Uterine fibroids are non-cancerous growths that develop in or around the uterus. Though they are common, they often go unnoticed because many women have no symptoms. However, if symptoms do occur, they can cause discomfort and interfere with daily life. Understanding uterine fibroids—what they are, how they develop, and how they can be treated—can help you make informed decisions about your health.
What Are Uterine Fibroids?
Uterine fibroids are growths made of muscle and fibrous tissue that form in or on the walls of the uterus. They vary in size and can grow as small as a pea or as large as a grapefruit. Some women may have one fibroid, while others may develop multiple. They are typically classified based on where they are located:
- Intramural Fibroids: These fibroids develop within the wall of the uterus and can cause it to stretch and change shape, leading to discomfort or pain.
- Submucosal Fibroids: These grow just under the lining of the uterus and can affect the uterine cavity. They are often linked to heavy or prolonged periods and, in some cases, may impact fertility.
- Subserosal Fibroids: These fibroids grow on the outer wall of the uterus. While they don’t directly affect the uterine cavity, they can cause pain or pressure as they press on surrounding organs, like the bladder or intestines.
- Pedunculated Fibroids: These are fibroids attached to the uterus by a stalk and can grow inside or outside the uterus. They may cause sudden pain if they twist or move.
While uterine fibroids are non-cancerous, it’s important to keep an eye on them as they can grow in size over time and lead to complications if left untreated.
Causes of Uterine Fibroids
The exact cause of uterine fibroids isn’t fully understood, but several factors can increase the likelihood of developing them:
- Hormones: Hormones like estrogen and progesterone, which regulate the menstrual cycle, play a role in fibroid growth. Fibroids tend to grow during years of higher hormone production, such as during pregnancy or while menstruating, and shrink after menopause when hormone levels drop.
- Genetics: If other women in your family, like your mother or sister, had fibroids, you may be at a higher risk of developing them too.
- Age: Fibroids are most common in women between the ages of 30 and 40, particularly during the childbearing years. They often shrink after menopause due to a decrease in hormone levels.
- Ethnicity: African-American women are more likely to develop fibroids and may experience larger fibroids and more severe symptoms compared to women of other ethnicities.
- Obesity: Being overweight can increase your risk of developing fibroids due to higher estrogen levels associated with extra fat tissue.
- Other Factors: Early menstruation (before age 10), not having children, and vitamin D deficiency are also linked to an increased risk of fibroids.
Symptoms of Uterine Fibroids
Many women with fibroids may not experience symptoms. However, when symptoms do occur, they can vary depending on the size and location of the fibroids. Common symptoms include:
- Heavy or Prolonged Periods: One of the most common symptoms of fibroids is very heavy or long periods. This may require frequent changing of pads or tampons.
- Pelvic Pain or Pressure: Fibroids can cause pelvic discomfort, a feeling of fullness, or heaviness in the abdomen, especially if they press against surrounding organs.
- Frequent Urination: If fibroids are pressing against the bladder, they may cause you to feel the need to urinate often or have difficulty fully emptying your bladder.
- Constipation: When fibroids press on the intestines or rectum, they can cause constipation or bloating.
- Pain During Sex: Some women may experience pain or discomfort during intercourse, especially if the fibroids are located near the cervix.
- Back or Leg Pain: Large fibroids can sometimes press on nerves, causing back pain or pain that radiates down the legs.
- Infertility: Fibroids, particularly submucosal ones, can interfere with a woman’s ability to get pregnant. They may block the fallopian tubes or alter the shape of the uterus, making it difficult for an embryo to implant.
- Miscarriage: Women with fibroids may be at an increased risk of miscarriage, especially if the fibroids are large or grow during pregnancy.
How Are Uterine Fibroids Diagnosed?
If you experience any of the symptoms listed above, your doctor may perform a pelvic exam to feel for any unusual growths in the uterus. To confirm the diagnosis and determine the size and location of the fibroids, your doctor may recommend one of the following tests:
- Ultrasound: A pelvic ultrasound uses sound waves to create images of your uterus. It’s the most common test used to detect fibroids.
- MRI (Magnetic Resonance Imaging): An MRI provides detailed images of the uterus and fibroids and can help your doctor plan for treatment if surgery is necessary.
- Hysterosonography: This procedure involves inserting a saline solution into the uterus to help your doctor see the fibroids more clearly on an ultrasound.
- Hysteroscopy: A thin tube with a camera is inserted into the uterus to check for fibroids, particularly those inside the uterine cavity.
- Laparoscopy: A laparoscope can be used to examine the outer uterus and check for fibroids if they are suspected to be outside the uterine cavity.
Treatment Options for Uterine Fibroids
The treatment for uterine fibroids depends on the severity of symptoms, the size of the fibroids, and the woman’s health and fertility goals. Some common treatment options include:
- Watchful Waiting: If the fibroids are small and not causing any significant problems, your doctor may recommend simply monitoring them over time without immediate treatment.
- Medications: Medicines can help control symptoms like heavy bleeding and pain.
- Minimally Invasive Procedures:
- Uterine artery embolization (UAE): This procedure blocks the blood supply to the fibroids, causing them to shrink.
- MRI-guided focused ultrasound: This treatment uses sound waves to destroy fibroids without the need for surgery.
- Surgical Options:
- Myomectomy: This surgery removes fibroids but leaves the uterus intact. It’s an option for women who want to preserve their fertility.
- Hysterectomy: For women who no longer wish to have children or who have severe symptoms, a hysterectomy (removal of the uterus) may be the best solution.
- Alternative Therapies: Some women explore alternative treatments like acupuncture or herbal remedies. While these may help manage symptoms, they should always be discussed with a healthcare provider.
Uterine fibroids are common and often manageable, but they can cause a variety of symptoms that affect your quality of life. If you experience symptoms such as heavy bleeding, pelvic pain, or infertility, it’s important to speak with your healthcare provider. With a variety of treatment options available, from medications to surgery, fibroids can be managed in a way that fits your lifestyle and health goals.
Early diagnosis and treatment can help you maintain control over your health and well-being. If you suspect you have fibroids, don’t hesitate to reach out to us to explore your options.
