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Uterine fibroids

By age 50, up to 80% of women have developed uterine fibroids, also called leiomyomas or uterine myomas. While many women don’t experience pain or symptoms from their fibroids, 25% will need treatment to manage pain or heavy bleeding, which often affects their quality of life.

What is a uterine fibroid?

Fibroids are benign tumors of the uterus that can range in size from as small as a seed to large enough to make a woman look pregnant. Fibroids tend to grow in size over time. Some women experience pain from their fibroids while others do not. Not all women with fibroids will have symptoms, and the tumors may be found incidentally while being evaluated for something else.

Fibroids: Symptoms

  • Fibroids can cause prolonged and heavy bleeding during the menstrual cycle.
  • The tumors can also cause pelvic pressure depending on where they are located.
  • Some people complain of urinary frequency along with constipation.
  • Women can also experience pain in the lower abdomen area especially if the fibroids are large.

Fibroids: Risk factors

Typically, fibroids appear in women who are in childbearing ages. There is a higher percentage of African American women who are affected by fibroids. Fibroid development is also related to genetics and family history.

Generally speaking, diet is not a risk factor for fibroid development or growth, and there are no particular foods that have been proven to prevent women from getting fibroids or to keep them from growing. However, significant consumption of beef and other red meats have been associated with uterine fibroids, so paying attention to a healthy diet with fruits and vegetables may be beneficial.

Fibroids: Types

  • Submucosal fibroids grow into the uterine cavity.
  • Intramural fibroids grow within the wall of the uterus.
  • Subserosal fibroids grow on the surface of the uterus.

Submucosal fibroids tend to cause increased bleeding, whereas subserosal and intramural fibroids can cause added pelvic pain and pressure.

Fibroids: What you need to know

  • Women should seek help based on the severity of their symptoms. If they are experiencing pain or heavy bleeding that hinders their daily life activities, they should speak with their gynecologist about their symptoms.
  • Birth control is an option to treat fibroid symptoms for women who experience heavy bleeding during their menstrual cycles. Though birth control will reduce the heavy flow and some of the cramping pain, it will not shrink the fibroids.
  • It’s important to seek early care and to understand that fibroids can result in a number of issues such as excessive blood loss leading to anemia, significant abdominal pains and potential risks in pregnancy.

Fibroids: Treatments

Treatment usually depends on the size of the fibroids and the symptoms. Also, treatment options may be based on the woman’s reproductive goals and the location of the fibroids.

The procedural options are recommended based on what is found during the physical or ultrasound examination. There are several types of surgical options available to treat uterine fibroids.

  • Uterine embolization is a minimally invasive procedure that essentially blocks the blood supply to the fibroid, thus causing the fibroid to shrink.
  • Radiofrequency ablation uses energy to destroy the uterine fibroids.
  • Laparoscopic/robotic myomectomy surgically removes the fibroids from the uterus. After the procedure, women are typically recovered and back to work within 5-7 days.

Fibroids sometimes will regrow after removal, so it is important to discuss your options with your doctor to find the best treatment for you. If a patient is older and is finished with childbearing, a hysterectomy may be an option, especially if there are multiple fibroids that have grown in size.

Do fibroids affect pregnancy?

Fibroids can’t prevent you from getting pregnant, but the tumors can cause complications. Submucosal fibroids are the ones that can cause the most issues, sometimes associated with miscarriages.

Often our surgeons will try to either remove those type of fibroids. Fibroids can also cause preterm labor. If the fibroid is really large, our experts will suggest removing it before a woman is pregnant, as it may lead to increased pressure and pain with both the fibroid and baby growing. Depending on the size of the fibroid, it could also cause the baby to be positioned abnormally.

Most women discover fibroids before they are pregnant, but sometimes women may learn about a tumor during pregnancy through ultrasound. In those cases, our physicians will monitor the tumor in order to ensure a safe pregnancy and delivery.

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