Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas or myomas, uterine fibroids are not associated with an increased risk of uterine cancer and have almost negligible risk of turning into cancer.
Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. They can be single or multiple, in extreme cases expanding the uterus so much that it reaches the rib cage.
As many as 3 out of 4 women have uterine fibroids sometime during their lives, but most are unaware of them because they often cause no symptoms. Your doctor may discover fibroids incidentally during a pelvic exam or prenatal ultrasound.
Causes
It is unclear why fibroids develop, but several factors may influence their formation.
Genetic changes: Many fibroids contain changes in genes that differ from those in normal uterine muscle cells. There’s also some evidence that fibroids run in families and that identical twins are more likely to both have fibroids than non-identical twins.
Hormones: Estrogen and progesterone, two hormones that stimulate development of the uterine lining during each menstrual cycle in preparation for pregnancy, appear to promote the growth of fibroids. Fibroids contain more estrogen and progesterone receptors than normal uterine muscle cells do. Fibroids tend to shrink after menopause due to a decrease in hormone production.
Other growth factors: Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth.
Symptoms
Not all women experience symptoms, but for those who do, the most common symptoms of uterine fibroids include:
- Heavy menstrual bleeding
- Prolonged menstrual periods — seven days or more of menstrual bleeding
- Pelvic pressure or pain
- Frequent urination
- Difficulty emptying your bladder
- Constipation
- Backache or leg pains
When to see the Doctor
See your doctor if you have:
- Pelvic pain that doesn’t go away
- Overly heavy or painful periods
- Spotting or bleeding between periods
- Pain consistently with intercourse
- Enlarged uterus and abdomen
- Difficulty emptying your bladder
Seek prompt medical care if you have severe vaginal bleeding or sharp pelvic pain that comes on suddenly.
Diagnosis
Uterine fibroids are frequently found incidentally during a routine pelvic exam. Your doctor may feel irregularities in the shape of your uterus, suggesting the presence of fibroids. If you have symptoms of uterine fibroids, you doctor may order tests like ultrasound or other screening tests like MRI or CT scan.
Treatment
Many treatment options exist, depending on the individual presentation of the condition. Many women with uterine fibroids experience no signs or symptoms, or only mildly annoying signs and symptoms that they can live with. In this case it is best to not do anything but keep getting regular check-ups to monitor the fibroids. Fibroids are mostly not cancerous, and they rarely interfere with pregnancy. They usually grow slowly — or not at all — and tend to shrink after menopause, when levels of reproductive hormones drop.
In case treatment is required it may include
- Medications to control symptoms like bleeding /pain,
- non-invasive procedures like MRI-guided focused ultrasound surgery, embolisation,
- minimally-invasive procedures like Laparoscopic or robotic myomectomy, and
- surgery to remove fibroids from the uterus (abdominal myomectomy) or hysterectomy.