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Uterine fibroids


Alternative Names:

Leiomyoma; Fibromyoma; Myoma; Fibroids

Symptoms:

Common symptoms of uterine fibroids are:

  • Bleeding between periods
  • Heavy bleeding during your period, sometimes with blood clots
  • Periods that may last longer than normal
  • Needing to urinate more often
  • Pelvic cramping or pain with periods
  • Feeling fullness or pressure in your lower belly
  • Pain during intercourse

Often, you can have fibroids and not have any symptoms. Your health care provider may find them during a physical exam or other test. Fibroids often shrink and cause no symptoms in women who have gone through menopause. A recent study also showed that some small fibroids shrink in premenopausal women.

Treatment:

What type of treatment you have depends on:

  • Your age
  • Your general health
  • Your symptoms
  • Type of fibroids
  • If you are pregnant
  • If you want children in the future

Treatment for the symptoms of fibroids may include:

  • Birth control pills to help control heavy periods
  • Intrauterine devices (IUDs) that release hormones to help reduce heavy bleeding and pain
  • Iron supplements to prevent or treat anemia due to heavy periods
  • Pain relievers such as ibuprofen or naprosyn for cramps or pain
  • Hormone therapy shots to help shrink fibroids (done only for a short time)
  • Watchful waiting: You may have pelvic exams or ultrasounds every once in a while to check the fibroid's growth

Surgery and procedures used to treat fibroids include:

  • Hysteroscopy. This procedure can remove fibroids growing inside the uterus.
  • Uterine artery embolization. This procedure stops the blood supply to the fibroid, causing it to shrink and die. This may be a good option if you want to have children in the future.
  • Myomectomy. This surgery removes the fibroids from the uterus. This also may be a good choice if you want to have children. It won't prevent fibroids from growing again.
  • Hysterectomy. This surgery removes the uterus completely. It may be an option if you don't want children, medicines do not work, and you cannot have any other procedures.
Support Groups:

National Uterine Fibroid Foundation - www.nuff.org

Outlook (Prognosis):

If you have fibroids without symptoms, you may not need treatment.

If you have fibroids, they may grow if you become pregnant. This is due to the increased blood flow and higher estrogen levels. The fibroids usually return to their original size after your baby is born.

Possible Complications:

Complications of fibroids include:

  • Severe pain or very heavy bleeding that needs emergency surgery
  • Twisting of the fibroid. This can causes blocked blood vessels that feed the tumor. You may need surgery if this happens.
  • Anemia (not having enough red blood cells) from heavy bleeding
  • Urinary tract infections: If the fibroid presses on the bladder, it can make it hard to empty your bladder completely.
  • Infertility, in rare cases.

If you are pregnant, there's a small risk that fibroids also may cause complications:

  • You may deliver your baby early because there is not enough room in your womb.
  • If the fibroid blocks the birth canal or puts the baby in a dangerous position, you may need a c-section.
  • You may have heavy bleeding right after giving birth.
When to Contact a Medical Professional:

Call your health care provider if you have:

References:

American College of Obstetricians and Gynecologists. ACOG practice bulletin. Alternatives to hysterectomy in the management of leiomyomas. Obstet Gynecol. 2008;112:387-400.

Borkan J. Uterine Fibroids. In: Ferri F.: Ferri's Clinical Advisor. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2014 Section 1 U.

Katz VL. Benign gynecologic lesions: Vulva, vagina, cervix, uterus, oviduct, ovary. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 18.

Rodriguez MI, Warden M, Darney PD. Intrauterine progestins, progesterone antagonists, and receptor modulators: a review of gynecologic applications. Am J Obstet Gynecol. 2010 May;202(5):420-8. Epub 2009 Dec 23. Review.

Moss J, Cooper K, Khaund A, et al. Randomised comparison of uterine artery embolisation (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST trial): 5-year results. BJOG. 2011 Jul;118(8):936-944.

Peddada SD, Laughlin SK, Miner K, et al. Growth of uterine leiomyomata among premenopausal black and white women. Proc Natl Acad Sci USA. 2008 Dec 16;105(50):19887-92. Epub 2008 Dec 1.

Van Voorhis B. A 41-year-old woman with menorrhagia, anemia, and fibroids: review of treatment of uterine fibroids. JAMA. 2009;301:82-93.


Review Date: 8/5/2013
Reviewed By: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

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