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Fibroids

Although uterine fibroids often produce no symptoms, they can cause health problems, discomfort, or interfere with your lifestyle. If you have uterine fibroids or if you have had fibroids in the past, we can help you determine the best course of action. If you do have fibroids and they are a problem, we can help you decide on the best treatment for your condition and your personal needs.

Uterine fibroids explained

Uterine fibroids are non-cancerous growths that can grow in or on the uterus. What causes fibroids is not known, but some studies have shown fibroid growth to be related to increases in hormone levels, such as those which occur during pregnancy or when birth control pills are taken. Likewise, fibroids tend to shrink when hormone levels drop, such as after pregnancy or during menopause.

Uterine fibroids can remain very small for a long time, grow slowly over a number of years, or suddenly grow rapidly. If fibroids are removed, others may grow. Fibroids can occur at any age, but they are most common in women between the ages of 30 and 40. They occur more often in African American women.

When uterine fibroids are large, numerous, or located in particular places, they can cause problems.

Uterine fibroid symptoms

When fibroids occur, the symptoms can include:

  • pressure, cramps or sharp pain in the abdomen or lower back
  • changes in menstruation length, frequency or intensity
  • bleeding between periods
  • difficult or frequent urination
  • constipation or rectal pain
  • enlarged uterus or abdomen
  • anemia
  • infertility
  • miscarriage

Uterine fibroids and pregnancy

If you are pregnant and have fibroids, the fibroids likely will not cause problems for you or your baby. About one in four women have uterine fibroids during their reproductive years, and most do not need to be treated. However, it is possible for fibroids in pregnant women to cause discomfort or increase the risk of preterm birth, breech birth or other complications, including miscarriage.

In rare cases, a large fibroid can block the opening of the uterus or keep the baby from passing into the birth canal. In this case, the baby can be delivered by cesarean birth.

Diagnosis of uterine fibroids

Uterine fibroids may be detected during routine pelvic exams. Ultrasound tests, laparoscopy (a minimally invasive surgical procedure), x-ray exams and other tests can show fibroids with more detail and track their growth over time.

Treatment of uterine fibroids

If fibroids are causing discomfort or other problems, there are many treatment options for fibroids, although options are more limited during pregnancy. Your treatment may depend on your own needs and your doctor’s advice, especially about the size and location of the fibroids.

Uterine fibroid treatments include the following options.

Drug therapy, including hormonal birth control, can reduce fibroid-related bleeding and painful periods, but they may not prevent fibroid growth of fibroids.

Myomectomy, or surgical removal of fibroids, leaves the uterus intact, allowing many women to conceive and bear children. In some cases, myomectomy can improve the likelihood of getting pregnant. However, other fibroids can grow after surgery, and any surgery has risks, such as bleeding and infection. Surgical scarring may also lead to infertility or, if pregnancy occurs, a cesarean delivery may be needed.

Endometrial ablation is a surgical procedure that destroys the uterus lining. It is also used to treat some women who have heavy menstrual periods. Risks include bleeding and infection. It is very important that you not become pregnant after this procedure. For more information on Novasure and hydrothermal ablation, please click here.

Uterine artery embolization is a procedure in which the blood vessels to the uterus are blocked, stopping the blood flow that allows fibroids to grow. This procedure may interfere with future pregnancy.

Hysterectomy is the surgical removal of the uterus via a cut in the abdomen or the vagina, depending on the size and location of the fibroids. Risks include bleeding and infection, and a hospital stay of a few days is typical. Pregnancy is not possible after a hysterectomy. This procedure is usually considered in cases of very large fibroids or if other treatments are impossible or unsuccessful.