Uterine Fibroids

About Uterine Fibroids

What are fibroids?

Fibroids are growths in the walls of the uterus. Sometimes, a fibroid is attached to the outside of the uterus by a stalk. Fibroids can be as small as a seed or a pea or as large as an orange or small melon. Although fibroids are called “tumors,” they are not cancer. They are smooth muscle growths.

About 2 of every 10 women who have not gone through menopause have fibroids. The technical term for a fibroid tumor is leiomyoma.

Fibroids may cause no symptoms at all, or they may cause pain or bleeding. Fibroids may make it hard to pass urine if they grow large enough to press on the bladder.

Fibroids also can make it hard for you to get pregnant. Sometimes fibroids can cause problems with pregnancy, labor, or delivery, including miscarriage and premature birth.

How are fibroids treated?

You may have several treatments to choose from if you have fibroids. It depends on how big the fibroids are, where they are, and whether you are pregnant or want to become pregnant.

Watchful waiting may be all the treatment you need if your fibroid is small and you do not have any symptoms. You will need regular visits to your doctor for a pelvic exam to monitor the growth of the fibroid.

Nonsurgical treatments for fibroids include hormones and pain relief medicines:

  • Estrogen dominance or too much estrogen may be the cause of fibroids. A study released in 2004 found that gene therapy in mice blocking the estrogen receptors of fibroids caused the fibroids to shrink, suggesting the importance of estrogen in maintaining fibroids. Using Bioidentical Progesterone Cream is a great way to reduce the effects of high estrogen levels, safely and effectively.
  • Taking gonadotropin releasing hormone (GnRH) can cause fibroids to shrink. This may make surgery easier, or it may be used instead of an operation.
  • Your doctor may prescribe ibuprofen (for example, Advil), acetaminophen (for example, Tylenol), or another medicine to relieve pain.

Surgical treatments for fibroids include hysterectomy and myomectomy:

  • Hysterectomy is usually recommended when the fibroids are causing symptoms, when they have grown rapidly, or when the fibroids are large (as large as a grapefruit).
  • Myomectomy is an operation to remove a fibroid tumor without taking out the uterus. This means that pregnancy is still possible, although a Cesarean section may be necessary.

Recovery time after a myomectomy is about 3 to 4 weeks. About 20 percent of women who undergo myomectomy need a blood transfusion, about 30 percent have a fever after surgery, and many patients develop adhesions (scar tissue) in their pelvis in the months following surgery. These complications are more likely to occur when there is more than one fibroid and when the fibroids are large.

The growths may come back after a myomectomy, and repeat surgery may be necessary. If you are considering a myomectomy, be sure to ask the doctor how likely it is that new fibroids might grow after the surgery.

You also should ask your doctor how much experience he or she has in doing this procedure. Not all gynecologists have been trained to perform myomectomies.

  • Another option is laser surgery, which usually is an outpatient procedure. With laser surgery, the doctor uses a high-intensity light to remove small fibroids.
  • Depending on the location of the fibroid, it may be possible to remove it during a laparoscopy. Or, the doctor may put a thin tube (called a hysteroscope) with a laser through the vagina and into the uterus. The tube may have a small scraper to scrape away the fibroid from the wall of the uterus.