Three out of four women have uterine fibroids at one point in their life, however, the majority of fibroids are so small, and produce no symptoms so their presence is never detected and no problems result. Uterine fibroids can, however, lead to problems and it is good to have an understanding of what they are.
What are uterine fibroids?
Uterine fibroids are benign (non-cancerous) growths found in the uterus. These growths may be located within the uterine cavity, within the walls of the uterus, or attached to the uterus with stem-like structures. Uterine fibroids are typically small, less than the size of a pea, and usually go undetected, however, they can become quite large and numerous, filling up the pelvis and distorting the shape of the uterus.
What are the symptoms of uterine fibroids?
Typically, small uterine fibroids will produce no symptoms, however, when fibroids become large or numerous, symptoms such as heavy bleeding during menstrual periods, pain during urination, constipation and rectal pain, swelling of the abdomen and uterus, and anemia may be signs of uterine fibroids.
What causes uterine fibroids?
There are no definitive causes for uterine fibroids, however, several theories exist regarding the development of uterine fibroids. Uterine fibroids are believed to be made worse by the hormones estrogen and progesterone, due to the high levels of these hormones (and their receptors) within the fibroids. Other theories suggest that the uterine fibroids are the result of mutated genes, as the genetic code of fibroids is similar to that of the uterine muscle tissue.
Can uterine fibroids affect fertility?
Uterine fibroids typically do not affect fertility and women experiencing them are usually able to get pregnant. However, due to the location of the uterine fibroids, a woman may be more likely to suffer a miscarriage. If a woman is struggling to become pregnant, fertility treatments or surgery may be feasible options to help women with uterine fibroids become pregnant.
What treatments are available for uterine fibroids?
There is no cure for uterine fibroids, however, medications may help reduce the size of the uterine fibroids and control heavy bleeding which can lead to anemia. Surgery may also be used to treat the presence of uterine fibroids.
Medications such as hormonal birth control pills, or hormonal intrauterine devices (IUD) may be used to help control the bleeding often associated with uterine fibroids. However, hormonal birth control will not decrease the size or number of uterine fibroids. Gonadotropin-releasing hormone agonists may be used to reduce the size and number of uterine fibroids. This medication is thought to work because it drastically lowers the amount of estrogen and progesterone in the body; something the uterine fibroids seem to feed off of. One disadvantage is that these medications may bring on symptoms similar to that of menopause. Male hormones (androgens) may also be taken in hopes of reducing the size and number of uterine fibroids.
Surgery may be an option for women suffering from unusually large or numerous fibroids. Women who do not with to have any more children may choose to undergo a hysterectomy (the removal of the uterus and cervix), however, once this is done, the woman is unable to become pregnant. Women wishing to preserve their ability may opt for myolysis, a procedure in which the uterus remains in place and only the fibroids are removed. Myolysis does carry the risk of uterine fibroids returning.
Other treatments, such as endometrial ablation, uterine artery embolization, and focused ultrasound surgery may also be options. These options however, have unknown levels of effectiveness and may carry other risks with their use.
ACOG Education Pamphlet AP074: Uterine Fibroids
Uterine Fibroids: MedlinePlus