What are Uterine Fibroids?

Fibroids
I mentioned that I have uterine fibroids, so I figured I’d give a crash course on what they are.

Uterine fibroids are noncancerous growths of the uterus. They are also called fibromyomas, leiomyomas or myomas, and although these names sound bad, uterine fibroids are not associated with an increased risk of uterine cancer and they almost never develop into cancer. Fibroids can range in size from very small, like the size of a pinpoint to very large, like the size of a melon.

Very large fibroids expand the uterus so much, that it can give a woman the appearance of being pregnant. (Incidentally, this is one very good reason never to assume a woman is pregnant unless she says she is).

Statistics vary on how many women have fibroids. The range is from 20%-75% of women ages 30 to 50, although women in their 20’s can also get fibroids. Also, for unknown reasons, they are most prevalent among African-American women. In addition, they are hereditary. If your mother or sister has them, you are more likely to have them. Of the women that do have fibroids, most don’t know it because they experience no symptoms. Symptoms include heavy or prolonged menstrual bleeding, or bleeding between periods, frequent urination or urinary incontinence, pelvic pressure or pain, and backache or leg pains. These symptoms vary based on the size and location of the fibroids. Asymptomatic fibroids usually are not treated, they are just watched (some grow, some shrink, some stay the same). Many women seek treatment if the fibroids cause unmanageable symptoms, or if they become very large. Prompt medical care is advised if you have sharp pelvic pain that comes on suddenly or severe vaginal bleeding.

There are many different treatments for uterine fibroids. One treatment is a hysterectomy, which is removal of the uterus, and the only proven permanent way to eliminate fibroids. This is a drawback for women in childbearing years, as it ends their ability to bear children. If the ovaries are removed as well, it brings on menopause. There is also a myomectomy, which removes fibroids (although they may grow back). In addition, there are drugs available to shrink them, methods to cut off the blood supply, and other treatments that freeze, burn, or send electric currents through the fibroids in order to destroy them. There is also newer method, called Focused Ultrasound Surgery, which uses sound waves to destroy the fibroids. Since the treatment methods vary so much, and there are pros and cons to each; it is best to do extensive research with your doctor’s input to find the best treatment for you, should you decide you need it.

Fibroids and pregnancy. Fibroids can make it more difficult to get pregnant. If they block one or both fallopian tubes, they can keep sperm from fertilizing an egg. Or they may fill the uterine cavity, interfering with implantation once an egg is fertilized. Once a woman is pregnant, fibroids located in the cavity of the uterus can increase the chance of a miscarriage or cause a woman to go into premature labor. Fibroids may also affect the position of the baby, causing it to be breech. This can increase the need for cesarean section. Rarely, fibroids can cause complications of pregnancy called placental abruption (when the placenta detaches before the baby is born) and postpartum hemorrhage (excessive bleeding after the baby is born). Despite all these possibilities, fibroids generally allow for problem-free pregnancies.

In my case, the fibroids have not affected my pregnancy so far. The specialist noted that two of them are located at the bottom of my uterus. If they remain there, I would need a Caesarean section (C-section). It is too early to tell because the uterus has a lot of growing to do and it is possible the fibroids may grow up and out of the way by the time the baby is ready to arrive. In that case, a C-section would not be necessary. She said we will get a better idea in the third trimester. Until then, we “watch and wait!”