As many as 40 percent of women older than age 30 have a condition known as uterine fibroids. In most women, the fibroids are harmless growths that don’t interfere with their daily lives. But in some instances, when the fibroids grow, the benign lumps can cause problems that require medical attention.
Uterine fibroids, medically known as leiomyomata, are masses made of muscle and other tissues. They can be as small as a pea or as large as a grapefruit; they often appear in clusters.
Although doctors don’t know why they form, they have found that fibroids occur most often during high-estrogen periods, such as during reproductive years, pregnancy or oral-contraceptive use.
Fortunately, fibroids are not dangerous and usually don’t cause any symptoms. In some case, women may experience:
- heavy menstruation
- anemia (fatigue, paleness, rapid heartbeat)
- difficult or frequent urination
- lower-back pain
- pressure in the lower abdomen
- infertility or miscarriage
If you think you might have fibroids, see your doctor right away. He or she will perform tests to rule out any other causes of the symptoms, such as ovarian cysts.
Since many women don’t have symptoms, the first time the fibroids are discovered is during another medical procedure or routine pelvic exam. The doctor may perform an ultrasound (an imaging technique using sound waves) or a biopsy to confirm diagnosis. In a biopsy, a sample of the tissue from inside the fibroid is removed and examined.
Doctors can treat uterine fibroids in many ways.
- Medication. Hormone therapies designed to block estrogen can shrink fibroids temporarily.
- Myomectomy. This surgery removes the fibroids but keeps the uterus intact. This procedure can be performed in three ways: laparotomy, removing the masses via a large incision in the abdomen; laparoscopy, using a laser for fibroid removal through a small incision; hysteroscopy, using a laser to remove the fibroids and the uterine lining.
Fertility can be preserved—and in some cases restored—with both laparotomy and laparoscopy. However, with all three procedures, there’s a chance the fibroids may return. Myomectomy is not recommended for patients with large fibroids.
- Fibroid embolization. A newer method of fibroid removal, this procedure involves the injection of tiny plastic or sponge particles into the arteries that supply blood to the fibroids, essentially starving the fibroid. The long-term effects of this technique have not been determined yet.
- Hysterectomy. The procedure is the only way to prevent reoccurrence but is usually only recommended when the fibroids are very large or life threatening.
Your doctor will help you decide which treatment is best for you.