Uterine fibroids, also called leiomyomas or myomas, are non-cancerous growths that affect the uterine wall. Fibroids typically appear during childbearing years and are most commonly seen in women who are in their 40s or early 50s. Fibroids can be as small as seeds that are virtually undetectable to the eye, or they can be large, bulky masses that distend the uterus. It’s also possible to have a single fibroid or multiple fibroids; in severe cases involving multiple large fibroids, the uterus may expand upward as far as the ribcage.
Fibroids almost never develop into cancer, and they aren’t associated with an increased risk of uterine cancer.
Because most fibroids don’t cause symptoms, most women never even know that they have them, but some women aren’t so lucky. Depending on the location, size, and number of fibroids present, women with symptoms may experience any of the following:
Pregnant women with uterine fibroids have an increased risk of complications during pregnancy and labor and are six times more likely to deliver by cesarean birth.
Fibroids are often found during a routine pelvic exam to check your uterus, ovaries, and vagina. If your gynecologist can feel a fibroid with their fingers, they may perform imaging tests to confirm the diagnosis. Although this can be achieved with a variety of diagnostic tools, it’s usually performed via ultrasound. If an ultrasound doesn’t reveal enough information, your doctor may perform a hysteroscopy procedure to examine the interior wall of your uterus, or a laparoscopy procedure to examine any fibroids on the outer wall of your uterus.
Fibroids that are small or don’t cause symptoms usually don’t need treatment. Because they tend to shrink during menopause, women who are approaching menopause may also opt to avoid treatment, particularly if their symptoms aren’t too severe. For women who have symptoms, or for those with larger fibroids who would like to become pregnant, treatment can be beneficial.
Birth control pills and other forms of hormonal medications can help reduce pelvic pain and heavy periods for women who aren’t planning to become pregnant. Another type of medication, called gonadotropin-releasing hormone (Gn-RH) agonists, may be used to stop the menstrual cycle temporarily, which helps shrink fibroids.
A myomectomy is a surgical procedure that removes fibroids while leaving the uterus in place. This treatment may be the best option for women who have significant fibroids and want to become pregnant. A hysterectomy, or the removal of the uterus, is the only way to cure a fibroid problem completely, but it means that pregnancy is no longer an option.
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