What They Are
As many as three out of four women of childbearing age develop these noncancerous tumors. Made up of the smooth muscle tissue of the uterus, fibroids (also known as fibromyomas, leiomyomas or myomas) can be as tiny as a seed or so large they expand the uterus until it reaches the rib cage. Fibroids are not associated with an increased risk of uterine cancer and almost never develop into cancer.
The reason fibroids appear is unknown, but women whose mothers or sisters have fibroids are at an increased risk of developing them, as are African-American women. The hormones estrogen and pro gesterone appear to promote the growth of these tumors, which often shrink after menopause when estrogen levels drop.
Fibroids often have no symptoms and may not be discovered until a doctor finds them during a gynecologic exam. If symptoms occur they usually include: l Heavy or prolonged menstrual periods l Pelvic, back or leg pain l Abnormal pain during sexual intercourse (dyspareunia) l Frequent urination, incontinence or urine retention
Oral contraceptives control menstrual bleeding but don't reduce fibroid size. Injected synthetic hormones called gonadotropin-releasing hormone agonists (Gn-RH) shrink fibroids, but once therapy is stopped, fibroids return. Raloxifene, a drug used to treat postmenopausal osteoporosis, is showing promise in shrinking fibroids with fewer side effects than hormone treatment. Uterine artery embolization involves injecting particles into the arteries that supply blood to the uterus, cutting off blood flow to the tumor, causing it to shrink. Myomectomy is a surgical technique in which fibroids are removed, leaving the uterus intact and making pregnancy possible. Hysterectomy involves removal of the uterus. Seek a second opinion if your doctor recommends this option first.
An image of the uterus is needed to confirm the location of fibroids. Ultrasound uses sound waves to map and measure the fibroids. An even more accurate picture can be gained by injecting a salt solution into the uterus and then performing the ultrasound (called sonohysterography). Other techniques include magnetic resonance imaging (MRI) and computerized tomography (CT).
In another procedure, called hysteroscopy, the doctor inserts a small, lighted telescope through the cervix and into the uterus. A fiber-optic light source and tiny camera in the tube allows the doctor to see any fibroids and measure their size
"Uterine fibroids do not need to be treated if they don't produce any symptoms. If you do have symptoms, talk to your doctor about a treatment option that best suits your needs and stage of life." Rebecca C. Brightman, M.D., clinical instructor of obstetrics and gynecology at Mt. Sinai School of Medicine, New York City
Want to Know More? Call the National Women's Health Information Center at 800-994-9662 for a free copy of Frequently Asked Questions About Uterine Fibroids.