What are uterine fibroids?
Uterine fibroids are benign (noncancerous) tumors that develop in or around the uterus. Fibroids are medically known as leiomyomas and are tumors of the smooth muscle, the tissue that normally makes up that wall of the uterus.
Uterine fibroids are a common condition that affects approximately 20% of childbearing women. African Americans are more likely than Caucasians to develop the disease, as are women who are over 30 years of age, are overweight or obese, or have never given birth (Source: PubMedHealth).
The fibroids may appear as one large fibroid or many small fibroids. Their cause is not known; however, they appear to be associated with the presence of estrogen. During childbearing years when a woman’s estrogen levels are high, fibroids slowly increase in size. But during menopause when a woman’s estrogen levels are low, fibroids rarely occur.
The symptoms of uterine fibroids may occur frequently or only occasionally. The disease course varies among individuals. Some women have no symptoms at all, while others have abdominal pain, abnormal vaginal bleeding, difficulty urinating, or pain during sexual intercourse. A uterine fibroid can grow large enough to put pressure on the bladder, making it difficult to expel urine and eventually causing infection.
Medications, hormones, and surgical procedures are effective in reducing symptoms or in removing the fibroid completely.
Seek immediate medical care (call 911) for serious symptoms, such as uncontrollable vaginal bleeding, dizziness, rapid heart rate (tachycardia) or fainting or loss of consciousness.
Seek prompt medical care if you are being treated for uterine fibroids but mild symptoms recur or are persistent.
What are the symptoms of uterine fibroids?
Uterine fibroids may not produce symptoms. In other cases they may cause abnormal bleeding or discomfort. The symptoms can vary in intensity among individuals.
Common symptoms of uterine fibroids
You may experience uterine fibroids symptoms daily or only occasionally. Any of these symptoms can be severe:
- Abdominal, pelvic, or lower back pain that can be severe (episodic or constant)
- Abdominal pressure
- Abdominal swelling, distension or bloating
- Heavy bleeding during menstrual period (menorrhagia)
- Longer than normal menstrual periods
- Pain during sexual intercourse
- Urgent need to urinate
- Vaginal bleeding between menstrual periods
Serious symptoms that might indicate a life-threatening condition
Rarely, uterine fibroids can be associated with life threatening symptoms. Seek immediate medical care (call 911) if you, or someone you are with, have heavy vaginal bleeding associated with any of the following symptoms:
- Abdominal, pelvic, or lower back pain that can be severe
- Confusion or loss of consciousness for even a brief moment
- Difficulty breathing or shortness of breath
- Dizziness or fainting
- Pale skin or pallor
- Rapid heart rate (tachycardia)
What causes uterine fibroids?
The cause of uterine fibroids is not known, however their development seems to be associated with the female hormone estrogen. Fibroids appear during the childbearing years when a woman’s estrogen levels are high.
A number of factors increase the risk of developing uterine fibroids. Not all people with risk factors will get them. Risk factors include:
- Early onset of menses
- African American ethnicity
- High weight or obesity
- No history of giving birth
How are uterine fibroids treated?
Treatment for uterine fibroids begins with seeking medical care from your health care provider. To determine whether you have uterine fibroids, your health care provider will ask you to undergo diagnostic testing.
Some women with uterine fibroids never have any symptoms. When symptoms do occur, however, you may be asked to undergo a pelvic examination and an abdominal ultrasound to determine the size and location of the fibroid. If it is deemed medically necessary, such as when the fibroid continues to grow and you experience pain or abnormal bleeding, your health care provider will determine the most appropriate treatment for you based on your age and symptoms and the characteristics of the uterine fibroids.
Uterine fibroids treatment options
There are several treatment options for fibroids. Treatments depend upon the severity of symptoms, as well as a woman’s age and desire for pregnancy. Relief of symptoms related to fibroids usually occurs at the time of menopause, when menstrual periods stop and hormone levels wane. Most, but not all, women have shrinkage of leiomyomas at menopause.
Treatment options include:
Hormones to regulate the menstrual cycle or to reduce symptoms such as oral contraceptive pills
Hysterectomy (removal of the uterus)
Hysteroscopic removal of the uterine fibroids using a hysteroscope (instrument to visualize the endometrial cavity)
Intrauterine device to release progestin within uterus to stop bleeding and pain
Myomectomy (surgical removal of the fibroids)
Pain control medications, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol)
Uterine artery embolization (procedure that interrupts the blood supply to fibroids)
Serious complications of fibroids are rare. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of uterine fibroids include:
- Adverse effects of treatment
- Anemia (low red blood cell count)