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What you need to know about fibroid tumors

How common are fibroids?

As many as 40 percent of American women older than 30 have uterine fibroids, also called uterine leiomyomas. Fibroids occur more frequently after age 40. For unknown reasons, fibroids are more common among African-American women: African-American women are two to three times more likely to develop fibroids than any other group, according to the National Uterine Fibroids Foundation.

Fibroids and fertility

Uterine fibroids can interfere with conception and pregnancy in several ways. A large tumor might block the fallopian tubes, preventing the egg and sperm from meeting. Tumors that block the cervix might also keep egg and sperm from meeting.

A submucous fibroid may distort the uterine lining to the point that it’s too thin for a fertilized egg to implant itself. If it does manage to attach itself, it may not be able to hold on to—and get nourishment from—the damaged lining, resulting in miscarriage.

Fibroids that have grown into the uterus itself can leave little room for the baby, as can fibroids positioned in such a way that they prevent the uterus from expanding to accommodate the baby. Both situations can cause miscarriage or premature delivery. During delivery, tumors can block the baby’s path out of the uterus or reduce the effectiveness of contractions. In either situation, a C-section could be necessary.

The word “tumor” may make you think of cancer, but fibroid tumors of the uterus are almost always noncancerous. In fact, most fibroids don’t create any problems. When symptoms do occur, they may include excessive bleeding and abdominal pain.

Some tumors, called submucous fibroids, grow just beneath the inner lining of the uterus. As these fibroids grow, the lining of the uterus stretches, which can cause abnormal vaginal bleeding. What starts as a heavier period may progress to almost constant bleeding. That can lead to anemia.

Another type of fibroid, called a subserous fibroid, occurs just beneath the outer lining of the uterus. If they are large, subserous fibroids may press against other pelvic organs. If a fibroid presses on the bladder, a woman may feel an almost constant need to urinate. If one presses on the urethra, a woman may have trouble urinating. A fibroid that grows toward the back may cause backache and constipation.

Fibroid tumors can grow a stalk, a peduncle, that stays anchored to the uterine wall while the fibroid continues to grow away from it. If a pedunculated fibroid extends into the uterus itself, the uterus may try to get rid of it by contracting, which causes painful cramps.

A pedunculated fibroid also causes pain if its blood supply is cut off.

Many women have fibroids without experiencing any symptoms. Most of those women don’t require treatment, especially if they’re nearing menopause, when fibroids tend to shrink. However, to rule out cancer, doctors often recommend a procedure called dilation and curettage (D&C), in which the lining of the uterus is scraped and tissue samples evaluated.

Surgery may be necessary if fibroids are interfering with fertility, causing excessive bleeding or pain, growing rapidly or growing near the ovaries (where it’s difficult to distinguish them from cancerous ovarian tumors).

There are two surgical options for uterine fibroids: hysterectomy (removal of the uterus) and myomectomy (removal of the fibroids only). Myomectomy is the treatment of choice for women who still want to have children. Women not concerned with staying fertile may be advised to consider hysterectomy, which is slightly more effective in the long run and has a lower rate of complications than myomectomy.

© 2014 Dowden Health Media