Fibroids

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Fibroids are grayish white tumors that are firm and round. They are non-cancerous tumors. These lumps or cysts grow on the walls of the uterus. Typically there may be several growing at once. They are most common for women in their 30’s and 40’s. After menopause, the fibroids will usually shrink.

The most common symptoms of fibroids are abnormal uterine bleeding and pelvic pressure. The prolonged and excessive bleeding occurs during a woman’s normal menstrual cycle. If the bleeding occurs between periods then most likely the reason is not due to fibroids. Your provider should be seen to investigate the causes of this bleeding between periods.

Pelvic pressure results from a uterus enlarged with the growing fibroids or from a particular fibroid pressing against an adjacent pelvic structure such as the bowel and/or bladder. This pressure can result in difficulty with bowel movements and constipation (if against the bowel) or urinary incontinence and frequency issues (if again the bladder).

Fibroids are relatively common in women. About 30 percent of all women will develop them. If they are not creating any abnormal or painful symptoms, then there is no real clinical reason to remove them.

There are some medicines that can help control the fibroid-related symptoms. Since fibroids are dependent on estrogen for their growth and development, those medicines (such as Lupron and Zolodex) that effect the estrogen level can also effect the fibroids growth, and hence, can reduce the related symptoms. Two drawbacks to consider with your provider are the other effects of a low-estrogen state and the results of someday stopping this treatment plan. Since your bones do require estrogen to maintain their density, prolonged use of these types of medicines can lead to bone loss or osteoporosis. If this treatment plan is stopped, then typically there is a rapid re-growth of the fibroids back to their original size.

Some fibroids can be identified during a pelvic exam. Other, smaller fibroids, may require a transvaginal ultrasound or a hospital-based procedure such a a hysteroscopy or laparoscopy where a special viewing instrument is used to examine the uterus.

One of the issues in considering surgical treatment is that of having more children. If more children are desired, they a myomectomy may be performed. In this operation the individual fibroids are removed from under the uterine wall. Your uterus and reproductive organs remain intact.

If additional children are not desired, then either an endometrial ablation or a hysterectomy should be considered. In an endometrial ablation a laser scrapes the lining of the uterus to remove the fibroids. The uterus and ovaries are preserved. A permanent means of preventing pregnancy should also be done at this time. In a hysterectomy the uterus is removed; the ovaries may or may not be removed, based on your discussion with your physician.