What are fibroids?
Fibroids are firm, compact growths that occur in or on the wall of the uterus. More than 99 percent are noncancerous, or benign, and do not increase your risk of developing uterine cancer.
Fibroids consist of smooth muscle cells that line the uterus and dense connective tissue. They can range from the size of a pea to the size of an orange. About 40 to 80 percent of women in their reproductive years have fibroids, according to the National Institutes of Health.
While the cause of fibroids is not completely understood, the sex hormone estrogen contributes to their growth. As women approach menopause and their estrogen levels decline, fibroids tend to shrink.
What symptoms do fibroids cause?
Fibroids often don’t cause symptoms. When symptoms do occur, they can vary in intensity and may include:
- Heavy or long menstrual periods
- Unusual bleeding between periods
- Pelvic pain, which is caused by the fibroid pressing on the uterus and nearby organs
- Severe cramping during periods
- Lower back pain
- Pain during sex
- Frequent urination because of a fibroid pushing on the bladder
- A firm mass in the pelvis, which your doctor can feel
Sometimes heavy or prolonged periods or bleeding between periods can lead to low red-blood cell counts (anemia), which also requires treatment.
How are fibroids diagnosed and treated?
Your doctor can sometimes detect fibroids during a routine pelvic exam. In addition to asking about your symptoms, your doctor may perform a transvaginal ultrasound, which uses sound waves to create pictures of the pelvic area, or other imaging tests.
Treatment for uterine fibroids is typically only necessary if they are causing symptoms. The type of therapy you and your doctor choose may depend on whether you have plans to become pregnant. While most women with fibroids can become pregnant without any problems, large fibroids can interfere with fertility.
Therapies for fibroids may include:
- Anti-inflammatory pain relievers. Non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen or naproxen can help to relieve pelvic pain and discomfort.
- Iron supplements. Women with anemia may need to take an iron supplement to boost red blood cell levels.
- Hormonal therapies. Birth control pills and other forms of oral contraception can help relieve heavy bleeding from fibroids. Androgens, or male sex hormones, can stop menstruation, correct anemia and shrink fibroids. Other drugs called gonadotropin-releasing hormone agonists (GnRH agonists) lower estrogen levels, creating a mini-menopause and helping to shrink fibroids.
- Uterine fibroid embolization. For this procedure, doctors find and block the arteries supplying blood to fibroids. This cuts off their blood supply and shrinks them.
- MR-guided focused ultrasound. This therapy uses sound waves to destroy the fibroids under real-time imaging of the treated tissue.
- Myomectomy. This is a conservative surgical therapy, in which doctors remove fibroids but leave the uterus intact so women have the option of becoming pregnant.
- Hysterectomy. Hysterectomies involve the surgical removal of the entire uterus.