For women during their child-bearing years, it’s always important to be aware of any changes that can develop in the reproductive system. It’s possible you’ve heard the term fibroids in passing, and are just unsure of what it means. So what are fibroids, exactly?
In short, fibroids are compact tumors that develop in the uterus. They are also known as myomas or leiomyomas. Uterine fibroids vary in size, number, and how disruptive they can be. There are different types of fibroids, depending on their location on or in the uterus. Intramural fibroids appear within the uterus on the muscular wall and are the most common type of fibroid. Subserosal fibroids, as the name suggests, develop on the serosa (outside of the uterus). Pedunculated fibroids are subserosal fibroids that develop small, supportive stems to support the tumor. Finally, submucosal fibroids develop beneath the menstrual layer of the uterus and bulge into the menstrual cavity.
Understandably the term tumor can invoke a lot of fear and panic, but in almost every single case (more than 99 percent of the time), these tumors are benign and not associated with any cancer. As many as 50% of women are estimated to have fibroids, but only about 20% of these women have symptoms to alert them to the presence of the fibroids.
Also, only a small percentage of fibroids are actually large enough for a doctor to identify, ranging in size from as small as a seed to as large as a baseball or more. Though fibroids appear in and on the uterus and are made in part of connective tissue developed in the uterus, they do not increase a woman’s chance to develop uterine cancer.
If they can go unnoticed for some women, then what are some possible symptoms that may point to fibroids as the culprit? Again, symptoms can vary from being non-existent to much more serious. Some women who have fibroids may never experience any symptoms, while others will find their day-to-day life interrupted.
Common symptoms of uterine fibroids include:
- Lower back pain
- Pain or pressure in the pelvis/lower abdomen
- Abdominal Swelling
- A firm mass in the middle of the pelvis
- Frequent urination
- Heavy bleeding during menstruation
- Menstrual cycles lasting longer than a week
- Pain during sexual intercourse
- Crampy menstrual cycles
- Irregular bleeding
You should see a doctor anytime these symptoms become disruptive or increase in their severity.
Fibroids are often detected unexpectedly during routine pelvic or abdominal examinations in the form of a mass. Physicians may also use CT scans, MRIs, ultrasound or hysteroscopy to properly identify and diagnose the presence of fibroids. Since heavy menstrual bleeding is often a symptom of fibroids, blood tests can also be used to detect iron-deficiency anemia that may result from the heavy bleeding.
It’s not completely clear what exactly causes fibroids other than being a woman in childbearing years, but there are a few factors that may contribute to their development. The presence of estrogen and progesterone may be a contributing factor in the development of fibroids. (They are the hormones that stimulate the uterine lining’s development to prepare for pregnancy during each menstrual cycle.) Other risk factors include a family history of fibroids and African American ethnicity. African American women are more likely to develop fibroids at a younger age, in greater numbers and larger sizes than women of other ethnicities.
Other Potential Risk Factors May Include:
- Use of hormonal birth control
- Vitamin D deficiency
- Starting menstruation at a young age
- Alcohol consumption
- Low intake of fruit, dairy, and green vegetables with higher red meat intake
Fibroids are rarely dangerous and rarely interfere with your ability to become pregnant. However, they may cause great discomfort and the heavy bleeding that can be associated with them can lead to anemia. Additionally, in rare cases, fibroids can cause infertility or miscarriages.
Treatment and Prevention
There are a number of approaches to treating fibroids and their associated symptoms of pain and bleeding once they are detected. A common option is birth control pills which shrink the menstrual lining of the uterus, usually leading to lighter and less crampy menstrual cycles. Progesterone-containing IUD’s like Mirena and Liletta can also accomplish the same symptom relief. Additionally, anti-inflammatory medications like Ibuprofen or Naproxen may often relieve the painful cramps associated with fibroids.
When symptoms of fibroids become intolerable and unresponsive to medications there are many other ways to relieve the symptoms with surgical and non-surgical procedures. These include minimally-invasive surgical removal of fibroids with hysteroscopy or laparoscopy or via laparotomy (a larger skin incision) when the fibroids become too large. Fibroid removal is typically used in situations when a woman wants to preserve her uterus for future pregnancies. Another minimally invasive procedure that can alleviate the fibroid symptoms is an endometrial ablation in which the menstrual lining of the uterus is melted away. This can often be performed in the doctor’s office and has a high success rate and a very rapid recovery associated with it. In some situations, especially if a woman has completed her child-bearing, a hysterectomy (removing the uterus) is the most appropriate treatment.
Additional procedures that can treat fibroids and their symptoms include fibroid embolization and high intensity ultrasound. Fibroid embolization involves injecting microscopic beads into the uterine blood vessels to attempt to block the blood supply to the fibroids. This can often shrink the fibroids and reduce the bleeding and cramping from the fibroids. Similar results can be achieved with high intensity ultrasound during which several ultrasound waves are targeted at the fibroids to attempt to melt away the fibroid tissue. This procedure is not readily available due to its lack of popularity.
Since the exact cause of fibroids is not entirely understood, prevention plans are difficult to recommend. However, leading a generally healthy diet and lifestyle may help reduce your risks for developing fibroids. It’s also vital to keep up with your annual OBGYN appointments to screen for abnormalities like fibroids
Your Florida Woman Care of Jacksonville OB/GYN will assess you and any potential risk factors for developing fibroids. If you’ve developed uncomfortable or disruptive symptoms and fear that fibroids could be the cause, schedule an appointment and let us help you determine the best course of action.