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Uterine Fibroids

What are uterine fibroids? How can you deal with them?

Uterine fibroids are benign (noncancerous) tumors that develop in a woman’s uterus.

Clinically, they are detected in 25 percent of women, but with modern imaging techniques, actual clinic prevalence may reach 77 percent.

While most fibroids do not always cause symptoms, their size and location can lead to severe problems for some women. Their size can range from very tiny to larger ones. In most cases, there is more than one fibroid in the uterus. Occasionally, they can cause the uterus to grow to the size of a five-month pregnancy.

What causes fibroids?

No one knows exactly what causes fibroids. They are thought to be caused by: hormones and genes.

  • Genes: fibroids are three times less common in black women.
  • Hormones: fibroids can dramatically increase in size during pregnancy. This is thought to occur because of the increase in estrogen levels during pregnancy. Estrogen, the female hormone, is naturally produced during pregnancy. After labor, fibroids usually shrink back to their pre-pregnancy size. On the contrary, during menopause, the level of estrogen decreases dramatically and uterine fibroids tend to shrink and symptoms are relieved.  However, menopausal women who are taking supplemental estrogen (hormone replacement therapy) maintain their estrogen levels and fibroids cannot shrink in size.

What are the symptoms of uterine fibroids?

Most women start experiencing symptoms in their late forties or early fifties. Depending on location, size and number of fibroids, symptoms can include: Prolonged menstrual periods, unusual monthly bleeding (sometimes with clots) that can lead to anemia, strong menstrual cramps, pelvic pain and pressure, pain in the pelvic and/or back, on the side of the waist and legs, pain during sexual intercourse, bladder pressure leading to a frequent urge to urinate, pressure on the bowel, leading to constipation and bloating and abnormally enlarged abdomen.

How are they diagnosed?

Uterine fibroids are usually diagnosed during a gynecological exam.  Your doctor can also determine the size of your uterus by means of a pelvic examination. They can also be diagnosed with a magnetic resonance imaging (MRI) or computed tomography (CT).

What does treatment involve?

Treatment depends on the size and location of fibroids and the severity of symptoms.

If you have fibroids without symptoms, your doctor may recommend no treatment but annual exams.

For women who do have symptoms, there are treatment options that can help: drug, surgical or non-surgical treatments.

  • Drug treatment can include nonsteroidal anti-inflammatory drugs (NSAIDs), birth control pills and hormone therapy.
  • Surgical treatment can include: myomectomy (the surgical removal of fibroids from the uterus lining) and hysterectomy (the surgical removal of the uterus.)
  • The non-surgical treatment consists in Uterine Fibroid Embolization (UFE). UFE is a less invasive technique designed to preserve the uterus: a tiny nick is made in the skin in the groin and a catheter is thread into a blood vessel till it reaches the uterine artery, then tiny particles are released. These tiny particles block the blood supply to the fibroids, causing them to shrink.

Prevention

As fibroids are caused by genetic and/hormone factors, they cannot be prevented.
However, annual exams are recommended to determine the presence of a fibroid and its treatment.