McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
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What are uterine fibroids?

Uterine fibroids are tumors made of connective tissue and smooth muscle. They grow slowly within the wall of the uterus or attach to the uterine wall. The uterus is the muscular organ at the top of the vagina. Babies develop in the uterus, and menstrual blood comes from the uterus.

A uterine fibroid may be as small as a pea or as large as a grapefruit. As the fibroid grows, the uterus may become deformed or pushed aside. When the uterus is deformed or blocked by a growth, the resulting pressure may cause symptoms in the bladder or intestine, such as increased urination, constipation, or pain. Most fibroids are noncancerous, but in some rare cases they may become cancerous.

Other terms used for a uterine fibroid are leiomyoma or myoma of the uterus.

How do they occur?

The cause of uterine fibroids is not known, but it may be related to changes in the levels of the hormones estrogen and progesterone and in proteins called growth factors. For example, pregnancy, use of birth control pills, and estrogen replacement therapy may speed the growth of fibroids. It also appears that women may inherit the tendency to develop fibroids.

Fibroids rarely occur in women younger than 20. They occur most frequently in women in their childbearing years. When a woman goes through menopause, these tumors usually shrink.

What are the symptoms?

Often there are no symptoms. When there are symptoms they may be:

• painful menstrual periods
• heavy menstrual bleeding
• more frequent or uncomfortable urination
• backache
• constipation
• pelvic pain or pressure
• infertility
• miscarriage.

How are they diagnosed?

Uterine fibroids are usually found during routine pelvic exams. An ultrasound scan can be used to help show the area, measure the size, and follow the growth of fibroids.

If you have severe menstrual symptoms or other pelvic problems, your health care provider may recommend an ultrasound scan or D&C (dilation and curettage) to determine the cause of the problems.

How are they treated?

Most fibroids do not need treatment. Your health care provider will evaluate your condition and make a recommendation based on:

• the amount of blood loss and pain during menstrual periods
• the rate of growth of the fibroid
• the absence or presence of cancer
• your age, physical condition, and desire for more children.

For fibroids that require treatment, your doctor may suggest a myomectomy or hysterectomy. A myomectomy is a type of surgery used to remove the fibroids without harming the uterus. In a hysterectomy the surgeon removes the uterus with the fibroids. A myomectomy can be technically more difficult than a hysterectomy and can lead to greater blood loss. The myomectomy may cause a deep scar on the uterus. The scar might make it necessary for you to have a cesarean delivery if you become pregnant.

Before you have a myomectomy or hysterectomy, you may be given a medicine for 2 to 3 months to shrink the fibroid. This will make the operation easier to perform. If you are close to menopause, your provider may prescribe this medicine for you to take until you are in menopause, so that you may not need surgery. This is especially important if surgery is particularly risky for you because of one or more medical problems you may have.

How long will the effects last?

Small fibroids that don't grow usually have no lasting effects. If you have symptoms caused by growing or enlarged fibroids, the symptoms will probably continue until the growths are removed surgically, or until they begin to shrink and disappear after menopause.

How can I take care of myself?

Call your health care provider if:

• Pain or heavy bleeding continues to be a problem.
• You notice your symptoms are getting worse.

In addition:

• Take acetaminophen or ibuprofen for cramps and body aches. Do not take aspirin because it may increase the bleeding.
• Rest in bed when symptoms are worst.
• Eat foods high in iron and take iron pills (if your health care provider recommends it) if you bleed heavily during your periods.
• Put a heating pad at a low setting on your abdomen to help relieve cramps or pain.
• Follow your health care provider's recommendations for treatment with medicine and for follow-up visits to see if the fibroid is growing.

What can be done to help prevent uterine fibroids?

No sure way is known to prevent fibroids from developing or recurring.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.