Uterine Fibroids

Uterine fibroids — also known as uterine myomas, leiomyomas or fibromas — are growths on the uterus. They develop from smooth muscular tissue when a cell single divides repeatedly to create a firm, rubbery growth, or tumor. In more than 99 percent of cases, uterine fibroids aren’t cancerous and aren’t associated with an increased risk of cancer.

A woman can have one or many fibroids, which can range in size from smaller than a pea to larger than a grapefruit. They’re very common and seem to be affected by hormones. Women in their 30s, 40s and 50s are at the highest risk for fibroids. After menopause, fibroids tend to shrink or disappear.

There are three types of fibroids:

• Submucosal fibroids (within the uterine cavity). 
• Intramural fibroids (within the uterine wall).
• Subserosal fibroids (outside of the uterus).

Symptoms

Symptoms of uterine fibroids can range from mild to severe. Many women experience no symptoms at all.

Common symptoms of uterine fibroids include:

• Heavy menstrual bleeding.
• Periods lasting longer than seven days.
• Bleeding between periods.
• Pain or pressure felt in the pelvis (lower stomach area).
• Frequent urination.
• Constipation or difficulty emptying your bladder.
• Back or leg pain.
• Pain during intercourse.
• Swelling in the lower abdomen.

Diagnosis

Often, uterine fibroids are discovered during a routine pelvic exam. If you’re experiencing symptoms, your doctor may perform tests to determine whether you have fibroids, such as a blood test to check for anemia (due to heavy bleeding). Your doctor may also use imaging exams such as X-ray, magnetic resonance imaging (MRI) or pelvic ultrasound exams.

Other exams used to diagnose uterine fibroids include:

• Hysterosalpingography. This exam uses X-ray and a special dye to examine your uterus and fallopian tubes.
• Hysteroscopy. During this procedure, your doctor inserts a special instrument (hysteroscope) into your vagina to examine your cervical canal and uterus.

Your doctor may also take an endometrial biopsy, or tissue sample, for further testing. To collect the tissue, your doctor guides a thin, flexible tube (catheter) into your cervix.

Treatments

Uterine fibroids are only treated if they’re causing discomfort. If symptoms aren’t bothering you, your doctor will continue to monitor the size of your fibroids and ask you about your symptoms during your annual pelvic exams.

In many cases, symptoms can be treated with medications, which can offer pain relief and treat period-related symptoms, such as heavy bleeding and pelvic pressure. Types of medications may include anti-inflammatory or analgesic medications, oral hormonal agents or a progestin-releasing intrauterine device (IUD), which affects hormones to relieve heavy menstrual bleeding.

When nonsurgical methods are insufficient for relieving symptoms, your doctor may recommend surgery. El Camino Health offers multiple techniques for removing fibroids, including:

• Uterine artery embolization. Also called uterine fibroid embolization, your doctor may use this minimally invasive technique to cut off the supply of blood to the fibroid. Fibroids shrink when they lose their blood supply. 
• Laparoscopic myomectomy. For small fibroids, your doctor may use this minimally invasive procedure to remove the fibroids and leave your uterus intact, which won’t affect your ability to become pregnant. Using this technique, your doctor manipulates specialized surgical instruments to remove fibroids through just a few small incisions. During the procedure, your doctor views magnified, 3-D images of the surgical area provided by a tiny camera attached to one of the instruments. 
• Hysterectomy. This procedure is often used as a last resort for women experiencing extreme symptoms since it prevents the possibility of pregnancy. In this procedure, the surgeon removes the entire uterus.