Uterine Fibroids

Fibroids are noncancerous tumors that develop in the uterus. They are the most commonly seen tumors of the female reproductive system, affecting an estimated 20 to 50 percent of women of reproductive age, although not all are diagnosed. These firm, compact tumors are made of smooth muscle cells and fibrous connective tissue, and can range in size from a pea to a grapefruit and even larger. While they are not associated with increased uterine cancer risk, they may interfere with a woman’s efforts to become pregnant if they grow into the uterine wall.

Most women who have fibroids do not experience symptoms. However, fibroids can sometimes produce:

• Heavy or prolonged menstrual periods
• Abnormal bleeding between menstrual periods
• Pelvic pain caused by one or more tumors pressing on pelvic organs
• Frequent urination
• Low back pain
• Pain during intercourse
• A firm mass, often located near the middle of the pelvis, which can be felt by a clinician

Diagnosing and Treating Uterine Fibroids

Because most women with uterine fibroids do not experience symptoms, most do not require treatment. For those who experience symptoms, treatment may be necessary (depending on symptom severity). Emergency treatment is sometimes needed when there is sudden, sharp pain or profuse bleeding.

Several methods can be used to diagnose uterine fibroids, including imaging exams such as ultrasound, X-ray, MRI or hysteroscopy (an optical instrument inserted through the vagina). In some cases, a biopsy may be performed to rule out cancer (although 99 percent of uterine fibroids are benign).

For mild cases, managing pain with anti-inflammatory drugs may be sufficient.

Other treatment options, which vary based on such factors as the severity and location of the fibroids, the patient’s age and whether the patient intends to become pregnant in the future, may include:

• Anti-hormonal drugs
• Myomectomy, a conservative surgical procedure that removes fibroids while leaving the uterus intact
• Uterine fibroid embolization, a minimally invasive, image-guided procedure that delivers small particles that destroy the fibroid tumors by cutting off their blood supply
• Hysterectomy