Uterine Fibroids Explained
Uterine fibroids are noncancerous growths of the uterus that develop in or just outside a woman’s uterus during childbearing years. Uterine fibroids develop from muscle cells that grow abnormally eventually forming a benign tumor. They can range in size from tiny seedlings to large masses that can alter and enlarge the uterus. For many cases, uterine fibroids will cause no symptoms at all, so most women don’t realize they have them until they are found during a pelvic exam or prenatal ultrasound.
What Causes Uterine Fibroids?
Doctors have not yet determined an exact cause. Uterine fibroids are extremely common yet we don’t exactly know why they develop. In fact, as many as 3 out of 4 women have them at some point in life. The growth of fibroids seems to depend on genetic changes and hormones. Most fibroids develop after puberty and usually after age 30 leading researchers to believe estrogen plays a large role in their growth. Uterine fibroids tend to shrink or disappear completely when hormone production decreases and estrogen levels fall after menopause. Uterine fibroids in most women are usually too small to cause any problems or even notice.
Factors That Increase Fibroid Development
- Taking birth control pills are less likely to develop uterine fibroids.
- Women whose first period was before age 10 are more likely to develop significant uterine fibroids.
- If female relatives have uterine fibroids, you are more likely to have them.
- Having children makes you less likely to develop uterine fibroids in the future.
- Most women are unaware of them because they often cause no symptoms.
Symptoms of Uterine Fibroids
- Persistent pelvic pain
- Heavy/painful menstrual bleeding
- Frequent urination
- Difficulty emptying your bladder
- Pain with intercourse
- Prolonged menstrual bleeding, for seven or more days
- Bloating/fullness in the belly or pelvis
- Spotting/bleeding between periods
Surgery for Uterine Fibroids
If the symptoms are mild, medication can be prescribed. Depending on how bad your symptoms, your physician may determine surgery is the best route. This kind of surgery has options – most of which are done by laparoscopy, which means they make small cuts instead of one big one.
Best for smaller fibroids, the doctor will cut the blood supply to the fibroid through freezing, heating, or radiofrequency activity. Your risk includes scarring in the uterus, or a possible infection, which could lead to infertility. Make sure you discuss your future family plans with your surgeon before choosing this method.
Uterine Artery Embolization
If going under the knife just isn’t for you, consider this method which inserts a catheter, or thin tube, into your uterine artery. Your doctor will inject a substance that essentially cuts off the blood supply to your fibroids, leaving them to shrink considerably. You more than likely be awake but have a sedative to relax you during the procedure. You can go home the next day with medication to ease any cramping or discomfort you may feel after the procedure. After an embolization, it is rare for any fibroids to grow back or new ones to develop.
If you have a very heavy period, small fibroids, and zero plans of getting pregnant, this procedure may be right for you. An endometrial ablation removes the lining of your uterus. There is no cutting in this procedure. Your doctor will go through the vagina to access your uterus. It may be done by several different methods, such as boiling water, electric current, freezing, or a laser. This tends to be an in-office procedure with a quick recovery leaving you with little or no bleeding in your future periods.
If you eventually want to start a family, your surgeon may suggest this procedure. In a myomectomy, healthy tissue of your uterus is left intact. Depending on the size, location and how many fibroids you have, your doctor will have several options to consider. She may do a surgical removal through the abdomen, hysteroscopic for fibroids inside your uterus, or laparoscopic.
The other option for those not wanting to get pregnant is a hysterectomy. This procedure completely removes the uterus altogether. For those with very heavy periods and larger fibroids, this is an ideal option. Depending on the size of the fibroids, your doctor will determine if entering through the vagina or abdomen is necessary. This is a major surgery, however, so consider if you have time to undergo such a long recovery time.
Remember: Seek prompt medical care if you have severe vaginal bleeding or sharp pelvic pain that comes on suddenly.