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Slideshow: A Visual Guide to Uterine
Fibroids
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What Are Uterine Fibroids?
Uterine fibroids are
noncancerous growths of the muscle tissue of the uterus. Fibroids can range in
number and size from a single growth to multiple growths, and from very small
to large. As many as 70% to 80% of all women will have fibroids by age 50. The
medical term for fibroids is leiomyoma or myoma.
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Symptoms of Fibroids: Pressure
Fibroids may cause very
mild symptoms, none at all or symptoms can be severe. In women who do feel
symptoms, these uterine growths can cause:
·
Pressure on the bladder or rectum
·
Frequent urination
·
Constipation and/or rectal pain
·
Lower back and/or abdominal pain
If fibroids become very
large, they can distend the stomach, making a woman look pregnant.
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Symptoms of Fibroids: Period Changes
Fibroids may also cause
changes to a woman's period, including:
·
Mild to severe cramping and pain
·
Heavier bleeding, sometimes with blood
clots
·
Longer or more frequent menstruation
·
Spotting or bleeding between periods
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Fibroids or Endometriosis?
Fibroids are one cause
of severe menstrual pain, but the pain also can be caused by endometriosis.
Endometriosis occurs when tissue from the inner lining of the uterus grows in
other parts of the body -- illustrated here by growths on the outside of the
uterus and bladder. This tissue breaks down and bleeds during your period,
causing painful scar tissue. The pain of fibroids or endometriosis also can
occur between periods.
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What Causes Fibroids?
The exact cause of
fibroids is unknown. Their growth has been linked to the female hormones
estrogen and progesterone. Studies have found that women who start their
periods at a younger age are more likely to develop fibroids. Although taking
female hormones is linked to fibroids, the use of birth control pills is not.
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Types of Fibroids
·
Intramural fibroids, the most common, grow in the wall of the
uterus.
·
Subserosal fibroids grow on the outside of the uterus. As
they grow larger, they can cause pain due to their size or pressure put on
nearby organs.
·
Submucosal fibroids grow just underneath the uterine lining
and can crowd into the uterus cavity and lead to heavy bleeding and other more
serious complications.
·
Pedunculated fibroids grow on small stalks inside or outside the
uterus.
It's possible to have
more than one type of fibroid.
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Who Gets Fibroids?
While it's unclear why
women develop fibroids, some patterns have been observed.
·
They usually occur between the ages of 30
and 40.
·
They are more common in black women.
·
They grow more quickly and appear at a
younger age in black women.
·
Having a family member with fibroids
increases a woman's risk.
·
Being overweight or obese and having high
blood pressure also may increase your risk.
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Complications: Fibroids and Anemia
Some women with fibroids
who experience unusually heavy bleeding during their periods may become anemic.
Many cases of anemia due to iron deficiency from periods are mild and can be
treated with a change in diet and iron supplement pills. Untreated anemia can
lead to fatigue and lethargy -- and, in severe cases, heart problems.
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Complications: Getting Pregnant
Fibroids usually do not
interfere with fertility and pregnancy. However, some women with fibroids
experience more pregnancy complications and delivery risks. Fibroids
may cause the baby to be in an abnormal position and can cause preterm
labor. They may also cause pelvic pain and heavy bleeding after delivery, which
may require surgery. In some instances, fibroids may block your fallopian
tubes. Fibroids growing along the inner uterine wall may make it difficult for
a fertilized egg to attach.
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When to See a Doctor
See your health care
provider if you have the following fibroid symptoms:
·
Heavy menstrual bleeding
·
Periods that became more painful
·
Frequent urination or inability to control
the flow of urine
·
A change in the length of your period over
three to six cycles
·
New persistent pain or heaviness in lower
abdomen or pelvis
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Diagnosis: Exam and Imaging
Your doctor may feel
moderate and large uterine fibroids during a routine pelvic exam. Tests, such
as an ultrasound, can show information about size and location of other
fibroids. For women with fibroids who are trying to get pregnant, a test called
a hysterosalpingogram will show an outline of the uterus and fallopian tubes
and may detect abnormalities. Other procedures to visualize the inside of the
uterus or abdomen also may be needed.
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Treatment: Pain Medication
Pain medications, such
as acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs), like as
ibuprofen or naproxen, can help relieve menstrual cramping.
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Treatment: Birth Control
Oral contraceptives
manage levels of estrogen and progestin. This usually leads to lighter periods
and can alleviate some of the pain associated with fibroids, such as heavy
bleeding and cramping. Other hormonal birth control methods that may lessen
fibroid symptoms include progestin injections or progestin-releasing IUDs.
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Other Hormone Therapies
Drugs called
gonadotropin-releasing hormone (GnRH) agonists may offer temporary symptom
relief from fibroids by stopping periods and shrinking fibroids. GnRH agonists
block the production of estrogen, so they can also cause bone loss, hot
flashes, and vaginal dryness. Fibroids will return to their previous size once
treatment ends. These may be used to shrink fibroids before fibroid removal
surgery.
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Treatment: Embolization
For mild to moderate
symptoms, uterine fibroid embolization may be a good option. A catheter is
guided to the uterine artery. Tiny particles of plastic or gelatin are then
released into the blood vessels that feed the fibroid, causing it to shrink
over time. Embolization should not be an option for women wanting to get
pregnant at some point after treatment.
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Treatment: Surgery
A myomectomy typically
removes the largest fibroids. It’s is an option for women who want to still
have children. A hysterectomy is when the uterus is removed. There is
a small chance that what was thought to be a fibroid could instead be a cancer
called uterine sarcoma. For this reason, the FDA recommends not cutting
the fibroid into small sections before removing it, a process called
laparoscopic morcellation. Endometrial ablation, which is good for treating
smaller fibroids, destroys the lining of the uterus, so pregnancy is not
possible.
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Treatment: Ultrasound
Ultrasound is one way to
destroy fibroids without risk of damaging the uterus. The treatment uses
high-intensity ultrasound waves that kill the fibroid tissue. Most women
recover quickly from this procedure and can return to regular activities within
24 hours. The long-term effects are still being studied, and it is not
recommended for women who want to become pregnant.
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Fibroid Remedy: Exercise
Regular exercise may
prevent fibroids. In one study, women who exercised seven or more hours a week
had significantly fewer fibroids than women who exercised less than two hours a
week. Obesity also is a risk factor for fibroids. So exercising regularly can
help you maintain a healthy weight and reduce your fibroid risk.
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Care for Anemia
Women with fibroids who
are not getting enough iron through diet alone may develop anemia, where the
body has fewer red blood cells than normal. Symptoms include fatigue, chest
pain, and shortness of breath. Treatment may include eating more iron-rich
foods, such as meats, poultry, fish, leafy greens, legumes, and iron-fortified
breads and cereals. Your health care provider also may suggest iron
supplements.
This tool does not provide medical advice.
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