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About Uterine Fibroids

In this section, you or a loved one can find out more about medical treatments and practical information about uterine fibroids. Read on to find answers to some of your questions as well as links to other information. Being informed is an important first step toward becoming an active decision-maker in your care plan.

What Are Uterine Fibroids?

Uterine fibroids, sometimes also called leiomyomas or myomas, are non-cancerous growths made of muscle cells and other tissues that develop in the uterus (womb). They can be single or multiple, small or large, and located in various parts of the uterus. Depending on their number and size, they can lead to uterus enlargement. Fibroids are common in women in their 30s and 40s, and they are particularly common in African-American women. 

What Causes Uterine Fibroids?

The exact cause of uterine fibroids is unclear but researchers believe they may be caused by genetic changes. An imbalance of the hormones estrogen and progesterone or other chemical signals within the body may cause them to grow. Characteristics that can increase the chance that a woman may develop uterine fibroids are having a close relative who had them, being overweight, getting your first period at an early age, and other factors. 

What Are the Effects of Uterine Fibroids?

Uterine fibroids don't always cause symptoms, but when they do, the following symptoms may occur:

  • Heavy menstrual bleeding (heavy periods) is the most common and bothersome symptom of fibroids that may cause severe anemia (too little iron in your blood). Heavy periods may also be associated with cramps (menstrual pain). 
  • Non-bleeding (bulk) symptoms are related to the size of uterus and location of the fibroids in the uterus. They include the following symptoms: 
    • Abdominal or pelvic pain
    • Abdominal or pelvic pressure
    • Abdominal or pelvic cramping
    • Back pain
    • Abdominal bloating
    • Urinary problems (for example, urinating too frequently or feeling a sudden need to urinate) 
Which Body Parts Are Affected?

The uterus is the part of the body most directly affected by uterine fibroids, but women may experience pain or pressure related to urination or bowel movements.

Are There Other Complications?

The types and severity of symptoms can differ from woman to woman. Many different factors can affect an individual's experience with uterine fibroids.

Some of the more troublesome complications surround pregnancy. 

Maintaining pregnancy can be more difficult as fibroids can contribute to miscarriage. Fibroids can also cause the placenta to separate from the wall of the uterus, a condition called placental abruption, which can deprive the fetus of oxygen. It can also cause a breech fetal position or induce preterm delivery. Labor may also fail to progress. Women with fibroids are more likely to require a cesarean section. 

Medical and Surgical Treatments

Interventions for uterine fibroids can differ widely from woman to woman. Therefore, treatment plans are usually tailored to each woman's unique circumstances. A woman should work closely with her doctor to create a treatment plan that is right for her. 

Medication

When uterine fibroids cause symptoms such as heavy menstrual bleeding, the first treatment that a doctor may prescribe is medication that helps regulate menstrual cycles. These medications may include oral contraceptives or progestins. Women with fibroids may receive a progestin-releasing intrauterine device (IUD) to reduce bleeding. Doctors may also recommend non-steroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen) to relieve pain, as well as vitamin D and iron to combat the anemia that can be associated with heavy bleeding. 

Surgery

Women with fibroids who do not want to have their uterus removed may elect for a "myomectomy," in which the fibroids are removed, either laparascopically (through a small incision), hysteroscopically (through the vagina and cervix), or abdominally (through a larger abdominal incision). Hysterectomy, or removal of the entire uterus, with or without the removal of the ovaries, remains the only permanent solution for uterine fibroids. Hysterectomy is a major surgery that ends the ability to have children and brings on menopause (if the ovaries are removed).

Other procedures 

Some women with fibroids may have uterine artery embolization (UAE), in which a substance is injected into an artery to cut off the blood supply to the fibroids. This procedure is used to starve the fibroids, causing them to die. MRI-guided focused ultrasound surgery (FUS) is a treatment that heats up and destroys fibroid tissue without damaging the entire uterus. Myolysis is a surgery performed through a small incision that uses an electric current or laser to destroy the fibroids. Cryomyolysis achieves the same effect through freezing. 

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