The Facts About Fibroids

Myoma. Leiomyoma. Fibroids. These are names for a common medical condition that affects many women. Fibroid tumors may sound like a serious condition, but for many women who have them, they're just a fact of life.

Fibroids are noncancerous growths that develop in the walls of the uterus. Each fibroid grows when a single cell in the uterine wall becomes supersensitive to estrogen. The more estrogen that is around, the bigger the fibroid may grow. Fibroids sometimes grow quite large during pregnancy, but shrink afterward. They also often shrink or disappear after menopause, when estrogen levels drop.

Many women have questions about fibroids. Here are the facts.

What are my chances of developing fibroid tumors?

Up to 80 percent of women develop fibroids by the time they reach age 50. You are more likely to get fibroids if a close relative has fibroids. Your chances are also higher if you are African American.

How can I tell if I have fibroids?

Many women have fibroids and don't know it. Often, a doctor will discover them during a routine pelvic exam. Some women notice symptoms. These vary depending on the location, size and number of growths. Most women who develop fibroids have more than one tumor. Because the vast majority of the time fibroids do not become cancerous, unless you are having problems from your fibroids, there is no reason to do anything about them.

These are some of the symptoms fibroids may cause:

Abdominal swelling
Heavy or longer menstrual bleeding
Bleeding between periods
Low abdominal or low back pain
Frequent urination (if a tumor presses on the bladder)
Constipation (if a tumor presses on the rectum)
Pregnancy losses and possibly infertility

Your doctor will perform an examination of your abdomen and pelvis and may do an ultrasound to determine the cause of your symptoms. This painless procedure can help locate a growth and determine if it is a fibroid.

If I develop fibroids, what are my options for treatment?

Treatments vary depending on the size of the tumors and the severity of your symptoms:

Watchful waiting. If fibroids aren't causing you problems, your doctor may decide to monitor their growth at your annual exam. This is the most common approach because most fibroids don't cause any problems. Sometimes they shrink or disappear on their own.
Medication. Certain medications can help control bleeding by blocking estrogen production. Blocking production of estrogen may temporarily help shrink fibroids. Often this type of medication is used to shrink tumors before surgery.
Surgery. Surgery may be necessary if you have severe symptoms. One type of surgery removes only the tumor (myomectomy). New treatments include uterine artery embolization, in which the blood vessels that feed the fibroid are blocked; and destruction of the fibroids with an extremely hot or cold instrument, using laparoscopy through the abdomen or the cervix. These treatments are possibilities depending on the location and size of the fibroid. If the main problem is bleeding, sometimes combining removal of the fibroids through the cervix with removal of the uterine lining by coagulation, laser or heat will stop the bleeding. In some cases, a hysterectomy may be preferred if a woman does not want to have children anymore, has heavy bleeding or is postmenopausal. Most women who develop fibroids do not need a hysterectomy.

All treatments for fibroids have pros and cons. Be sure to talk with your doctor and weigh your options before deciding on a course of action.

If I have fibroids, am I at higher risk for cancer?

No. Having fibroids does not increase your risk for cancer. Only in very rare cases does a fibroid growth become cancerous. Fear of cancer in the fibroids is generally not a good reason for hysterectomy, unless your physician suspects that problem for other reasons.