9130