What are fibroids? Uterine growths that appear during childbearing years, fibroids may be as small as seedlings or large enough to distort the uterus beyond its normal size. Uterine fibroids can grow inside or outside the uterine wall or within the uterine cavity. While these growths are non-cancerous, they can still cause a great deal of discomfort and even cause infertility.
Unfortunately, many women will develop fibroids at some point in their lives. In fact, according to the National Institutes of Health, 70% of white women and 80% of African American women have fibroids by age 50. Read on to learn what causes fibroids as well as the options available for treating this unpleasant condition.
What Causes Fibroids?
Uterine fibroids, or fibroid tumors, occur when stem cells in the smooth tissue of the uterus divide, creating a mass. Doctors don’t know why some women develop uterine fibroids and others do not. However, the condition seems to have a hereditary component. If a woman’s mother or sister has fibroids, she has a higher risk of developing the condition. Additionally, uterine fibroids can occur as a result of genetic changes, growth factors, and hormones.
Doctors believe that fibroid production tends to decrease after menopause because of the decline in estrogen and progesterone, the two reproductive hormones that regulate the menstrual cycle. Fibroids contain more receptors for these hormones than typical uterine muscle cells do.
The following factors may increase a woman’s risk for developing fibroids:
- Race (African American women are at a higher risk)
- Early menstruation
- Birth control usage
- Having a vitamin D deficiency
- Consuming a diet with large amounts of red meat
- Drinking alcohol
Fibroids Symptoms and Signs
Some women who have fibroids don’t know it. That’s because the condition doesn’t always have noticeable symptoms. Typically, the location, size, and number of fibroids a patient has determine how severe the symptoms are.
The most common symptoms of fibroids include:
- Heavy bleeding or periods lasting longer than 7 days
- Bleeding or spotting between menstrual periods
- Pelvic pain and pressure
- Frequent urination or trouble urinating
- Back pain and/or leg pain
If you suffer severe bleeding or pain, don’t hesitate to see your doctor.
Types of Fibroids
A woman can have multiple fibroids and types, and a specific diagnosis depends on the location of the fibroids.
- Intramural fibroids: Growing inside the wall of the uterus, this type of fibroid is the most common.
- Subserosal fibroids: These fibroids grow outside of the uterus and often result in pain due to the pressure they put on adjacent organs.
- Submucosal fibroids: Because they grow underneath the uterine lining they can protrude into the uterine cavity and cause heavy bleeding and other serious health risks.
- Pedunculated fibroids: grow inside or outside the uterus on small stalks.
Getting a Fibroids Diagnosis
Your doctor may diagnose uterine fibroids during a typical pelvic exam. If fibroids aren’t causing you pain or distress, it’s likely that no further treatment will be needed. However, if you’re suffering irregular bleeding and/or pain, your doctor may recommend an ultrasound to confirm the presence of fibroids and measure their size. He or she may also perform a complete blood count and other lab tests to rule out anemia and other underlying conditions. In rare cases, an MRI (magnetic resonance imaging) may be needed to determine the size and location of fibroids that may be disrupting well-being.
Best Fibroids Treatment
Because many women with fibroids experience few if any symptoms, the best treatment for the condition is often watchful waiting. Most fibroids have little impact on a woman’s quality of life or ability to conceive and bear children. In many cases, these slow-growing tumors shrink or go away on their own after menopause, when estrogen levels drop.
If you opt for the watchful waiting approach to fibroid treatment, you might want to take anti-inflammatory drugs like ibuprofen to alleviate your discomfort. However, these come with side effects and risks, especially when taken long term, so more natural anti-inflammatory treatments may be warranted.
If your fibroids are causing severe pain, irregular bleeding, or fertility problems, you may need medication or even surgery to correct the problem. Gn-RH agonists (gonadotropin-releasing hormone) work by blocking estrogen production and can help shrink fibroids. However, because these drugs cause hot flashes and other negative symptoms, they are typically recommended only for the short term.
Your doctor may recommend a progestin-releasing IUD (intrauterine device) to alleviate the heavy menstrual bleeding associated with this condition. However, this treatment option only alleviates symptoms; it doesn’t make fibroids disappear.
If fibroid growth occurs and fibroids become severe, your doctor may suggest MRI-guided focused ultrasound surgery or another non-invasive surgical treatment to alleviate your symptoms. Performed on an outpatient basis, this treatment involves the use of ultrasound waves to heat and destroy fibroids. The procedure is performed inside an MRI machine and causes little to no discomfort.
In more severe cases, doctors may recommend uterine artery embolization, in which embolic agents are injected into the arteries to cut off blood supply to fibroids. However, this treatment can compromise blood flow to the ovaries or other organs.
The only permanent solution for uterine fibroids, hysterectomy is reserved for the most severe cases in which large fibroids, painful periods, and menstrual bleeding are compromising quality of life. It’s important to know that hysterectomy is a serious procedure that terminates a woman’s ability to bear children down the line. According to the National Center for Health Statistics, a third to a half of all the hysterectomies performed in the United States each year are because of fibroids.