Fibroids: What are they and how do I deal with them?

Located in Fibroids (click link to see other articles).

Fibroid locationsUterine fibroids are benign (non-cancerous) tumors that grow in or around the wall of the uterus, also known as myomas or leiomyomas.  They are extremely common, affecting about three-quarters of women at some point in their life, and one of the most common reasons women undergo gynecologic surgery.  They don’t always cause symptoms, but women with fibroids may experience heavy, prolonged, irregular, or painful menstrual bleeding, urinary or bowel problems, pain during intercourse, or complications with pregnancy (infertility or miscarriage).

Unfortunately, we still don’t know what causes fibroids to develop.  They are stimulated by hormones and sometimes we use hormonal medications to shrink them temporarily.  Factors that may be associated with fibroids include being of African descent, being overweight (fat cells make estrogen which stimulates fibroid growth), family history, having never been pregnant, and early age at first period.

Fibroids can vary greatly in their size, shape and location—they can be as small as a pea or larger than a soccer ball.  A fibroid that gets close to the lining of the uterus (called the endometrium—this is the tissue that sheds every month in menstruation) can cause significant bleeding problems, while a medium-sized fibroid deeper in the wall of the uterus might be completely unnoticeable.  The really big ones generally are physically uncomfortable and can push on other organs in the abdomen and pelvis—doctors call these “bulk” symptoms.  Some women may have only one or two fibroids, while others may have twenty or thirty.  The figure below illustrates some of the ways we describe fibroid locations:

It can sometimes be very difficult to decide what, if anything, to do about fibroids once they’re diagnosed.  For example, what if a woman has a medium-sized fibroid that isn’t causing much in the way of symptoms but she’s looking to try to get pregnant.  Is it better to undergo surgery on her uterus to remove the fibroid or avoid surgery and try to get pregnant with the fibroid left alone?

In my next post, we’ll get into some of these issues.

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Last updated on Jun 9, 2023