Q: My GYN provider found I have fibroids during my annual exam. Can you tell me more about them?
A: Uterine fibroids are the most common, benign tumors in women of childbearing age. They are made of muscle cells and other tissues that grow within the wall of the uterus or into the interior wall of the uterus or on the outer surface. A fibroid may also hang by a stalk inside or outside of the uterus.
A woman may have one fibroid, or many fibroids, of varying sizes. Fibroids range in size from very small to much larger, weighing several pounds. The fibroid(s) may stay small for a long time and grow slowly over years, or grow very quickly.
Benign tumors are non-cancerous and do not spread to other organs or systems of the body. Fibroids are rarely associated with cancer.
We don't really know the cause of uterine fibroids. However, African American women, overweight women and women who have never given birth have a higher risk factor for fibroids. Also heredity plays a factor, so if your mother or sister had fibroids, you have an increased risk for them.
Often, the fibroids have no symptoms and women do not know they have them. Those with symptoms report heavy or painful periods, or bleeding between periods.
They may also complain of a feeling of fullness in the lower abdomen or back pain, or pain during intercourse. Pressure from the fibroids can cause difficulty urinating or urinary frequency, as well as constipation or rectal pain.
In addition, women may have difficulty getting pregnant, go into early labor or have miscarriages.
Diagnosis can often be made from a detailed medical history and a pelvic exam. Ultrasound, hysteroscopy, hysterosalpingogram and laparoscopy will provide more information about the size and location of the fibroids. MRI or CT scan may also be performed to follow the growth of the fibroids.
Treatment of fibroids is dependent upon your age, the severity of your symptoms, the type of fibroid you have and your future pregnancy plans.
If there are no symptoms, no treatment is needed. If you have pain or any of the other symptoms presented, there are many different options for treatment. A mild over the counter anti-inflammatory drug or pain killer can control occasional discomfort.
There are medications available that can decrease pain and stop the growth of the fibroids. Oral contraceptives may be used to decrease heavy bleeding and pain. Gonadotropin-releasing hormone (GnRH) agonists is a hormonal therapy to stop the menstrual cycle and to shrink the fibroids. After stopping the medication, though, the fibroids may grow back. Progestin IUDs can help reduce bleeding and pain, but will not treat the fibroid itself.
There are also several different surgical procedures to treat fibroids. A myomectomy will remove the fibroids, leaving the rest of the uterus intact. With this procedure a woman may still get pregnant after.
Uterine artery embolization cuts off the blood supply to the uterus and fibroids, causing them to shrink. An endometrial ablation destroys the lining of the uterus and can be used to treat women with small fibroids. A hysterectomy removes the entire uterus along with the fibroids. These options are only appropriate for women who have completed child bearing, as they will no longer be able to sustain a pregnancy.
Again, fibroids are very common and benign. They may require no treatment at all. If they do require treatment, options can range from medications to surgical procedures. Talk to your provider about which treatment method will be the best option for you.
Ila Shebar is a women's health nurse practitioner specializing in women's pelvic health and continence at Pioneer Valley Urology in Springfield. She has also taught fitness classes at the Jewish Community Center in Springfield for more than 20 years, and is the mother of three sons. Her "Ask Ila" column appears every other Wednesday in the Health & Science section of The Republican and on MassLive.Com. She can be reached at ilashebarnp.pvu@ gmail.com