WHAT ARE THEY?

Fibroids are non-cancerous (benign) tumors that can grow inside the uterus, on the surface of the uterus or in the muscular wall of the uterus. Extremely common, fibroids can cause no symptoms and require no treatment, or, can cause many problems, including pain, abnormal bleeding or in rare cases, infertility. These tumors are most commonly found in women in their 30s and 40s, and are, at least, twice as likely to affect African-American women as Caucasian women. It is unclear why some women develop them and others don't.

SYMPTOMS

The most common symptoms of fibroids are prolonged or profuse menstrual bleeding (periods lasting longer than usually lasts more than seven days) and pelvic pressure felt in the pelvic, rectal or bladder area. This pressure can cause difficulty with bowel or urinary function (constipation, pain, urinary retention or incontinence, recurrent urinary tract infections)

In some cases, fibroids are also associated with recurrent miscarriage, infertility and premature or complicated labor.

DIAGNOSIS

If the fibroids are large enough, a health care professional can detect them during a pelvic exam. Scanning by ultrasound, MRI (magnetic resonance imagery) or CT (computed tomography) can confirm the diagnosis. Submucous fibroids, or fibroids that grow just beneath the lining of the uterus, may not appear on imaging, and are diagnosed by various procedures, including hysterosalpingography (dye is injected into uterus; x-rays evaluate uterine cavity); sonohysterography (saline solution injected into uterus; ultrasound evaluates uterine cavity), or hysteroscopy (the uterus is expanded with liquid or gas and a small telescope inserted into uterus) allowing the health care professional to look for fibroids. Fibroids within the uterine cavity may also be removed during hysteroscopy.

TREATMENT

If your fibroids do not grow too large or cause symptoms, your health care professional may suggest a "watch and wait" approach. Regular follow-up visits to monitor the size of the fibroids may be scheduled.

Oral contraceptives and progestins are the most common medical treatments for fibroid-related abnormal bleeding. GnRH agonists (gonadotropin-releasing hormone) are another treatment option. They temporarily shrink fibroids by blocking estrogen production needed for their growth. GnRH agonists are mainly used in patients close to menopause or to shrink fibroids before surgery. Once the agonists are discontinued the fibroids usually grow back.

In cases where symptoms are severe and/or other organs are affected, surgery may be required. The type of surgery depends on the location and size of the fibroid, type of symptoms, woman's age and fertility concerns.

Surgical options include:

COMMONLY ASKED QUESTIONS

Question: Do I have fibroids, and if so, how will they be diagnosed and do I need a specialist to treat them?
Answer: If you have heavy periods for more than seven days and breakthrough bleeding, pelvic pressure, see your health care professional for a pelvic exam and possibly imaging studies to determine if you have fibroids. If the diagnosis is positive, you may be recommended to a gynecologist.

Question: How will my fibroids be treated?
Answer: If you are of child-bearing age, hysterectomy most likely will not be performed. Other treatment options include medications, minimally invasive therapies such as uterine artery embolization (UAE) and endometrial ablation, and myomectomy, which removes the fibroids but leaves the uterus in tact. The type of myomectomy (laparotomy, which is performed through the abdomen, or laparoscopy, which is similar to the laparotomy but uses a smaller incision) will be determined by fibroid location.

Question: How can I prevent fibroids?
Answer: There is no way to prevent fibroids. They cause problems for an estimated one in four women of reproductive age, but as many as three in four women may have fibroids and not know it.

Question: Is it safe to take birth control pills if I have fibroids?
Answer: Birth control pills do not appear to have any effect on fibroid size. They are actually beneficial in controlling fibroid-related prolonged or heavy bleeding during menstruation.

QUESTIONS TO ASK YOUR HEALTH CARE PROFESSIONAL

Be prepared to talk with your health care professional about uterine fibroids. Click here for a list of questions at your next office visit.

For more in-depth information about uterine fibroids - diagnosis, treatment, test your knowledge quiz and more - click here.

Resources:

"Uterine Fibroids." The Mayo Clinic. Last updated June 2005. http://www.mayoclinic.com/health/uterine-fibroids/DS00078/DSECTION=1. Accessed January 2007.

"Uterine Fibroids: Treatment." The Mayo Clinic. Last updated June 2005. http://www.mayoclinic.com/health/uterine-fibroids/DS00078/DSECTION=8. Accessed January 2007.

"Treatment, uterine fibroids." The National Women’s Health Resource Center, Awww.tazo.com Z conditions. Last updated Nov. 2006. http://www.healthywomen.org/healthtopics/fibroids/treatment. Accessed January 2007.

Developed with an educational grant from TAP Pharmaceutical Products Inc.

Create Date: 5/06/05
Date Last Updated: 2/01/07