At least two out of every five American women between the ages of 35 and 50 suffer from fibroids. These are sometimes known as uterine fibroids, uterine myomas, leiomyomas or fibromas.
They’re the most common type of tumor found in the female reproductive system.
Some fibroids are never diagnosed because only about a third are large enough to be found during a physical exam.
Fibroids are firm, compact tumors made of muscle cells and other tissues. They grow in or around the wall of the uterus. They can be as small as a pea or as large as a softball.
The exact cause of fibroids is unknown. Estrogen in the uterus may spur a tumor to grow from abnormal muscle cells. In more than 99 percent of cases, fibroid tumors are non-cancerous and they don’t increase a woman’s risk for uterine cancer. Women who are African American or overweight are at higher risk for fibroids.
Signs of fibroids
Many women have fibroids but don’t experience any symptoms. Others have bothersome or painful symptoms. Common indications that you may have fibroids include:
¦ Having heavy, prolonged or painful periods or bleeding between periods. Keep in mind that excessive bleeding may lead to iron-deficiency anemia.
¦ An abnormally enlarged abdomen
¦ Frequent urination
¦ Pain during sex
¦ Lower back or pelvic pain
¦ Reproductive problems, such as infertility, multiple miscarriages or early labor
How are fibroids diagnosed?
The primary way to diagnose a fibroid is through a health care provider’s routine pelvic exam. The provider may feel a firm, irregular pelvic mass. He or she may also use imaging tests such as X-ray, ultrasound or MRI (magnetic resonance imaging) to check for fibroids.
Other ways to diagnose this condition include:
¦ Hysteroscopy — A visual exam of the cervix and the uterus using a viewing instrument
¦ Endometrial biopsy — A tube is inserted into the uterus to take a tissue sample
How are fibroids treated?
When women approach menopause, fibroids will typically stop growing and may even shrink. In those cases, treatment may not be necessary.
If you do have fibroids, your health care provider may suggest “watchful waiting.” Your provider will periodically check the fibroid(s) to keep track of growth and/or the appearance of new fibroids. These checks can be done during your regular health checkups.
However, if fibroids grow to a significant size or cause serious symptoms, medical treatment may be necessary, based on:
¦ Your health and medical history
¦ The size of your fibroids
¦ Your plans for future pregnancy
¦ How you’ve responded to treatment
¦ Your treatment preferences
Treatments may include medical, surgical or radiological options.
Medical treatments
¦ Pain medication: over the counter or prescription
¦ Birth control pills or other types of hormonal birth control
¦ Progestin-releasing intrauterine device (IUD)
¦ Anti-hormonal agents to slow or stop the growth of fibroids
Medical treatments may provide only temporary relief. Once a person stops treatment, the fibroids may return.
Surgical treatments
¦ Endometrial ablation — The lining of the uterus is altered using a heated balloon or a tool that emits controlled microwave energy. Pregnancy should be avoided after an ablation.
¦ Myomectomy — Fibroids are surgically removed, but healthy areas of the uterus remain intact. This procedure should not impact fertility.
¦ Hysterectomy — All or part of the uterus is removed. This is a sure way to cure uterine fibroids. Pregnancy is not possible after a hysterectomy.
Radiological treatments
¦ Uterine artery embolization (UAE) — Tiny particles are surgically inserted into the blood vessels feeding the area around the fibroids. The particles block the blood flow to the fibroids, causing them to shrink.
¦ Magnetic resonance imaging (MRI)-guided ultrasound — High intensity ultrasound waves can destroy the fibroids. The ultrasound waves are administered from a source outside of the body. The waves pass through the skin, hit the fibroid and reduce its size.
If you are troubled by fibroid symptoms, please see your health care provider. There are many treatment options available today that can greatly improve your quality of life.
Dr. Emily Ermis is an OB/GYN at Aurora Bay Area Health Center, 3130 Shore Drive, Marinette. Her office can be reached at 715-732-7421.