Fibroids are benign solid tumors of the uterus. Other names given to fibroids are myomas, leiomyomas, and fibromas. They represent the most common pelvic tumor found in women. Roughly, 20% of women over the age of 30 and in nearly 40% of women after the age of 40 have fibroid tumors. They can range in size from microscopic to as much as 25 – 50 pounds and may be solitary but are most often multiple. The largest ever recorded weighed 140 pounds!
Fibroids develop from the muscular layer of the uterus, called the myometrium. Each tumor originates from a single muscle cell, which continuously duplicates itself. They may grow rapidly or very insidiously.
They can grow in the presence of the hormone estrogen, as medical studies have found a higher concentration of protein structures called estrogen receptors on their cell surface of the tumors that may make them grow. However not all fibroids enlarge despite receiving high doses of estrogen. Since they are unpredictably responsive to estrogen, they may shrink to varying degrees after menopause.
Fibroids are usually discovered when they cause symptoms, although many women are asymptomatic when they are diagnosed on routine physical examination.
Some women with fibroids experience changes in menstrual patterns. These changes may include heavier bleeding, often with clotting, or periods lasting longer than 7 days, or bleeding between periods. Anemia is a common finding among women with heavy periods related to fibroids, and as a result, they may feel easily fatigued.
Pain and pressure in the pelvis are also common complaints among fibroid sufferers, as the enlarging uterus puts pressure on surrounding structures including the bladder (frequent urination similar to early pregnancy) and rectum (constipation and continuous rectal pressure). Pain with intercourse is also common.
A history of the previously mentioned symptoms will tip us off to the possibility of fibroids. Next, a physical exam may or may not reveal fibroids (some are located deep within the uterus and are therefore difficult to feel). Nevertheless, if symptoms are significant, an ultrasound examination should be done, searching for the etiology. Generally, office ultrasound will show fibroids clearly. If they are located in the center of the uterus, then office saline hysterosonography will assess whether or not the fibroids may be removed in a conservative fashion.
If they are small and asymptomatic, they do not need to be treated. They only need therapy if symptoms warrant. So let’s assume that they are significant in size and symptoms. There are several therapies available:
Fibroids are common, and are easy to diagnose and treat. But if nobody is taking the time to evaluate complaints mentioned above, they may indeed go undiagnosed and untreated. If you have any questions about symptoms that may be related to fibroids, please call our office for an appointment