What Are Fibroids?
Highlights
1. Fibroids are abnormal growths that develop in
or on a woman’s uterus.
2. It is unclear why fibroids develop, but several
factors may influence their formation, such as hormones and family history.
3. About 70 to 80 percent of women experience
fibroids by the age of 50.
Fibroids are abnormal
growths that develop in or on a woman’s uterus. Sometimes, these tumors become
quite large and cause severe abdominal pain and heavy periods. In other cases,
they cause no signs or symptoms at all. The growths are typically benign
(noncancerous). The cause of fibroids is unknown.
According to the
National Institutes of Health (NIH), about 70 to 80
percent of women have them by
the age of 50, but most women do not have any symptoms.
TYPES
Different fibroids
develop in different locations in and on the uterus.
Intramural Fibroids
Intramural fibroids
are the most common type of fibroid. These types appear within the muscular
wall of the uterus. Intramural fibroids may grow larger and can stretch your
womb.
Subserosal Fibroids
Subserosal fibroids
form on the outside of your uterus, which is called the serosa. They may grow
large enough to make your womb appear bigger on one side.
Pedunculated Fibroids
When subserosal tumors
develop a stem (a slender base that supports the tumor), they become
pedunculated fibroids.
Submucosal Fibroids
These types of tumors
develop in the middle muscle layer (myometrium) of your uterus. Submucosal
tumors are not as common as other types, but when they do develop, they may
cause heavy menstrual bleeding and trouble conceiving.
CAUSES
It is unclear why
fibroids develop, but several factors may influence their formation.
Hormones
Estrogen and
progesterone are the hormones produced by the ovaries. They cause the uterine
lining to regenerate during each menstrual cycle and may stimulate the growth
of fibroids.
Family History
Fibroids may run in
the family. If your mother, sister, or grandmother has a history of this
condition, you may develop it as well.
Pregnancy
Pregnancy increases
the production of estrogen and progesterone in your body. Fibroids may develop
and grow rapidly while you are pregnant.
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RISK
FACTORS
Women are at greater
risk for developing fibroids if they have one or more of the following risk
factors:
- pregnancy
- a family history of fibroids
- being over the age of 30
- being of African-American
descent
- having a high body weight
SYMPTOMS
Your symptoms will
depend on the location and size of the tumor(s) and how many tumors you have.
If your tumor is very small, or if you are going through menopause, you may not
have any symptoms. Fibroids may shrink during and after menopause.
Symptoms of fibroids
may include:
- heavy bleeding between or during
your periods that includes blood clots
- pain in the pelvis and/or lower
back
- increased menstrual cramping
- increased urination
- pain during intercourse
- menstruation that lasts longer
than usual
- pressure or fullness in your
lower abdomen
- swelling or enlargement of the
abdomen
DIAGNOSIS
You will need to see a
gynecologist to get a pelvic exam. This exam is used to check the condition,
size, and shape of your uterus. You may also need other tests, which include:
Ultrasound
An ultrasound uses
high frequency sound waves to produce images of your uterus on a screen. This
will allow your doctor to see its internal structures and any fibroids present.
A transvaginal ultrasound, in which the ultrasound wand (transducer) is
inserted into the vagina, may provide clearer pictures since it is closer to
the uterus during this procedure.
Pelvic MRI
This in-depth imaging
testing produces pictures of your uterus, ovaries, and other pelvic organs.
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TREATMENT
Your doctor will
develop a treatment plan based on your age, the size of your fibroid(s), and
your overall health. You may receive a combination of treatments.
Medications
Medications to
regulate your hormone levels may be prescribed to shrink fibroids. Gonadotropin-releasing
hormone (GnRH) agonists, such as leuprolide (Lupron), will cause your estrogen
and progesterone levels to drop. This will eventually stop menstruation and
shrink fibroids.
Other options that can
help control bleeding and pain, but will not shrink or eliminate fibroids,
include:
- an intrauterine device (IUD)
that releases the hormone progestin
- over-the-counter
anti-inflammatory pain relievers, such as ibuprofen
- birth control pills
Surgery
Surgery to remove very
large or multiple growths (myomectomy) may be performed. An abdominal
myomectomy involves making a large incision in the abdomen to access the uterus
and remove the fibroids. The surgery can also be performed laparoscopically,
using a few small incisions into which surgical tools and a camera are
inserted.
Your physician may
perform a hysterectomy (removal of your uterus) if your condition worsens, or
if no other treatments work. However, this means that you will not be able to
bear children in the future.
Minimally Invasive Procedures
A newer and completely
noninvasive surgical procedure is forced ultrasound surgery (FUS). You will lie
down inside a special MRI machine that allows doctors to visualize the inside
of your uterus. High-energy, high-frequency sound waves will be directed at the
fibroids to destroy (ablate) them.
Similarly, myolysis
shrinks fibroids using an electric current or laser, while cryomyolysis freezes
the fibroids. Endometrial ablation involves inserting a special instrument into
your uterus to destroy the uterine lining using heat, electric current, hot
water, or microwaves.
OUTLOOK
Your prognosis will
depend on the size and location of your fibroids. Fibroids may not need
treatment if they are small or do not produce symptoms. If you are pregnant and
have fibroids, or become pregnant and have fibroids, your physician will
carefully monitor your condition. In most cases, fibroids do not cause problems
during pregnancy. Speak with your doctor if you expect to become pregnant and
have fibroids.
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Uterine
Fibroids (Benign Tumors Of The Uterus)
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INDEX
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GuideUterine
Fibroid Pictures: Anatomy Diagrams, Pictures of Fibroids, Tests, Treatments,
and More
We do not know exactly why women
develop these tumors. Genetic abnormalities, alterations in growth factor
(proteins formed in the body that direct the rate and extent of cell
proliferation) expression, abnormalities in the vascular (blood vessel) system,
and tissue response to injury have all been suggested to play a role in the
development of fibroids.
Family history is a key factor,
since there is often a history of fibroids developing in women of the same
family. Race also appears to play a role. Women of African descent are two to
three times more likely to develop fibroids than women of other races. Women of
African ancestry also develop fibroids at a younger age and may have symptoms
from fibroids in their 20s, in contrast to Caucasian women with fibroids, in
whom symptoms typically occur during the 30s and 40s. Early pregnancy decreases the likelihood that
fibroids will develop. Fibroids have not been observed in girls who have not
reached puberty, but adolescent girls may rarely
develop fibroids. Other factors that researchers have associated with an
increased risk of developing fibroids include having the first menstrual period (menarche) prior to age
10, consumption of alcohol (particularly beer), uterine infections, and
elevated blood
pressure (hypertension).
Estrogen tends to stimulate the growth of fibroids in
many cases. During the first
trimester of pregnancy, about a third of fibroids will enlarge
and then shrink after the birth. In general, fibroids tend to shrink after menopause, but postmenopausalhormone therapy may cause symptoms to
persist.
Overall, these tumors are fairly
common and occur in about 70% to 80% of all women by the time they reach age
50. Most of the time, uterine fibroids do not cause symptoms or problems, and a
woman with a fibroid is
usually unaware of its presence. Continue Reading
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