What are uterine fibroids?
Also called: Fibroids, Uterine leiomyomata
Uterine fibroids are the most common non-cancerous tumors in women of childbearing age. Fibroids are made of muscle cells and other tissues that grow in and around the wall of the uterus, or womb. The cause of fibroids is unknown. Risk factors include being African-American or being overweight.
Many women with uterine fibroids have no symptoms. If you have symptoms, they may include:
- Heavy or painful periods or bleeding between periods
- Feeling "full" in the lower abdomen
- Urinating often
- Pain during sex
- Lower back pain
- Reproductive problems, such as infertility, multiple miscarriages or early labor
Most women with fibroids can get pregnant naturally. For those who cannot, infertility treatments may help. Treatment for uterine fibroids includes medicines that can slow or stop their growth, or surgery. If you have no symptoms, you may not even need treatment.
What causes uterine fibroids?
Doctors are not sure what causes fibroids. But the female hormones estrogen and progesterone seem to make them grow. Your body makes the highest levels of these hormones during the years when you have periods.
Your body makes less of these hormones after you stop having periods (menopause). Fibroids usually shrink after menopause and stop causing symptoms.
What are the symptoms?
Often fibroids do not cause symptoms. Or the symptoms may be mild, like periods that are a little heavier than normal. If the fibroids bleed or press on your organs, the symptoms may make it hard for you to enjoy life. Fibroids make some women have:
- Long, gushing periods and cramping.
- Fullness or pressure in their belly.
- Low back pain.
- Pain during sex.
- An urge to urinate often.
Heavy bleeding during your periods can lead to anemia. Anemia can make you feel weak and tired.
Sometimes fibroids can make it harder to get pregnant. Or they may cause problems during pregnancy, such as going into early labor or losing the baby (miscarriage).
How are uterine fibroids diagnosed?
To find out if you have fibroids, your doctor will ask you about your symptoms. He or she will do a pelvic exam to check the size of your uterus.
Your doctor may send you to have an ultrasound or another type of test that shows pictures of your uterus. These help your doctor see how large your fibroids are and where they are growing.
Your doctor may also do blood tests to look for anemia or other problems.
How are they treated?
If your fibroids are not bothering you, you do not need to do anything about them. Your doctor will check them during your regular visits to see if they have gotten bigger.
If your main symptoms are pain and heavy bleeding, try an over-the-counter pain medicine like ibuprofen, and ask your doctor about birth control pills. These can help you feel better and make your periods lighter. If you have anemia, take iron pills and eat foods that are high in iron, like meats, beans, and leafy green vegetables.
If your symptoms bother you a lot, you may want to think about surgery. Most of the time fibroids grow slowly, so you can take time to consider your choices.
There are two main types of surgery for fibroids. Which is better for you depends on how big your fibroids are, where they are, and whether you want to have children.
- Surgery to take out the fibroids is called myomectomy. Your doctor may suggest it if you hope to get pregnant or just want to keep your uterus. It may improve your chances of having a baby. But it does not always work, and fibroids may grow back.
- Surgery to take out your uterus is called hysterectomy. This is the most common surgery for fibroids. And it is the only way to make sure that fibroids will not come back. Your symptoms will go away, but you will not be able to get pregnant.
It is normal to have mixed feelings about hysterectomy. Some women are sad to lose part of what makes them a woman. Other women just want their symptoms to go away. If you are thinking about hysterectomy, learn all you can about it. This will help you make the choice that is right for you.
There are a number of other ways to treat fibroids. One newer treatment is called uterine artery embolization. It can shrink fibroids. It may be a choice if you do not plan to have children but want to keep your uterus. It is not a surgery, so most women feel better soon. But fibroids may grow back.
If you are near menopause, you might try medicines to treat your symptoms. Heavy periods will stop after menopause.