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 fallopian tubes.
• 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
• Infertility
• 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 fibroids.