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]  

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 fibroids—Grow directly under the uterine lining and project into its inner cavity 

• Intramural fibroids—Embed within the uterine walls 

• Subserosal fibroids—Bulge outward from the uterine wall, just beneath the outer coating of the uterus 

• Pedunculated fibroids—Hang 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 Health, older 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:  

• Ultrasound—The 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 available. Determining 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 Lupron—This 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. 

• Laparoscopic myomectomy—For 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 myomectomy—For fibroids in the lining of your uterus. A camera and instruments are inserted directly through your cervix into the uterus. 

• Abdominal myomectomy—For 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. 

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