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Symptomatic Uterine Fibroids

Fibroids are noncancerous tumors that grow in the uterus. They can vary in size from very small to as big as a melon. In most instances, a woman with fibroids will experience no symptoms, but this is not the case in all situations. The uterus will grow to accommodate the largest fibroids, sometimes inflating to the size of a 5-month pregnancy.

  1. Symptoms

    • Only 10 to 20 percent of women with fibroids experience symptoms, but those who do usually require treatment. Fibroids can grow in or under the lining of the uterus. Just as with most tumors, symptoms depend on the size and location of the fibroid. The most common symptoms include unusually heavy menstrual periods; pain in the pelvis, back and legs; urinary urgency; pain during sex; and abdominal issues such as pain, bloating and constipation.

    Data

    • Uterine fibroids are quite common in women over 35. Up to 40 percent of women in that age bracket have or have had fibroids, though most are asymptomatic. Fibroids are the most common cause for a hysterectomy, counting for about one-third of those performed on premenopausal women. Fibroids can grow during pregnancy, because of the amount of estrogen that is released then. Afterward, they will shrink. The issue is similar for postmenopausal women taking estrogen supplements, which may lead fibroids to cause symptoms.

    Diagnosis

    • Women experiencing symptoms from fibroids will usually consult with a gynecologist. The doctor will perform an ultrasound to check for the tumors. If there is evidence of any growths in the uterus, the doctor will order an MRI, which can provide a more accurate picture of what exactly is happening. Based on the MRI, your doctor will prescribe the treatment. For symptomatic fibroids, surgery is usually the recommended option.

    Surgery

    • In the most extreme cases, a hysterectomy, removal of the entire uterus, is conducted to relieve symptoms associated with fibroids. This is not a preferred treatment, since the woman will no longer be able to have children. Myomectomies remove just the fibroids and allow the woman to have children, but there is a risk that fibroids will return. Another method is uterine artery embolization, which cuts off the blood supply to the fibroid and shrinks it. This is the least invasive, but it can also damage your organs.

    Medications

    • Some medications can help regulate the menstrual cycle and in theory shrink the fibroid. Gonadotropin-releasing hormone (Gn-RH) agonists help lower estrogen levels and make fibroids smaller. Androgens relieve symptoms from fibroids, but have side effects such as weight gain and hair growth. The birth control pill may help symptoms, but does nothing to the size of the tumor. While drugs may minimize symptoms, they do not remove the fibroids.

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