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Uterine Fibroids

What are Uterine Fibroids?

Uterine fibroids or uterine myomas are benign growths of the muscle of the uterus, affecting more than 20% of women, mostly those in their 40’s. Most fibroids are asymptomatic and usually do not require any treatment unless their growth affects adjacent organs such as the bladder or rectum.

Fibroids are classified by their location. The symptoms experienced depend upon the location of the growth.

  • Fibroids that are inside the wall of the uterus are termed intramural and can be responsible for pain and abnormal bleeding during the menstrual cycle.
  • Fibroids that are just underneath the endometrial lining are called submucous fibroids. These can affect implantation and fertility and cause significant pain and prolonged menstrual cycles.
  • Fibroids that are typically asymptomatic, located outside of the wall of the uterus, are termed pedunculated. Because these fibroids grow inside the abdominal cavity, they can cause pressure on the bladder, bowel or rectum.

What Causes Uterine Fibroids?

While it is not clearly known what causes fibroids, it is believed that each tumor develops from an aberrant muscle cell in the uterus, which multiplies rapidly because of the influence of estrogen.

Symptoms of Uterine Fibroids

Some women who have fibroids have no symptoms, or have only mild symptoms, while other women have more severe, disruptive symptoms. The following are the most common symptoms for uterine fibroids; however, each individual may experience symptoms differently. Symptoms of uterine fibroids may include:

  • Heavy or prolonged menstrual periods
  • Abnormal bleeding between menstrual periods
  • Pelvic pain (caused as the tumor presses on pelvic organs)
  • Frequent urination
  • Low back pain
  • Pain during intercourse
  • A firm mass, often located near the middle of the pelvis, which can be felt by the physician

In some cases, the heavy or prolonged menstrual periods, or the abnormal bleeding between periods, can lead to iron-deficiency anemia, which also requires treatment.

How to Get Rid of Fibroids

Treatment is definitely required for rapidly growing fibroids to rule out cancer, fibroids that cause a significant amount of bleeding and cramping during the menstrual cycle and fibroids that are affecting fertility.

The treatment of fibroids depends upon the symptomatology.

  • Fibroids that significantly affect neighboring organs, such as the bladder and the rectum, need to be surgically removed.
  • Small fibroids that cause significant pain and bleeding can be resected through the vagina and through the cervix via a small telescope.
  • Fibroids affecting fertility need to be removed.
  • Currently there has been some treatment with medications such as gonadotropin releasing hormone agonists, which induce a temporary chemical menopause. Since the growth of the fibroid is dependent upon estrogen, a decline in estrogen production usually will reduce the size and the symptoms of the fibroid.
  • Uterine artery embolization can be employed to reduce the blood supply to the fibroid and consequently to prevent and reduce the size of its growth. Recent reports suggest however, that uterine artery embolization may affect fertility as well as induce pregnancy-related complications (repeated pregnancy loss).

To schedule a consultation to discuss the work-up, diagnosis and treatment of fibroids please call the office at (610) 447-2727.