What Are Uterine Fibroids?
Uterine fibroids are the most common benign (not cancerous) tumors, or growths, that develop from the muscle tissue in the uterus. They can vary in size, shape, and amount. While they can occur at any age, they are most common in women ages 30–40. Fibroids occur more often in Black women than in white women. Research has also shown they occur at a younger age and grow more quickly in Black women.
Causes and Symptoms
Although there isn’t a definite cause of fibroids, research suggests they can develop from misplaced cells that are in the body before birth. Estrogen and progesterone appear to be involved in their growth. Levels of these hormones are subject to change throughout a woman’s life. For example, menopause causes a decrease in estrogen, and fibroids often shrink when women enter menopause. Certain hormonal medications that contain estrogen, like birth control pills, may cause fibroids to grow.
Symptoms of fibroids vary. Women may experience the following:
- Changes in menstruation
- Longer, more frequent, or heavy menstrual periods
- Menstrual pain such as cramps
- Vaginal bleeding unrelated to menstruation
- Anemia due to blood loss
- Pain
- In the abdomen or lower back
- During sex
- With menstruation
- Pressure
- Difficulty urinating or frequent urination
- Constipation or difficult bowel movements
- Abdominal cramps
- Enlarged uterus and abdomen
- Miscarriages
- Infertility
It’s important to note that fibroids may not cause any symptoms at all. The first signs of fibroids can be found during a routine pelvic exam. Tests such as an ultrasound exam, hysteroscopy, hysterosalpingography, sonohysterography, and laparoscopy may be used to track the growth of fibroids over time.
Treatment
There are many treatment options for fibroids depending on your own wishes, their size, and where they’re located. Fibroids that don’t cause symptoms or are small typically don’t require treatment.
Medications are an option, as they may reduce heavy bleeding and painful periods; however, they may not prevent the growth of fibroids. Some possible medication treatment options include the following (this list is not comprehensive):
- Birth control pills
- Gonadotropin-releasing hormone (GnRH) agonists: These medications stop the menstrual cycle and can shrink fibroids.
- Progestin-releasing intrauterine device (IUD): This option reduces heavy and painful bleeding but does not treat fibroids themselves.
- Tranexamic acid: This is used to treat heavy bleeding and reduces the blood lost during your period, but it does not stop your periods.
Many other medications are being studied for the treatment of fibroids. Myomectomy and hysterectomy are two surgery options for more serious cases. A myomectomy is the surgical removal of fibroids while leaving the uterus in place. Fibroids do not regrow after they are removed, but new fibroids may develop, so further surgery may be necessary. A hysterectomy is the removal of the uterus where the ovaries may or may not be removed. This surgery is done when other treatments have not worked or the fibroids are very large. Women who undergo this surgery are not able to have children. There are also other procedural and surgical options for fibroid management that do not require the removal of the fibroids or uterus.
Schedule an Appointment
Anywhere from 20 percent to 80 percent of women develop fibroids by the time they reach 50. Talk with your provider about all your treatment options and their risks and benefits. Together, we can alleviate any concerns and decide which treatment is right for you. To schedule an appointment, call us at (203) 562-5181.
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