Information From Your Health Care Provider

FIBROID TUMORS OF THE UTERUS

(Myomas; Leiomyomas)

Basic information

Fibroid tumors are tumors that grow in and around the muscular wall of the uterus. There may be one or many fibroids. Fibroids are benign (not cancerous) and rarely turn into cancer (less than 1%). Fibroid size can be very tiny to the size of a cantaloupe or larger. Rarely, they affect the cervix. Fibroids are common in women of childbearing age. Major types of fibroids include:
- Subserous (grow outwards from the uterine wall).
- Intramural (grow inside the wall of the uterus).
- Submucous (grow inward from the uterine wall).
- Pedunculated myomas (are attached to the uterine wall by stalks).

Often, no symptoms occur. The fibroids may be diagnosed during a pelvic exam.
Menstruation may be more frequent, with (possibly) heavy bleeding, and (sometimes) passing clots.
Bleeding between periods.
Abdominal pain or pressure.
Anemia (weakness, fatigue, and paleness).
Increased vaginal discharge (rare).
Painful sexual intercourse or bleeding after intercourse (rare).

Exact cause is unknown. May involve excess estrogen.

Increasing age until after menopause.
Use of certain oral contraceptives and estrogen replacement therapy, as these stimulate fibroid growth.
Genetic factors. They occur 3 to 5 times more often in African American women than in white women.
Family history of fibroids.
Diet high in fat and/or obesity may be a risk factor.

Cannot be prevented at present. Routine pelvic exams can help with early diagnosis and treatment

Treatment is usually not needed when there are no symptoms or the symptoms are mild.
Drugs can help relieve some symptoms, but will not cure fibroids. Fibroids can be removed with surgery.
Fibroids may decrease in size after menopause.

Your health care provider will do a physical exam and a pelvic exam. Medical tests may include blood studies, pregnancy test, Pap smear, and an ultrasound. More specific tests (laparoscopy, hysteroscopy, hysterosalpingogram, or biopsy) may be done to find type of fibroid.
Treatment will vary depending on symptoms and diagnostic tests, location and size of the fibroids, general health, and desire for future pregnancies.
No treatment may be needed in cases of mild symptoms. You will be re-examined every 3 to 12 months.
Hormone therapy, to suppress natural estrogen, is often the first step in treatment or before surgery.
Surgery may be recommended. Several different surgical procedures are possible. Be sure you understand all aspects of your choices, and the risks and benefits involved. Hysterectomy is surgery to remove the uterus. A myomectomy removes the fibroids.
Uterine fibroid embolization (UFE), also called uterine artery embolization (UAE), is a nonsurgical procedure. It treats fibroids by cutting off their blood flow.
Radiofrequency ablation (RFA) or myoma coagulation (called myolysis) uses electric current to treat fibroids.
Cryomyolysis uses a probe that freezes the fibroid.
Blood transfusions may be needed for severe anemia.

A combination of nonsteroidal anti-inflammatories, birth control pills, or progestins may be prescribed.
Iron supplements may be prescribed for anemia.
A gonadotropin-releasing hormone may be prescribed. It will induce an abrupt, artificial menopause that stops the bleeding and reduces size of the fibroid.

Some limits may apply after surgery. Regular aerobic and weight training exercise is helpful for good health.