Fibroids

Nearly 80 percent of women of childbearing age will develop fibroids. They're usually detected at a gynecological exam. Fibroids are often symptom-free, but some women do experience pain. If you're one of them, talk with our gynecologists. We know the latest ways to keep fibroids at bay, or even shrink them.

Uterine fibroids are benign tumors and there are several types. The most common is intramural fibroids that grow within the uterine lining. They can grow very large, making them candidates for surgical removal. Subserol fibroids grow outside the uterus. Another type that forms deeper in the lining (submucosal) can cause trouble with conception.

Treatments for Fibroids

Fibroids can be a pain, which is no news to you if you have them. The Spectrum Health gynecologists and specialized urogynecologists have years of experience treating fibroids. 

You will want to know for sure that it's a fibroid and if it's growing. You will also want to know if it can morph into something worse. We can answer those questions, and treat those fibroids. Let's team up to decide on the best treatment to help alleviate your fibroid pain. Start here with some fibroid treatments and how they work.

Fibroid Myomectomy
This is the surgical removal of fibroids in the uterine lining, leaving the uterus in place. Fibroids do not regrow. However, new fibroids may develop.

Fibroid Removal
This minimally invasive procedure is also called a hysteroscopy (not to be confused with a hysterectomy). It removes fibroids protruding into the cavity of the uterus. A high-tech tube called a resectoscope destroys fibroids using electricity or a laser beam.

Fibroid Shrinking
This procedure uses a process called embolization. It means that tiny particles are injected into the arteries of the uterus. The particles cut off blood flow to the fibroid and cause it to shrink.

Hysterectomy
When other fibroid treatments haven't worked or are impossible because of the size of the fibroids, the uterus is removed either with or without the ovaries.

Medicine
Birth control pills and other hormone therapy drugs can reduce the heavy bleeding and painful periods that can accompany fibroids. They do not prevent the growth of fibroids.

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What Are Fibroids?

Fibroids, or leiomyomata (myomas), are common noncancerous growths that usually occur in or on the muscle walls of the uterus. One cell divides repeatedly and grows into a firm, rubbery mass separate from the rest of the uterine wall. Almost half of women older than 50 have these growths. They’re more common in African American women than in Caucasian women. They can grow as a single mass or more often as a number of masses of different sizes.

What Causes Fibroids?

The cause isn’t clear. Several factors probably work together to produce fibroids. These factors may be hormones such as estrogen, genetics (runs in families), and environmental. Being overweight, never having had a child, and getting periods before age 10 also may have an effect. The fibroids usually, but not always, shrink after menopause (change of life).

What Are the Symptoms of Fibroids?

Most fibroids (30% to 50%) cause no symptoms. Problems, when they occur, are related to the size and location of the fibroids. Fibroids may grow to be quite large so that a woman may look pregnant and have symptoms of pregnancy: pressure in the pelvic area (lower belly), heaviness, and need to go to the bathroom often to urinate. Fibroids in the uterine wall or in the cavity of the uterus may cause bleeding between periods or heavier and more painful periods. Constipation, backache, pain during sex, and lower belly pains may occur. Rarely, fibroids cause sudden pain or bleeding.

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How Are Fibroids Diagnosed?

The health care provider will do an examination of the pelvic area. Ultrasound or x-rays may be used but aren’t always needed for diagnosis. The doctor may do a special procedure (hysteroscopy) for women with bleeding symptoms. This simple procedure lets the doctor look into the uterus to find the cause of the bleeding or to plan or carry out therapy.

How Are Fibroids Treated?

Most fibroids need no treatment and only regular checks to be sure that they’re not growing too large or causing problems. Medicines including hormones and drugs that act against hormones can be tried. If fibroids continue to be a problem, hysterectomy (surgery to remove the uterus) is an option. Sometimes, fibroids alone may be surgically removed (myomectomy), which saves the uterus if children are wanted. Another newer method is uterine artery embolization. In this method, arteries to the uterus are blocked so they don’t feed the fibroids. Myolysis (electric current destroys fibroids and shrinks blood vessels feeding them) and cryomyolysis (liquid nitrogen is used instead of electric current) are other methods. However, fibroids can return and mean more surgery later. Newer medicines may shrink fibroids, but this change is only temporary.

DOs and DON’Ts in Managing Fibroids:
  • DO get regular health care provider checkups.
  • DO tell your health care provider your concerns and describe your symptoms.
  • DON’T delay having children just because you have fibroids. They usually won’t get in the way of pregnancy. If you do need treatment for fibroids, some treatments can temporarily or permanently prevent you from becoming pregnant.
  • DON’T worry about getting cancer from fibroids. Typical fibroids are not cancerous.
FOR MORE INFORMATION

Contact the following sources:

  • American College of Obstetricians and Gynecologists
    Website: http://www.acog.org
  • WebMD
    Website: http://www.webmd.com
  • U.S. Department of Health and Human Services
    Websites: http://womenshealth.gov
    http://www.4women.gov/faq/fibroids.htm

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor