Uterine fibroid tumors are a very common finding on pelvic ultrasound or pelvic exam and tend to cause women to worry unnecessarily. As many as one in 5 women have fibroids, and most will never cause any disruption in a woman’s health. Most commonly, a woman will have an annual exam and an ultrasound will be ordered because her uterus is felt to be enlarged or for another reason such as abnormal bleeding or pelvic pain, and fibroids will be one of the findings on the ultrasound. Fibroids can range in size from very small (grape sized) to very large (grapefruit sized) and can be solitary or numerous. Whether or not something needs to be done about them depends on factors such as size, number, location and symptoms.
What are the symptoms of fibroids? They can vary immensely. Most women with small or few fibroids may have no symptoms at all. These fibroids can be monitored periodically with ultrasound to check for growth. Fibroids that are asymptomatic and not growing rapidly can be left alone because they will shrink after menopause. Other fibroids can cause symptoms such as heavy bleeding, pain, pressure on the bladder or rectum, increased abdominal size, and difficulty becoming pregnant or carrying a pregnancy.
Treatments for fibroids vary based on symptoms. Some menstrual bleeding abnormalities can be managed with medications, even when fibroids are involved. There are nonsurgical solutions for fibroids such as uterine artery embolization or MRI guided ultrasound treatment- these procedures block the blood supply to the uterus or fibroids and shrink the tumors. They should not be used if future childbearing is desired.
Fibroids in the uterine lining can be removed with outpatient hysteroscopic surgery or can be treated during a uterine ablation procedure. Larger fibroids in the muscle of the uterus can be removed with a surgery called a myomectomy, if a woman desires future childbearing. Alternatively, a hysterectomy can be done if a woman is done having children. Either of these surgeries can be done open or laparoscopically. While there is no medicine available that can eliminate fibroids, a drug called Lupron is often used prior to fibroid surgeries to shrink the tumors.
In conclusion, a diagnosis of fibroid tumors usually does not mean disruption to a woman’s life or health. Many fibroids live quietly in the uterus and never cause symptoms. Luckily, if and when fibroids become symptomatic, there are a number of nonsurgical and surgical treatments to treat them. Further information about fibroid tumors can be found at my Mesa Ob/gyn office.
Tamar Gottfried is a Board Certified Obstetrician/ gynecologist practicing general Ob/gyn in Mesa Arizona and affiliated with Banner Desert and Banner Gateway Medical Centers. She can be contacted at 480-545-0059. This is a general interest article only and is not intended to be medical advice. See a medical professional before making medical decisions
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