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Pregnancy

Fibroids, also known as Leiomyomata

The uterus is made of muscle. A fibroid tumor is a growth of the uterus or cervix that is not cancer - also called “benign“.  The fibroid continues to grow until a "knot" forms. This usually happens in many locations in the uterus and can cause multiple fibroids.

The reason that fibroids occur is not completely known, but the growth is related to the presence of estrogen in the body.  Commonly, fibroids will grow rapidly during pregnancy, when hormone levels are high. They shrink when anti-hormone medicine is used.  They also stop growing or shrink once a woman reaches menopause.

Listed below are some questions and answers about fibroids:

 

What should you know about fibroids?

 

What makes a woman more likely to have fibroids?

Age - Fibroids become more common as women age, especially during the 30s and 40s through menopause. After menopause, fibroids usually shrink. Although estrogen contributes to the growth of fibroids, the levels used in hormone replacement therapy - or “HRT“- are unlikely to cause growth of existing fibroids.

Family history - Having a family member with fibroids increases your risk. If a woman's mother had fibroids, her risk of having them is about three times higher than average.

Ethnic origin - African-American women are more likely to develop fibroids than white women are.

Obesity - Overweight women are at higher risk for fibroids. For very heavy women, the risk is two to three times greater than average.

Eating habits - Eating a lot of red meat - for example, beef - and ham is linked with a higher risk of fibroids. Eating plenty of green vegetables seems to protect women from developing fibroids.

 

What are the symptoms?

Women who have symptoms often find fibroids hard to live with. Symptoms may include:

 

How can I know for sure that I have fibroids?

Pelvic exam - A doctor can feel the fibroid with her or his fingers during an ordinary pelvic exam.  It is usually a painless lump on the uterus.

Imaging tests - Your doctor can do imaging tests to confirm that you have fibroids. These tests create a "picture" of the inside of your body without surgery. These tests might include:

Surgery - You may need surgery to know for sure if you have fibroids. There are two types of surgery to do this:

 

How big are fibroids?

Your doctor can use a pelvic exam or ultrasound to determine the size of the fibroids. Often, a doctor will describe how small or how large the fibroids are by comparing their size to the size your uterus would be if you were pregnant. For example, you may be told that your fibroids have made your uterus the size it would be if you were 16 weeks pregnant. Or the fibroid might be compared to fruits, nuts, or a ball, such as a grape or an orange, an acorn or a walnut, or a golf ball or volleyball.

 

How are fibroids treated?

There are some important things to thing about when deciding how to treat fibroids including:

 

What procedures are used to treat fibroids?

It is considered as a minor surgery and can be done on an outpatient basis or even in a doctor's office. Complications can occur, but are uncommon with most of the methods. Most people recover quickly. About half of women who have this procedure have no more menstrual bleeding. About three in 10 women have much lighter bleeding.

It is important to consider that a woman cannot have children after this surgery.

 

What medications are used to treat fibroids?

Pain control medications.  Over-the-counter drugs such as ibuprofen or acetaminophen can be used for mild pain.

Iron supplements.  If you have heavy bleeding during your period, taking an iron supplement can keep you from getting anemia or correct it if you already are anemic.

Birth control.  Several drugs commonly used for birth control can be prescribed to help control symptoms of fibroids. Low-dose birth control pills do not make fibroids grow and can help control heavy bleeding. The same is true of progesterone-like injections such as Depo-Provera®.  An IUD - or “intrauterine device” - called Mirena® contains a small amount of progesterone-like medication, which can be used to control heavy bleeding as well as for birth control.

Hormones - Other drugs used to treat fibroids are "gonadotropin releasing hormone agonists" or “GnRHa”. The one most commonly used is Lupron®. These drugs, given by injection, nasal spray, or implanted, can shrink your fibroids. Sometimes they are used before surgery to make fibroids easier to remove.

Side effects of GnRHas can include:

Most women tolerate GnRHas quite well. Most women do not get a period when taking GnRHas. This can be a big relief to women who have heavy bleeding. It also allows women with anemia to recover to a normal blood count.

GnRHas can cause bone thinning, so their use is generally limited to 6 months or less. These drugs also are very expensive, and some insurance companies will cover only some or none of the cost. GnRHas offer temporary relief from the symptoms of fibroids; once you stop taking the drugs, the fibroids often grow back quickly.

 

How do fibroids affect getting pregnant, pregnancy and having a baby?

Fibroids may cause:

Even though fibroids tend to grow very slowly, the location or size of a fibroid might make it more difficult to carry a baby to term. The extra hormones a woman's body makes during pregnancy can cause a fibroid to grow and take up space in the uterus that the baby needs. The baby could end up being born early or be miscarried. Fibroids near the cervix may not allow the baby to pass through the birth canal and require a Cesarean section for delivery.

 

Can fibroids turn into cancer?

Fibroids are almost never cancerous.  Less than 1 person in 1,000 has a fibroid that becomes cancer. This is called leiomyosarcoma. Doctors think that these cancers do not arise from an already-existing fibroid. Having fibroids does not increase the risk of developing a cancerous fibroid. Having fibroids also does not increase a woman's chances of getting other forms of cancer in the uterus.

 

Sources

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Last Reviewed: Sep 26, 2013