If you suffer from heavy vaginal bleeding, severe cramps or pressure in your lower abdomen and rectum, frequent urination and pain during intercourse, you could have uterine fibroids. In fact, you may have fibroids even if you don’t have any symptoms. Only about 30 percent of women who have fibroids experience symptoms.

Fibroids are very common, mostly affecting women in their 30s and 40s. By age 50, 70 percent of white women and 80 percent of black women in the United Stateswill have fibroids, according to one study cited by the National Institutes of Health (NIH).

What are fibroids?

Fibroids are benign tumors that grow in the wall of the uterus. You can have one or many. Some may be as small as an apple seed or the size of a grapefruit. Rarely are they cancerous. Fibroids can cause infertility or complications during pregnancy.

The cause of fibroids is unknown, but they are affected by hormones (estrogen and progesterone). Fibroids grow rapidly when hormone levels are high, as in pregnancy, and shrink when hormone levels diminish, as in menopause.

Genetics may play a role. Research suggests that a woman’s chance of developing fibroids is passed on to her by her father. The role of diet in fibroid growth is under study as well.

Treatment

Doctors usually discover a fibroid while conducting a pelvic exam. Imaging tests, such as ultrasound, are done to confirm the diagnosis.

Treatment is dependent on a number of factors. Your doctor will determine the best course of action based on your age, whether you are planning to become pregnant, the size or location of fibroids, and the severity of symptoms. A woman with no symptoms and small fibroids, for example, may not need any treatment and will simply be monitored for any changes.

For mild symptoms, doctors often recommend medications. These can include over-the-counter preparations for pain and low-dose birth control pills to reduce heavy bleeding. The amounts of hormones in the latter are not high enough to spur growth.

A gonadotropin releasing hormone antagonist (GnRHa) may be prescribed to shrink the fibroids. GnRHa stops the production of estrogen and progesterone. When on these drugs, women usually do not get a period and experience symptoms of menopause, such as hot flashes. GnRHa also thins the bones and, therefore, is prescribed only for a short period. The drug is commonly prescribed several months before surgery to reduce tumor size and stop heavy bleeding.

Surgical treatment is usually recommended for moderate or severe symptoms. A woman who hopes to have children in the future may opt for a myomectomy – removal of just the fibroids. All other surgical remedies leave a woman unable to bear children. They include:

• Hysterectomy, the most common option;
• Endometrial ablation, a minor surgical treatment that involves the removal or destruction of the uterus lining by laser, freezing or other methods;
• Myolysis, a laparoscopic surgery that uses electric current or freezing to destroy the fibroid;
• Uterine Fibroid Embolization (UFE) or Uterine Artery Embolization (UAE), a procedure that blocks the blood supply to the fibroid (Note: Not all fibroids can be treated with UFE.);
• MRI-guided ultrasound surgery, which uses a high-intensity ultrasound beam to destroy the fibroid.

A number of other experimental drugs and procedures are under study in an effort to find treatments that do not affect women’s ability to bear children. In clinical trials, ulipristal acetate (UPA), which is approved by the Food and Drug Administration (FDA) as an emergency contraceptive, has shown promise in shrinking the tumors.

For more information on uterine fibroids and their treatment, visit the Center for Uterine Fibroids. Also check out the National Uterine Fibroids Foundation page on Facebook.

Photo Credit: Ohmega1982