Uterine fibroids are common, non-cancerous growths. They develop within the tissue of the uterus, typically during one’s child-bearing years. Often, they are effectively symptomless, making it difficult for researchers to pinpoint precisely how many women are affected by this condition. Most estimates place the number of adult women who have had a uterine fibroid sometime during their lifetime at somewhere between 25%-80%.
Researchers still aren’t entirely sure what causes uterine fibroids to develop. But if you’re pregnant or attempting to become pregnant, you should talk to your OBGYN about possible impacts that they might have on your pregnancy. For most women, however, they will eventually go away on their own.
What Are Uterine Fibroids?
A uterine fibroid is a type of non-cancerous tumor that can develop and grow in the uterus. The size of these growths can range from tiny enough to be invisible to the human eye to large enough to disrupt blood flow. Women can have a single fibroid or multiple fibroids of varying sizes throughout the uterus.
While researchers have not clearly identified the root causes of uterine fibroids, the most widely accepted working theory is that a stem cell located on the rather smooth tissue of the uterus begins to divide rapidly. This accelerated cell division ultimately creates a firm, rubbery mass that’s quite distinct from the other tissues around it.
How Are Uterine Fibroids Diagnosed?
The vast majority of uterine fibroids likely go undiagnosed, as they tend to cause no noticeable symptoms. As a result, they are sometimes discovered incidentally during a routine pelvic exam. In other cases, uterine fibroids can be identified during a diagnostic imaging scan, such as an MRI or ultrasound.
- Uncommonly, however, uterine fibroids can and do cause symptoms. Some of those symptoms may include:
- Painful and prolonged period.
- Periods that are heavier than usual.
- Anemia (in some cases, periods can be so heavy as to cause a low red blood cell count).
- Bleeding or spotting between your typical period schedule.
- Difficulty or pain when urinating.
If you experience these symptoms, you should talk to your OBGYN about the possibility that you may be experiencing uterine fibroids. Rarely, the fibroids can become so large as to exceed their own blood supply, causing acute pain. In other instances, fibroids can become so large that they begin to exert pressure on the rib cage.
Severe pain, discomfort, or bleeding should be promptly reported to a doctor and you should seek medical attention.
How Are Uterine Fibroids Treated?
There’s no one-size-fits-all approach to treating uterine fibroids. The best treatment will likely depend on your symptoms, your situation, and your physiology. The most common treatment approach is to simply wait and see. A considerable percentage of them ultimately go away on their own and, therefore, do not require treatment.
However, if the uterine fibroids are interfering with your health or comfort, treatment may be necessary. There are various treatments for available, including:
- Hormones: Taking hormones that block the absorption of estrogen and progesterone can trick your body into entering a menopause-like state. Because uterine fibroids only develop in women of child-bearing age, this hormone strategy can often effectively slow or reverse their growth.
- Contraceptives: Some contraceptive types–including oral contraceptives or a progestin-releasing intrauterine device (IUD)–can help minimize some of the symptoms of uterine fibroids by limiting the severity and frequency of your periods.
- MRI-Guided Ultrasound Surgery: A novel approach, this treatment takes place while you’re inside an MRI machine. The MRI itself finds and targets the uterine fibroid. Then, ultrasonic waves concentrate on the fibroid and, essentially, destroy the unwanted tissue. Long term results are still being analyzed, but the procedure does seem promising. That’s especially true because ultrasound “surgery” is entirely non-invasive.
- Surgery: In some cases, more invasive surgical options are called for. Options range anywhere from a minimally invasive, targeted procedure to a hysterectomy, which removes the entire uterus. In most cases, a hysterectomy is reserved for only the most severe circumstances and is not recommended for patients who want to have children in the future. We perform laproscopic, abdominal, and vaginal hysterectomies. To read more about these surgical services, click here and scroll down to “hysterectomy”.
Depending on your particular situation, your doctor may also look into other medication options to help you treat your uterine fibroids and minimize the associated symptoms.
Do I Have to Worry About Them if I’m Pregnant?
Uterine fibroids can present before and during pregnancy. In most cases, they will not impact your pregnancy. This is especially true when your they’re on the smaller side.
However, there are some complications that it’s a good idea to be cognizant of throughout your pregnancy:
- Cesarean Section: Women who have uterine fibroids during pregnancy are six times more likely to require a c-section during childbirth. This doesn’t mean that a c-section will become a certainty; simply that the risk for needing a c-section is increased.
- Breech: In some cases, uterine fibroids could cause a baby to be breech. This means that the child would not be in optimal position for delivery during childbirth.
- Premature delivery: though not common, uterine fibroids can cause premature delivery.
- Placental Abruption: This is a medical term for the placenta breaking away from the uterine wall, which causes the fetus to suffer from a lack of oxygen.
The risks for each of these complications is relatively low; but larger uterine fibroids can increase that risk. The treatment course if you’re pregnant will depend on your unique situation, so it’s vital that you talk to your OBGYN or midwife about your options.
Something to Keep an Eye On
For most people, uterine fibroids will prove to be entirely harmless. They’ll go away on their own and, in most cases, you’ll never even know they were there. When they do present with symptoms, you’ll need to talk to your doctor about your level of discomfort and weigh the benefits and drawbacks of each treatment approach.
When you’re pregnant, uterine fibroids can present unique challenges, and you may need to keep a close watch for specific symptoms or occurrences. Complications are rare, but they can happen.
Most patients with uterine fibroids will take a wait-and-see-approach to determine whether the fibroids grow or cause more discomfort as time goes on. Just because they are quite common doesn’t mean that any patient should have to live with discomfort. Patients will have several treatment options to choose from.