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Uterine Fibroids, Part One


What are Uterine Fibroids?

Uterine fibroids, also called leiomyoma, are muscular tumors that grow in the walls of a woman’s uterus, and can range from the size of a small seed to the size of a softball [2]. A woman can have one fibroid or several, with the average affected uterus having six or seven [1]. Almost all uterine fibroids are benign (not cancerous), and less than 1 in 1,000 women will have a cancerous form of fibroids called leiomyosarcoma [2]. There are different types of fibroids: a submucosal fibroid grows into the uterus cavity; an intramural fibroid grows within the walls of the uterus and; a subserosal fibroid grows on the outside of the uterus [2].

Who is at Risk for Having Fibroids?

Women of reproductive age can develop fibroids, with women in their 40s and early 50s having the highest risk [2]. After menopause, these tumors tend to shrink and disappear. Women who are African American are three times as likely to have fibroids than White, Asian and Hispanic women, but the incidence rate is unknown in Native women [3]. Women with a family history of fibroids are at higher risk to develop fibroids, as are women who have diabetes, hypertension, polycystic ovary syndrome or who smoke [4]. Women who are overweight are also at higher risk, and eating a diet high in red meat increases odds of developing tumors, while eating a diet rich in green vegetables decreases odds [2].

Cause of Uterine Fibroids

The cause of uterine fibroids is unknown, but many scientists believe it is genetically linked in some way. While it is unknown what causes a fibroid to form, it is known that hormones, mainly estrogen and progesterone, regulate its growth [2]. However, women taking oral contraceptives actually have a decreased risk of developing fibroids [1].

Symptoms of Uterine Fibroids

Only about 25% of women show fibroid related symptoms [1]. These include: heavy bleeding, painful periods, feeling of fullness in lower abdomen, enlargement of the lower abdomen, difficulty urinating or passing bowel movements, pain during sexual intercourse, pregnancy complications, and in rare cases, reproductive problems such as infertility [2]. The most common symptom is heavy bleeding, also called menorrhagia; indicators of heavy bleeding include periods lasting longer than seven days, having to change sanitary products frequently, and avoiding public engagements for fear of embarrassing bleeding [1].

How to Know if You Have Uterine Fibroids

Doctors often find fibroid tumors during routine pelvic exams (where a physician inserts two fingers into the vagina while pressing down on the abdomen to check for abnormalities), but fibroids can also be identified using either abdominal or vaginal ultrasound (using sound waves to create a picture) [2]. Sometimes a regular ultrasound does not pick up fibroids, and a Magnetic Resonance Imaging (MRI), CAT scan, or an X-ray is used [2]. Another test that doctors may use is a hysterosalpingogram where dye or water is inserted into the uterus and X-rays are taken (if water is used instead of dye, it is called a sonohysterogram) [2]. Rarely, a doctor will need perform surgery to confirm the presence of a fibroid tumor, in which a long thin scope is inserted vaginally or through a small incision in the abdomen to explore the uterus [2]. Since pelvic exams are the easiest way to find problematic fibroids, it is important to schedule an annual gynecological exam.

Tips for Talking with your Doctor

Many women will never know that they have a fibroid tumor and do not require treatment, but if you are experiencing symptoms, see a healthcare professional. It is important for them to know your age, family history of fibroids, if you are experiencing any symptoms and if you wish to get pregnant in the future, because this will affect your treatment options. Some questions to ask your healthcare provider if you have uterine fibroids include: How many fibroids do I have? What size are they? Are they growing larger and how will I know if they do? What problems can I encounter? What tests/images are best for tracking my fibroids? What are my treatment options [2]? In the next article, we will discuss different methods of treatment for uterine fibroids, if treatment is necessary.


Sources

[1] Center for Uterine Fibroids (n.d.). About Uterine Fibroids. Brigham and Women’s Hospital. Retrieved on Oct. 13, 2010 from http://fibroids.net/homepage.html.

[2] National Women’s Health Information Center (2008, May 13). Uterine Fibroids. U.S. Department of Health and Human Services. Retrieved on Oct. 13, 2010 from http://www.womenshealth.gov/faq/uterine-fibroids.cfm.

[3] National Uterine Fibroids Foundation (2004, Aug. 27). Getting Involved: Introduction. Retrieved on Oct. 13, 2010 from http://www.nuff.org/bod.htm.

[4] Okolo, S (2008). Incidence, aetiology and epidemiology of uterine fibroids. Clinical Obstetrics and Gynecology, 22(4), 571-588. Retrieved on Oct. 13, 2010 from http://www.bestpracticeobgyn.com/article/S1521-6934(08)00062-X/abstract.

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