Fibroids are benign (noncancerous) growths that form in the smooth muscle tissue of the walls of the uterus (womb). They can be as small as a pea or grow larger than a grapefruit.
- Fibroids is the common term for uterine fibroids, leiomyoma or myoma.
- Fibroids are very common. By age 50, approximately 80% of African-American women and approximately 70% of Caucasian women will have had fibroids, although they don’t all cause symptoms.330
Causes and Symptoms
The exact cause of fibroids is unknown, but evidence suggests that many fibroids require the hormones estrogen and progesterone to grow. Typically, when a woman reaches menopause (average age of 51), hormone levels decline and existing fibroids tend to shrink.
Although fibroids often do not cause any symptoms, depending on their size, number and location, fibroids can lead to more serious symptoms or complications including:
- Heavy periods or prolonged menstrual bleeding (7 days or more)
- Anemia due to chronic excessive bleeding. Anemia is a condition that develops when your blood lacks enough healthy red blood cells or hemoglobin.
- Pelvic pressure or pain
- Pain in the abdomen, lower back or legs
- Pain during sex
- Difficulty urinating, frequent urination or constipation
- Infertility (the inability to have children)
- Difficulties during childbirth
Types of Fibroids
Fibroids can occur as one single growth or multiple growths located inside the uterus, within the walls, or on its surface.
- Submucosal Fibroids
Bulge from the uterine wall into the uterine cavity, sometimes distorting it, which can cause pain, abnormal bleeding, and infertility.
- Intramural Fibroids
Remain confined within the uterine wall and can cause symptoms similar to those of submucosal fibroids.
- Subserosal Fibroids
Grow from the uterine wall to the outside of the uterus and can push on the bladder, bowel, or intestine, causing bloating, abdominal pressure, cramping, and pain.
A routine pelvic exam can help diagnose fibroids. Different diagnostic tests may also be used to determine the characteristics of fibroids as well as to rule out other conditions such as ovarian tumors, bowel masses, or early pregnancy.
Uses high-frequency sound waves to create a picture of the pelvic organs. No anesthesia is necessary for this office procedure. Sometimes the uterus is filled with a fluid, through the cervix, to improve visibility.
- Magnetic resonance imaging (MRI) is another common imaging test that may be used. This test is non-invasive and involves the use of magnetic fields to develop images.
These tests are effective for diagnosing submucosal fibroids only.
- Hysterosalpingography (HSG)
An X-ray of the inside of the uterus in which a special dye is used to outline abnormalities. HSG is typically performed in a radiology suite with no anesthesia.
- Diagnostic Hysteroscopy
Allows the physician to look into the uterine cavity through a telescope-like instrument called a hysteroscope, which is inserted into the uterus through the cervix. Hysteroscopy can be performed as an office procedure under local anesthesia or in an outpatient surgery center with general anesthesia.