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What You Need to Know About Fibroids

What You Need to Know About Fibroids

Many women have them and don’t even know it.

Fibroids are benign tumors that grow within the wall of the uterus. They are common, although many women don’t know they have them. In fact, one study found that by age 50, between 70 and 80 percent of participants had fibroids, but weren’t aware. 

While fibroids can be worrisome, especially for women of childbearing age, they are treatable. Here’s what you need to know.

What are fibroids?
Fibroids, also known as leiomyomas, are tumors that grow in the wall of the uterus, or womb. They are almost always benign; only 1 in 1,000 fibroids are cancerous. Most women have multiple fibroids. Fibroids can be smaller than a pea or grow as large as a cantaloupe.  

Who gets fibroids?
Any woman can develop fibroids, but you may be at increased risk if:

  • You’re between 30 and 40 years old
  • You have a family history of fibroids
  • You’re African American
  • You’re overweight
  • You eat a lot of red meat

Healthcare providers (HCPs) don’t know for sure what causes fibroids but it may have to do with elevated hormone levels. Fibroids tend to grow during pregnancy when hormones are high. They often shrink after menopause, or when a woman takes anti-hormone medications. 

What are the symptoms?
Fibroids don’t always cause symptoms, but when they do they may include:

  • Heavy or prolonged menstruation
  • Feeling full in the pelvic region (lower stomach)
  • Enlargement of the uterus and abdomen
  • Frequent urination
  • Pain during sex
  • Pain in the lower back
  • Pregnancy and delivery complications
  • Reproductive issues

Your doctor may feel fibroids during a pelvic exam and will confirm the diagnosis using ultrasound or other imaging tests. Fibroids without symptoms are often found incidentally, while examining or imaging for another condition.

How are fibroids treated?
Not everyone needs treatment. It depends on your symptoms, location and size of the fibroids, your age and if you want to have children. If the fibroids aren’t causing bothersome symptoms or if you don’t plan on becoming pregnant in the future, you may not need to do anything.

For mild symptoms, HCPs often suggest ibuprofen or acetaminophen to relieve pain and discomfort. Another first-line medicine used to treat heavy periods is tranexamic acid. It specifically affects the uterine lining to diminish heavy flow and is taken for up to five days when a woman is menstruating. Low-dose birth control methods can also be used for heavy bleeding, though this added amount of hormone may trigger additional fibroid growth. Other hormone-type drugs may be used to temporarily shrink fibroids before surgery.

If fibroids are especially large or cause severe pain, you may have several treatment options. A myomectomy is a procedure that removes the larger fibroids but often leaves behind smaller ones, preserving the uterus; if you undergo myomectomy, you may need another procedure once the smaller fibroids grow. A hysterectomy is another possibility. It’s a surgery that removes the fibroids along with the uterus, with or without the ovaries. Women contemplating myomectomy should also know that they can wake up after surgery with a hysterectomy if bleeding cannot be adequately controlled.

Another procedure, called uterine fibroid embolization (or UFE), is nonsurgical and preferred by many women. It’s performed by an interventional radiologist, a physician specially trained in image-guided procedures that replace the need for traditional surgery. Compared to surgical approaches, UFE is typically safer, less invasive, less expensive and has a much shorter recovery time—up to one week, versus six to eight weeks. What’s more, women keep their uterus. 

Other procedures such as endometrial ablation and myolysis are done in certain cases, but they do not have as long a track record of efficacy as the previous three options.

Talk to your HCP about all your treatment options and together you can come up with the best treatment plan for you.

Medically reviewed in August 2019.

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