Fibroids are tumors of the smooth muscle, normally found in the wall of the uterus. Uterine fibroids are common. As many as 1 in 5 women may have fibroids during their childbearing years, and about half of all women will have fibroids by age 50.

The exact reasons why some women develop fibroids are unknown. Fibroids tend to run in families, and affected women often have a family history of fibroids. Women of African descent are two to three times more likely to develop fibroids than women of other races.

Fibroids grow in response to stimulation by the hormone estrogen. As long as a woman with fibroids is menstruating, a fibroid will probably continue to grow, usually in a slow fashion. Fibroids can range from microscopic size to very large. They may fill the entire uterus, and may weigh several pounds. Although it is possible for just one fibroid to develop, usually there is more than one.

They can grow into the uterine cavity (submucosal), into the thickness of the uterine wall (intramuscular), or on the surface of the uterus (subserosal) into the abdominal cavity.

Most often uterine fibroids cause no symptoms at all, so most women don’t realize they have them, they are often found during a regular pelvic examination. The ones that are symptomatic will present with:

• Prolonged menstrual periods (7 days or longer)

• Heavy bleeding during periods

• Bloating or fullness of the abdomen or pelvis

• Pain in the lower abdomen or pelvis

• Constipation

• Pain with intercourse

• Infertility

In order to diagnose them, the doctor will perform a pelvic exam. This may show a change of size and shape of the uterus. An ultrasound may be done to confirm the diagnosis of fibroids. Sometimes, a pelvic MRI may be required. A biopsy of the uterine lining may be needed to rule out cancer in some occasions.

Most uterine fibroids don’t need any treatment, because they don’t cause symptoms or problems. Uterine fibroids causing problems may be treated with non-surgical or surgical options.

Treatment for the symptoms of fibroids may include:

• Birth control pills (oral contraceptives) to help control heavy periods.

• Intrauterine devices (IUDs) that release the hormone progestin to help reduce heavy bleeding and pain.

• Iron supplements to prevent or treat anemia due to heavy periods.

• Nonsteroidal anti-inflammatory drugs such as ibuprofen or naprosyn for cramps or pain.

• Short-term hormonal therapy injections to help shrink the fibroids.

THE SURGICAL ALTERNATIVES ARE:

• Hysteroscopic resection of fibroids: is an outpatient procedure to remove fibroids growing inside the uterine cavity.

• Uterine artery embolization: This procedure stops the blood supply to the fibroid, causing it to die and shrink. Not indicated for women who may want to become pregnant in the future.Myomectomy: There are multiple techniques for this surgery, which removes the fibroids. It is often the chosen treatment for women who want to have children, because it usually can preserve fertility. Unfortunately more fibroids can develop after a myomectomy.

• Hysterectomy: This invasive surgery may be an option if medicines do not work and other surgeries and procedures are not an option.

If you are presenting these symptoms or have fibroids, you can visit us to discuss in more detail your personal needs.