Surprising facts about fibroids

Key takeaways: 

  • Fibroids affect nearly half of all women age 50 and older. 

  • Many fibroids don’t require treatment unless they cause troublesome symptoms. 

  • Hysterectomy is no longer the only treatment option for fibroids. 

[3 MIN READ]  

This article was updated to reflect recent research on February 8, 2021. 

Have you been diagnosed with uterine fibroids? If so, you’re in good company. 

As many as one in five women have fibroids and nearly half have fibroids by the time they celebrate their 50th birthday, according to the National Institutes of Health. Fibroids are abnormal growths on a woman’s uterus. They are usually noncancerous but may become large, causing heavy periods and painful abdominal cramps.  

Fibroids do not require treatment unless they cause bothersome symptoms. Their cause is unknown. 

How do fibroids form? 

Fibroids develop from the muscular tissue of the uterus, called the myometrium. Although they have similar symptoms as fibroids, polyps come from a different tissue that is the same as the tissue in your uterine lining. A single cell of that tissue reproduces until it becomes a pale, firm rubbery mass. You can have a single fibroid or several at once. Their size varies from microscopic to basketball-sized. Some fibroids grow slowly and some don’t change once they appear. 

What are the different types of fibroids? 

  • Submucosal fibroidsGrow directly under the uterine lining and project into its inner cavity 

  • Intramural fibroidsEmbed within the uterine walls 

  • Subserosal fibroidsBulge outward from the uterine wall, just beneath the outer coating of the uterus 

  • Pedunculated fibroidsHang from a stalk inside or outside the uterus and cause symptoms if they twist 

Who’s at risk for fibroids? 

According to the National Institutes of Healtholder women have a greater likelihood of developing fibroids than younger women do. Other risk factors include: 

  • Family history of fibroids 

  • African American race 

  • High blood pressure 

  • Obesity 

  • Vitamin D deficiency 

Symptoms 

Depending on the size and location of your fibroids, you may experience: 

  • Heavy and prolonged menstrual bleeding 

  • Bleeding between periods 

  • Cramping  

  • Urinary problems 

  • Sharp, sudden and severe pain in the lower abdomen 

  • Bloated feeling 

Diagnosis 

Diagnosis of fibroids typically begins with a pelvic examination to check for abnormalities. Other testing may include:  

  • UltrasoundThe most common and reliable way to detect most fibroids. Sound waves generate images of the uterus and fibroids, if they exist. After an abdominal ultrasound, you may also have a transvaginal ultrasound where a “wand” is inserted into the vagina. Looking at a screen, the ultrasound technician or doctor can get a closer look at the pelvic organs. 

  • X-ray with dyes or saline (hysterosalpingography)Fibroids growing in the lining of the uterus are detected by using a dye to highlight the uterine cavity and fallopian tubes on X-ray images. 

  • MRI (magnetic resonance imaging)This procedure may be recommended to gain a more detailed understanding of your fibroids, if a surgical procedure is planned. 

Non-surgical treatments 

Hysterectomy was once the only treatment for fibroids, but now several minimally invasive treatment options are availableDetermining the proper treatment for you depends on the size and type of fibroids, your symptoms, your childbearing plans and how soon you’ll hit menopause.  

Non-surgical treatment options include: 

  • Birth control pills or progesterone-based IUD Hormones may help treat symptoms of heavy bleeding or reduce cramping during your period. They work best when your fibroids are smaller and not inside the uterine cavity. 

  • Depot LupronThis synthetic hormone shrinks large fibroids by simulating a post-menopausal state. If you’re having surgery to remove them, your doctor may recommend this treatment prior to surgery for less blood loss and a better surgical outcome. 

Surgical options 

Myomectomy is the only surgical procedure that preserves your ability to get pregnant. Unlike a hysterectomy, which removes your entire uterus, a myomectomy removes only the fibroids (one or more) and leaves the uterus intact. 

Uterine artery embolization is a good option if you are unable to withstand the stress of surgery. This procedure cuts off blood supply to the fibroids, causing their eventual shrinkage. Through an incision in the groin, sand-sized plastic particles are injected into the uterine artery. 

Depending on the size, number and location of the fibroids, your surgeon may choose one of these three types of minimally invasive surgery: 

  • Laparoscopic myomectomyFor fibroids outside your uterus or on its wall. Two or more tiny incisions in your lower abdomen make way to insert a telescope and surgical instruments. 

  • Hysteroscopic myomectomyFor fibroids in the lining of your uterus. A camera and instruments are inserted directly through your cervix into the uterus. 

  • Abdominal myomectomyFor large fibroids and large uteruses, an incision is made similar to a Caesarian section. 

Is it time to visit your doctor? 

Talk to your doctor if you answer “yes” to any of these questions: 

  • Have you noticed an increase in your bleeding during menstruation? 

  • Are menstrual cramps becoming more frequent and/or painful? 

  • Is your abdomen swollen and enlarged? 

  • Are you having difficulty with conception or fertility? 

If you’re considering having your fibroids removed, get a second or third opinion from gynecologists who regularly deal with the kind of fibroids you have. 

 

If you’re one of the many women dealing with the health challenges caused by #fibroids, share your journey with readers @providence. 

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Find a doctor 

The specialists in Obstetrics and Gynecology at Providence understand the special health needs women experience at every stage of life. Through Providence Express Care Virtual, you can access a full range of healthcare services. If you need to find a doctor, you can use our provider directory or search for one in your area. 

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Related resources 

This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions. 

About the Author

The Providence Women's Health team is committed to providing useful and actionable insights, tips and advice to ensure women of all types can live their healthiest lives.

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