Uterine fibroids (myomas) are tumors that grow in the uterine walls. They are usually benign, and vary in size and quantity. The exact cause of uterine fibroids is unknown, but their formation may be affected by genetics, with a woman being more likely to develop them if she has a family member similarly afflicted. Most fibroids do not cause any symptoms and do not require any treatment, although, in some cases, they lead to pregnancy complications. Uterine fibroids are most common in women older than 30, and during the reproductive years.
Symptoms of Uterine Fibroids
Uterine fibroids can form on the inside or outside of the uterus. In many cases, they are asymptomatic. If symptoms are present, however, they include the following:
- Heavy bleeding
- Feeling of fullness
- Pelvic pressure
- Lower-back pain
- Frequent urination
If uterine fibroids grow very large, they may put pressure on the large bowel, causing painful bowel movements, constipation or hemorrhoids. In some cases, sexual intercourse becomes painful.
Complications of Uterine Fibroids
In rare cases, uterine fibroids cause infertility or pregnancy complications. They can prevent implantation or growth of an embryo. If the fibroids cause infertility or miscarriage, a doctor may recommend removing them before another pregnancy is attempted. Fibroids present during pregnancy may increase the risk of premature delivery and Cesarean section.
Diagnosis of Uterine Fibroids
Uterine fibroids are commonly discovered during a pelvic exam. If fibroids are suspected, the doctor may confirm the diagnosis with blood tests, and additional imaging tests such as ultrasound, hysterosonography, MRI scans and hysterosalpingography.
Treatment of Uterine Fibroids
In cases in which uterine fibroids are not causing problems, monitoring them may be all that is necessary. Uterine fibroids usually grow slowly, and tend to shrink after menopause, when reproductive-hormone levels drop. When uterine fibroids cause uncomfortable symptoms, hormonal medications may be prescribed to shrink them. A common method used to treat uterine fibroids is fibroid embolization, which is a minimally invasive procedure that blocks blood flow to the fibroids, shrinking or destroying them. There are several other minimally invasive procedures, including the following, available to treat uterine fibroids:
- Laparoscopic myomectomy
- Endometrial ablation and resection of fibroids
In cases in which uterine fibroids have grown very large, more traditional surgical methods such as abdominal myomectomy or hysterectomy may be performed. A hysterectomy, which removes the uterus, is an option only for women who no longer want to have children. Except with a hysterectomy, it is possible that new fibroids will develop even after being treated.