(Fibroids; Leiomyoma; Myoma; Fibromyoma)
DefinitionFibroids are benign (noncancerous) growths in the wall of the uterus. The uterus is the organ where a fetus grows during pregnancy.Fibroids are common. They may be very small or they could grow to eight or more inches in diameter. Most fibroids remain inside the uterus. Sometimes, they may stick out and affect nearby organs. It is common for there to be more than one fibroid.
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CausesThe cause of fibroids is unknown.Fibroid growth is stimulated by female reproductive hormones. As a result:
- Fibroids grow larger during pregnancy then shrink after childbirth.
- Fibroids become less of a problem after menopause . However, symptoms may return with hormone replacement therapy (HRT) .
Risk FactorsAfrican American women are at increased risk. Other factors that affect your risk of fibroids include:
- Risk increases with age until menopause
- Family history
SymptomsThere many not be any symptoms. Or, symptoms may be mild or severe. This depends on the size and location of the growths.Symptoms may include:
- Pelvic pain or pressure
- Heavy menstrual bleeding
- Clots in menstrual flow
- Long periods
- Bleeding between periods
- Increased cramping during periods
- Pain during sex
- Frequent need to urinate
- Abdominal swelling
- Low back or leg pain
- Infertility by blocking the fallopian tubes
DiagnosisMost fibroids are found during routine pelvic exams.Images may be taken of your bodily structures. This can be done with:
TreatmentMost women with fibroids do not have symptoms and do not need treatment. Your doctor may recommend monitoring any changes on a regular basis. Treatment may be done later if needed.Treatments include:
Pain MedicationYour doctor may advise:
- Over-the-counter pain relievers to ease mild symptoms
- Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and relieve cramping
- Prescription pain medication—If pain cannot be managed with medications above
- Tranexamic acid to control bleeding symptoms
Hormonal TherapyHormone medications may be an option if you are not trying to become pregnant. These drugs can shrink fibroids, reduce abnormal bleeding, and lessen pain. However, fibroids can return after you stop taking the drugs. These drugs may be used to make fibroids smaller just before surgery.
ProceduresSurgery may be considered if:
- The uterus becomes extremely large
- The fibroids are interfering with fertility
- Symptoms are severe
- Myomectomy —An incision is made in the abdomen. The fibroids are removed from the uterus.
- Hysterectomy —The entire uterus is removed. You will be unable to have children if you have this surgery.
- Uterine fibroid embolization—This is a minimally invasive procedure. It blocks blood flow to the fibroids. This will make the fibroids shrink.
- Focused ultrasound therapy—Energy is centered on the fibroid to destroy it. This procedure may not be ideal for patients who are overweight, have very large fibroids, or have extensive scars from prior abdominal surgeries.
PreventionThere are no guidelines for preventing fibroids.
The American Congress of Obstetricians and Gynecologists
The International Council on Infertility Information Dissemination, Inc.
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
Fibroids. Healthy Women website. Available at: http://www.healthywomen.org/condition/fibroids. Updated August 9, 2011. Accessed October 30, 2014.
Uterine fibroid embolization (UFE). RadiologyInfo.org website. Available at: http://www.radiologyinfo.org/en/info.cfm?pg=ufe. Updated August 5, 2013. Accessed October 30, 2014.
Uterine leiomyoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated August 27, 2014. Accessed October 30, 2014.
- Reviewer: Andrea Chisholm, MD
- Review Date: 12/2014
- Update Date: 12/20/2014