7 Things You Need to Know About Uterine Fibroids

Cramps? Painful sex? It could be fibroids.

1 / 8

By Olivia DeLong

You may have heard of uterine fibroids, but you may not know exactly what they are or how they’re treated. And you might not know they are super common—one study found that by age 50, a whopping 70 percent of Caucasian women and 80 percent of African American women had developed fibroids. 

In a nutshell, uterine fibroids, otherwise known as leiomyomas, or myomas, are noncancerous growths that develop in the wall of the uterus. It’s very rare for fibroids to be cancerous. In fact, less than 1 out of 1,000 are cancerous. “I let my patients with fibroids know right away that the chance for malignancy is extremely, extremely low and they are just smooth benign muscle growths,” says OBGYN Adrian Roznowski, MD, of Plantation General Hospital in Florida.

While many women have no symptoms at all, some may experience symptoms like painful sex, constipation and menstrual changes. There is a small chance that fibroids may also cause complications for women who are pregnant.

Here’s what you need to know about the signs, symptoms and treatment options.

There are different types

2 / 8 There are different types

Fibroids can differ in size (they can be as tiny as an apple seed or as large as a walnut or grapefruit), location and shape. They are usually characterized by their location, says Roznowski:

  • Intramural: on the inside, muscular, layer of the uterine wall
  • Submucosal: bulging into the uterine cavity 
  • Subserosal: within the outside layer of the uterine wall
  • Pedunculated: hanging from a stalk or stem outside the uterus 
Symptoms vary

3 / 8 Symptoms vary

Many women will not have any symptoms at all, says Roznowski. “A lot of times fibroids are incidental findings on ultrasounds.” But other women will have mild to severe symptoms that can include:

  • Menstruation issues such as long and heavy periods, cramps and bleeding between menstrual cycles
  • Lower back pain
  • Painful sex
  • Frequent urination or difficulty urinating
  • Constipation
  • Abdominal cramping
  • Enlarged uterus

The two most common symptoms are abdominal cramping or pain, and heavy bleeding during menstruation, says Roznowski. “Pain usually occurs because the fibroids extend to the uterus, protrude and get bigger, and even touch other pelvic and abdominal organs or nerves.”

The bleeding can be tricky to understand, though. “The prevailing hypothesis is that the fibroid does not allow the uterus to adequately contract during menstrual cycles,” says Roznowski. “Because it’s not contracting, it’s not expelling everything so the uterus stays larger and bleeds in spurts.” 

They’re more common in African American women

4 / 8 They’re more common in African American women

Any woman can have fibroids, but they’re most common in women who are 30 to 40 years old—and more African American women have fibroids than Caucasian women. They also tend to appear at a younger age, grow more quickly and cause more severe symptoms for African American women.

Experts aren’t sure what causes them

5 / 8 Experts aren’t sure what causes them

Researchers aren’t exactly sure what causes fibroids, but they do think they could be hereditary and that they may be connected to a woman’s estrogen and progesterone levels. Why they grow or shrink is somewhat of a mystery too, but hormones may be able to control this to some extent. Fibroids typically grow when hormones are high during pregnancy, and shrink when levels are low, during menopause or when a woman takes anti-hormone medication.

Roznowski says the first thing he does is talk through a patient’s medical history. “I’m interested to learn if their moms, sisters or aunts have them,” says Roznowski. “I also like to know how big they got and whether or not they had a hysterectomy, or surgery to remove the uterus.” Discussing these details helps Roznowski determine the proper plan of action.

There are a lot of treatment options

6 / 8 There are a lot of treatment options

There are many fibroid treatment options, and the one that’s best for you depends on whether or not you’d like to have kids in the future along with any symptoms that you’re having. Here are the possibilities:

Over-the-counter medications: Acetaminophen or ibuprofen may be recommended for mild pain.

Birth control: Birth control pills, hormone injections or intrauterine devices can encourage the fibroids to shrink and help control heavy bleeding.

Gonadotropin releasing hormone agonists: These injections, nasal sprays or implants help to shrink the fibroids and can reduce heavy bleeding. These medications may also be recommended before surgery, since they make the fibroids easier to remove.

There are a few different surgery options as well. For example, your doctor may remove your uterus—and the fibroids—if you don’t plan to have children, or leave your uterus intact while removing the fibroids if you plan to become pregnant. 

They may cause issues for pregnant women

7 / 8 They may cause issues for pregnant women

The good news is that most women with fibroids carry pregnancies to term with no problems. “The fibroids move out of the way,” says Roznowski.

But in general, pregnant women who have fibroids do have an increased risk of preterm labor, since fibroids occupy space in the uterus. There is also an increased risk for a cesarean section, breech baby, labor problems and placental abruption, where the placenta fails to release from the uterus prior to delivery.

Talk to your OBGYN before you become pregnant so you can discuss any necessary precautions. If you are pregnant and learn you have fibroids, your OBGYN can monitor you closely. But remember, most women have successful pregnancies without any complications.

See your OBGYN if you have symptoms

8 / 8 See your OBGYN if you have symptoms

Since not all women have symptoms, you may not even know you have fibroids until you have a routine pelvic exam, where your OBGYN checks your uterus, ovaries and vagina. If they feel a lump on your uterus, they may suspect you have fibroids. Other tests and surgeries can confirm that you do, too:

  • Pelvic ultrasounds
  • Hysterosalpingograms (HSG) or sonohysterograms
  • Magnetic resonance imaging (MRIs)
  • CT scans
  • Hysterosalpingograms (HSG) or sonohysterograms
  • Laparoscopy
  • Hysteroscopy

From there, you and your OBGYN can determine any necessary treatment plans. 

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