Uterine Fibroids

Also known as Fibromyoma, Leiomyoma, Myoma or just plain Fibroids, Uterine fibroids are non-cancerous tumors that develop within or attach to the wall of the uterus, a female reproductive organ. Uterine fibroids are the most common, non-cancerous tumors in women of childbearing age.

The fibroids are made of muscle cells and other tissues that grow within and around the wall of the uterus.

Risk factors for uterine fibroids:

      * African American woman are at three- to five-times greater risk than white women for fibroids.
      * Women who are overweight or obese for their height are at greater risk.
      * Women who have given birth are a lower risk.

Symptoms of uterine fibroids

Many women with uterine fibroids have no symptoms. Symptoms of uterine fibroids can include:

      * Heavy or painful periods, or bleeding between periods
      * Feeling full in the lower abdomen
      * Urinating often
      * Pain during sex
        * Lower back pain

     

        * Reproductive problems, such as infertility, multiple miscarriages, or early labor

    Most women with fibroids do no have problems with fertility and can get pregnant. Some women with fibroids may not be able to get pregnant naturally. But advances in treatments for infertility may help some of these women get pregnant.

    Treatment

    Health care providers consider a number of things when recommending treatment for fibroids, including:

    Does the woman have symptoms of uterine fibroids? Does she want to become pregnant? How large are the fibroids? What is the womans age?

    If you have uterine fibroids, but show no symptoms or have no problems, you may not need any treatment. Your health care provider will check the fibroids at your routine gynecological exam to see if they have grown. Also, because fibroids are dependent on hormones, your fibroids may decrease in size during/after menopause.

    If you have pain now-and-then or feels mild symptoms, your health care provider may suggest pain medication, ranging from over-the-counter remedies to strong prescription drugs.

    Medical Therapy

    If you have many symptoms or feel pain often, you may benefit from medical therapy- that is, therapy using certain medications rather than surgery. Keep in mind that many medications have side effects, some of them serious.

        * One way to reduce symptoms of uterine fibroids is using one of a group of hormones called gonadotropin releasing hormone agonists (GnRHa). These hormones block the body from making the hormones that cause women to menstruate or have their periods. If you have symptoms, have health conditions that make surgery less advisable, and are near menopause or do not want children, you may receive GnRHa therapy to treat your fibroids.
        * Antihormonal agents, like mifepristone, also slow or stop the growth of fibroids.
        * Medical therapy is often used before a woman has surgery for her fibroids. This therapy offers only temporary relief from the symptoms of fibroids; once you go off the therapy, your fibroids may grow back.

    Surgical Therapy

    If you have moderate symptoms of fibroids, surgery may be the best form of treatment. Talk to your doctor about the different types of surgery. Surgery can be a major or minor procedure. Also talk about the possible risks of the procedure and the side effects.

    Myomectomy removes only the fibroids and leaves the healthy areas of the uterus in place. This procedure can preserve a womans ability to have children. Sometimes a laparoscope is used to see the inside the abdomen during a myomectoy. A hysteroscope may be used to see the size, shape, and location of fibroids inside the lining of the uterus. In some cases, surgeons may use the instrument to remove the fibroid.

    Hysterectomy is used if your fibroids are large, or you have heavy bleeding, and you are either near or past menopause, or you don’t want children. Hysterectomy is the only sure way to cure uterine fibroids. In general, recovery time from a hysterectomy is one to two months. Health care providers now have hysterectomy options that differ in how invasive they are. If you are pre-menopausal, talk to your doctor about keeping your ovaries. The ovaries provide hormones that help maintain bone health and sexual health. Sometimes surgeons use a laparoscope to see inside the abdomen during a hysterectomy.

    • Abdominal hysterectomy is a procedure that involves a cut into the abdomen to remove the uterus.
    • Vaginal hysterectomy is less invasive because the doctor reaches the uterus through the vagina, instead of making a cut into the abdomen. This procedure may not be an option if the fibroids are very large.

    Uterine Artery Embolization (UAE) (also called uterine fibroid embolization or UFE) is a newer treatment that cuts off the blood supply to the fibroids, making them shrink. Recovery time for UAE is much shorter than for hysterectomy. Because this procedure can affect how the ovaries function and can limit fertility, health care providers do not recommend UAE for women who still want to have children.

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