Uterine fibroids impact the lives of millions of women in the United States every year.
Uterine fibroids, also known as myoma or uterine leiomyomata, are the most common benign (noncancerous) uterine growths in women of childbearing age. The fibroids arise from muscle cells and other tissues within the wall of the uterus. Fibroids can occur individually or as clusters of varying sizes. Fibroid growth is dependent on hormone levels; an increase in a woman's hormone levels may cause the size of the fibroid to increase. After menopause occurs, the body's production of these fibroid-causing hormones decreases dramatically, and as a result, the fibroid(s) may shrink. Uterine fibroids are classified according to their location.
The following are the primary types of fibroids:
- Intramural fibroids - The most common type of fibroid, these develop within the uterine wall and expand, making the uterus feel larger than normal. This type of fibroid may cause bloating, pelvic pressure, and other general discomfort known as "bulk symptoms."
- Pedunculated fibroids - These fibroids grow on a small stalk, which connects them to the inner or outer wall of the uterus.
- Submucosal fibroids - Developing just under the lining of the uterine cavity, these are the fibroids that often cause abnormal or extensive menstrual bleeding, and those that can cause infertility and miscarriage.
- Subserosal fibroids - These develop in the outer portion of the uterus and continue to grow outward.
Symptoms of Uterine Fibroids
Symptoms are related to the size and location of the fibroids, and may affect your quality of life, even becoming so unbearable that treatment will be required. If you are experiencing any of the following symptoms of fibroids, you should speak with your doctor:
- Heavy bleeding or painful periods
- Frequent urination (caused by a fibroid pressing on the bladder)
- Bleeding between periods
- Pain during sexual intercourse
- Feeling "full" in the lower abdomen
- Lower back pain
- Distended abdomen which may be mistaken for weight gain or pregnancy
- Difficulty becoming pregnant
The majority of these symptoms are due to the fact that as fibroids grow, the uterus in enlarged, and the space normally occupied by other organs is invaded. As a result, pressure may be placed on the surrounding nerves, organs, spine or pelvic bone, which may result in frequent pain and discomfort. As the fibroids encroach into the endometrium, a bleeding reaction is triggered and there is a chance for fibroids to cause infertility.
If you believe you are suffering from uterine fibroids, please consult your doctor. You should talk with your doctor about your concerns during your annual gynecological examination or during a special visit to investigate symptoms similar to those related to uterine fibroids. Your doctor will check your uterus and if it feels enlarged, an abdominal or transvaginal ultrasound or a magnetic resonance imaging (MRI) exam of your pelvis will be performed. These imaging techniques can confirm the presence, location and size of fibroids. After identifying the size and location of your fibroids, and possibly after other diagnostic tests, your doctor may be able to rule out other conditions, advise you of your options, and recommend a course of treatment for fibroids.
There are many options for the treatment of uterine fibroids, and your doctor is the best person to discuss treatments with you. Treatments include the following:
- Watchful waiting - involves following the fibroids over time, with no initial intervention
- Hysterectomy - surgical removal of the uterus
- Abdominal myomectomy - surgical removal of the fibroids through an incision in the abdomen
- Laparoscopic myomectomy - involves the removal of the fibroid using a long narrow telescope inserted through a small incision to visualize the fibroid, with surgical tools inserted through other small incisions
- Hysteroscopic myomectomy - a long narrow telescope is passed to the uterus through the cervix to allow passage of the surgical instruments to remove the fibroids
- Uterine artery embolization - blocks the blood supply to the fibroid, causing it to die
- Hormone therapy - uses medications to deprive the fibroids of the hormones they need to grow, typically a temporary approach
Our physicians at Houston Methodist specialize in fibroid care at the following convenient locations: