Uterine fibroids

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at March 9, 2016
StartDiseasesUterine fibroids

Uterine fibroids are a problem that affects women during their childbearing years. Also called fibroids, they are generally benign growths in the uterus that can produce a variety of symptoms that may cause discomfort or inconvenience.

Contents

Definition & Facts

Uterine fibroids generally develop in women in their 30s and 40s. The drop in hormone levels during menopause can cause fibroids to decrease in size. Fibroids can cause difficulties with fertility, pregnancy and birth. A number of treatments are available for women who suffer from troublesome uterine fibroids.

Uterine fibroids are benign growths of tissue that develop in the lining of the uterus. The growths are almost always benign, but they can become quite large, causing discomfort to the individual and even noticeably increasing the size of the abdomen.

When uterine fibroids grow into the uterus, they are called submucosal fibroids. When they grow on the outside of the uterus, they are called subserosal. When they grow inside the wall of the uterus, they are called intramural fibroids.

A fibroid may be a single growth, or there may be several growths. They grow be very small, the size of an apple seed, or as large as a grapefruit. In some cases, uterine fibroids can grow very large.

Symptoms & Complaints

A woman may experience a number of different symptoms related to the uterine fibroid growth, including:

Causes

Research into uterine fibroids indicates a number of factors may be in play in their development. Changing hormone levels may cause fibroids to grow or shrink. The high hormone levels of pregnancy cause them to grow faster. Taking anti-hormone medication makes fibroids shrink. Other factors are also involved, such as:

  • Family history – There appears to be a strong genetic predisposition to developing uterine fibroids. If your mother has had them, you are three times more likely to develop them yourself.
  • Age – Women are more like to develop uterine fibroids in their 30s and 40s.
  • Obesity – Being obese increases the risk for developing uterine fibroids by two or three times.
  • Dietary factors – Eating a great deal of red meat is associated with an increased risk of uterine fibroids. A diet rich in green vegetables appears to protect women from this condition.
  • Ethnic origin – African-American women are at higher risk for developing uterine fibroids than Caucasian women.

Diagnosis & Tests

Physicians are sometimes able to feel the presence of fibroid growth when they do pelvic examinations. Ultrasounds can also be used to note the size and the location of the growth. MRIs are sometimes used to identify the type of fibroid.

Hysterosonography uses a saline infusion to expand the uterine cavity so that growths seen more clearly. Hysterosalpingography uses a dye to see structures in the uterus on X-ray. Hysteroscopy uses a tiny, lighted instrument to see inside the uterus. Any of these methods may be used, or a combination of methods may be needed to properly determine the size and location of the fibroid.

Treatment & Therapy

Uterine fibroids may not require treatment if they don’t produce symptoms. The physician may advise monitoring the growth of the fibroid to determine if active treatment is needed later. However, when symptoms are present, physicians have a number of treatments available for this condition. The type of treatment the physician uses may depend the size of the growths, the location of the growths, the age of the patient and whether the patients wishes to become pregnant in the near future.

Medications are available to treat uterine fibroids, such as low-dose birth control pills that help control heavy bleeding or a medroxyprogesterone injection, commonly marketed as Depo-Provera® injections, which can help reduce heavy menstrual flow.

Gonadotropin-releasing hormone agonists may be prescribed to shrink the fibroid. This drug can be administered in an injection, a nasal spray, or as an implant. However, this type of drug does have side effects, including bone thinning.

Women experiencing moderate to severe problems with uterine fibroids may require surgery for relief of symptoms. A myomectomy may be done to remove the growth, while preserving healthy tissue around it. This procedure may be done when the patient has plans to have children after treatment. Hysterectomy may be required if the uterine fibroids are large and if symptoms cannot be adequately treated in other ways.

Endometrial ablation is a technique that removes or destroys the endometrium which is the lining of the uterus with electric current, laser or other means, to control heavy bleeding. It is minor surgery that can be done in the doctor’s office. However, it is not used for women who wish to become pregnant after treatment.

Myolysis is a procedure in which a needle is used to direct an electric current of freezing into the growth to destroy it. Uterine artery embolization injects a gel or plastic particles into the growth to block the blood supply that feeds it. Radiofrequency ablation employs heat to destroy fibroid growths, while preserving surrounding tissue. Anti-hormonal drugs may also be used.

Prevention & Prophylaxis

Although research has found no certain way to prevent uterine fibroids, physicians recommend that patients avoid gaining significant amounts of weight over the age of 18. Some data indicates that careful weight management may help to reduce the risk for these growths.

In addition, women are advised to get regular gynecological examinations to find small growths early, so they can be more easily treated. If you have been diagnosed with uterine fibroids, see your physician regularly to monitor the growths and receive treatment as needed.