When Uterine Fibroids Become Problematic
Uterine fibroids are common and benign — but they can sometimes lead to painful symptoms and even infertility. These treatment options can help.
By Krisha McCoy
Medically Reviewed by Lindsey Marcellin, MD, MPH
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Uterine fibroids are very common — 20 percent to 80 percent of women will develop them during their childbearing years, many without even knowing it. And while uterine fibroids are not cancerous, they can sometimes cause uncomfortable symptoms and problems getting pregnant. But they can be treated.
What Are Uterine Fibroids?
Uterine fibroids are benign growths that develop in the muscular wall of the uterus. They range in size from smaller than a pea to as large as a grapefruit.
Uterine fibroids are controlled by the hormones you produce most readily during your childbearing years, progesterone and estrogen. This is why your fibroids may stop growing and even shrink once you go through menopause.
In some women, uterine fibroids do not cause any symptoms. But depending on the size, shape, and number of your uterine fibroids, you may experience one or more of the following:
Because uterine fibroids and premenstrual syndrome (PMS) share certain symptoms (abdominal pain, bloating, constipation), some women may assume their symptoms are simply a part of PMS. But uterine fibroids can be more serious than PMS, so it is important to talk with your doctor if you have possible symptoms of fibroids.
Non-Surgical Fibroids Treatment Options
Uterine fibroids are most often found during a pelvic exam. You may need to have an ultrasounds or a procedure like a laparoscopy to give your doctor a clearer picture of your fibroids. During laparoscopy, your doctor will use a thin tube with a camera attached to the end of it, which is inserted into the body near the navel so that the doctor can get a clear view of your uterus.
Uterine fibroids that are not causing any symptoms or problems may not need to be treated.
If your symptoms are mild, your doctor may recommend over-the-counter pain medications such as Advil or Motrin (ibuprofen) or Tylenol (acetaminophen) to help reduce your pain. Ask your doctor if you should take an iron supplement to prevent or treat anemia related to your fibroids.
But if your uterine fibroids are causing severe pain or other problems, fibroids treatment options include:
- Medications.Hormonal therapy, like birth control pills, can help manage heavy bleeding and menstrual pain, but it can cause fibroids to grow. Gonadotropin-releasing hormone (GnRH) agonists are sometimes temporarily used to halt the menstrual cycle, shrink fibroids, and help control bleeding.
- Intrauterine device.If your fibroids are not changing the shape of the inside of your uterus, your doctor may recommend an intrauterine device that releases progesterone into your uterus to reduce heavy bleeding and menstrual pain.
Types of Fibroids Surgery
Sometimes, surgery is needed to shrink or remove uterine fibroids. There are several types of fibroids surgery:
Myomectomy.In myomectomy, your fibroids will be surgically removed through an incision or with a laser beam, leaving the rest of your uterus intact. If your fibroids are making it difficult for you to become pregnant, myomectomy may help.
Endometrial ablation.Endometrial ablation destroys the uterine lining with heat or microwaves. This procedure, which helps to manage heavy menstrual flow or remove small fibroids, is typically used only after a woman has stopped having children, since most women cannot get pregnant after endometrial ablation.
Magnetic resonance imaging-guided ultrasound surgery.Using MRI for guidance, a doctor directs ultrasound waves at fibroids to shrink or destroy them. This method seems to give good results for up to one year; longer term results are unknown, but they are being studied.
Hysterectomy. In severe cases of uterine fibroids, a hysterectomy, a surgery in which the uterus is removed, may be necessary to completely eliminate uterine fibroids. You cannot have children after a hysterectomy.
Uterine artery embolization (UAE).UAE blocks the blood supply that feeds the fibroids, enabling them to grow. For this procedure, your doctor will pass a thin tube into a small incision in your groin area, through a large artery, until it reaches the small arteries that supply blood to your uterus. There, your doctor will inject tiny particles into the arteries to cut off blood flow. UAE is usually recommended as an alternative to hysterectomy for women with severe symptoms who do not want any more children.
Uterine fibroids are common and not usually associated with serious problems. But talk with your doctor if you have symptoms of fibroids, since early treatment can reduce your risk of complications.
Video: Fibroids On Uterus Symptoms
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