Fibroids

Fibroids are benign (non cancerous) growths found in the uterus. They are made up of smooth muscle cells and connective tissue. They are extremely common, especially in African American and Hispanic women. They can range in number and size and affect different women differently.  There are several different types of uterine fibroids and are named based on where they grow:

• submucosal: located under the uterine lining and can push into the uterine cavity
• intramural: located within the wall of the uterus
• subserosal: located on the outer portion of the uterus
• pedunculated: located on “stalks” that connect to the wall of the uterus

The exact cause of fibroids is unknown.  They grow in the presence of estrogen and thus can increase in size during the reproductive years and pregnancy.  Similarly, they typically shrink after menopause when estrogen levels decrease.

Not all women with fibroids have symptoms. Small fibroids (less than 3 centimeters) are typically asymptomatic and women with fibroids this size often do not even know they have them.  In contrast, in some women fibroids grow very large (10 centimeters or greater) or are numerous. These can cause symptoms such as heavy bleeding, painful periods, bloating, pain with sex, pelvic pain/pressure, infertility, and even bladder/bowel problems.  

Many women with fibroids are asymptomatic and do not know they have fibroids until a pelvic exam or ultrasound is performed.  Most commonly, they are found on routine ultrasound at the time of pregnancy.  CT scans and MRIs can also detect fibroids, but these imaging studies are not usually necessary for diagnosis.  

There are various treatment methods for fibroids including medications to control symptoms. procedures to shrink the size of the fibroids, and surgical interventions to remove the fibroids.  The physicians at Alliance Obstetrics & Gynecology Group can help you in selecting the treatment plan that is most appropriate for you. 

Given that fibroids are non-cancerous, they do not need to be removed unless they are bothersome.  If they are causing significant symptoms, surgery may be recommended.  For women desiring future fertility, a myomectomy is performed.  It is important to note, however, that with a myomectomy the uterus is spared and fibroids have the ability to regenerate.  For women who have completed childbearing, a hysterectomy is typically recommended. 

If you have or think you may have fibroids, schedule a consultation with us at Alliance Obstetrics & Gynecology and The Center for Pediatric & Adolescent Gynecology.