Uterine Fibroids: Symptoms, Causes And Treatments

Uterine fibroids are growths that occur on the uterus. They are muscular tumors that are noncancerous, and rarely turn into cancer or increase your risk of developing uterine cancer.  Uterine fibroids often appear during a women’s childbearing years, and may be uncovered during a pelvic exam or an ultrasound.

Your doctor may refer to these growths as leiomyomas, or myomas. 

Where are uterine fibroids located?

Uterine fibroids can be big or small, and may appear in your uterus, within the uterine wall, or on the surface of the uterine wall.

You may have just one uterine fibroid, or many, to the point that they expand or change the shape of the uterus.  Where the fibroids are located, the number of fibroids, and their size, may determine if they are causing symptoms or require any treatment.  

Uterine Fibroid Symptoms

Believe it or not, you may have had a uterine fibroid without even knowing it, as many women experience no symptoms. For those that do experience symptoms (which may have something to do with the size or location, and number of fibroids you have), common symptoms are:

• Heavy and/or prolonged menstrual bleeding

• Pain or pressure in the abdomen

• Increased menstrual cramping

• Back pain

• Frequent urination

• Loss of bladder control

• Difficulty emptying your bladder

• Constipation and bloating

• Pain during sexual intercourse

• Anemia, which may lead to fatigue 

Pain due to uterine fibroids may be experienced not only in the abdomen, but also in the lower back or even the legs. The location of the fibroids may determine the where the pain is experienced.  fibroid distorting the shape of the uterus, pressing against the bladder, rectum or  spinal nerves, or even sitting atop sciatic nerves can cause pain to occur in different parts of the body. 

Why uterine fibroids occur

It is not known why fibroids occur, but experts think that it may be a combination of environmental, hormonal or genetic factors. Fibroids may grow slowly or rapidly, or they may stay the same size. Some may also shrink on their own after time.   About 30% of women of childbearing age experience uterine fibroids, and about 20-80% of women will develop them by age 50. Black women are more likely to have them than other races. Additionally, if your mother or sister has had uterine fibroids, you have a higher chance of getting them too.

Do Uterine Fibroids Cause Infertility?

Most of the time, uterine fibroids don’t cause a problem with getting pregnant, and most women with fibroids will not be infertile. However, in some cases (usually depending on the size of the fibroid and where it’s located, uterine fibroids can reduce fertility. Fibroids that change the shape of the cervix or uterus, block the fallopian tubes, or impact the blood flow to the uterine cavity may impact fertility.

While most women with uterine fibroids will have no issues from them during pregnancy, fibroids occurring during pregnancy do present some concerns. Complications may include preterm delivery, fetal growth restrictions, miscarriage, or even placental abruption.  Your doctor will monitor your health during this time and if there are any concerns, bed rest, hydration, and mild pain relievers may be prescribed to help manage the symptoms. In most cases, treatment is limited during pregnancy in order to protect the fetus. 

Fibroids may also grow or shrink during pregnancy.

When Uterine Fibroids Burst

Most of the time, uterine fibroids are not life threatening. However, if a fibroid rupture, it requires a visit to your doctor as soon as possible.  Uterine fibroids may burst because of an increase in blood pressure or abdominal pressure, a twisted fibroid, an injury, or a fibroid that has grown too large for it’s blood supply.  Increased blood pressure or acute blood loss are serious complications of a ruptured uterine fibroid. If you experience severe abdominal pain or suspect you have a burst fibroid, see a doctor immediately. 

Treatment Options For Uterine Fibroids

Depending on your symptoms, you may not need any treatment for uterine fibroids, although it’s still a good idea to keep an eye on growth during your yearly pelvic exams. 

For mild symptoms, you can treat the pain the same way you would normal menstrual cramping. Lots of rest, hydration, pain relievers, and even a hot water bottle pressed against your lower belly can do a lot to relieve pressure or pain.

If you want to address your fibroids head on, there are several types of medications that adjust your hormone levels, which may help to shrink the fibroids, or control the bleeding and cramping that can accompany them. 

Your doctor may also suggest one of several other procedures.  Endometrial ablation removes the lining of the uterus to control heavy bleeding associated with fibroids. Myomectomy is a surgery that removes the fibroids without taking out the healthy tissue of the uterus. A hysterectomy is a surgery that removes the uterus. Myolysis is a procedure that uses an electric current or freezing to destroy the fibroids. All of these procedures come with their own set of risks and some of them don’t allow a woman to become pregnant again. In addition, it’s not uncommon for uterine fibroids to grow back, or for new ones to develop even after treatment, so it’s important to talk through your options with your doctor to make sure you’re comfortable with whatever option you choose. 

Prevention

 While it’s not known how to prevent uterine fibroids from developing, healthy choices can go a long way toward decreasing your risk.

It’s been shown that diets high in red meat and low in green vegetables may increase the chance of having fibroids, as well as alcohol consumption. Maintaining a health weight and incorporating lots of fruits and vegetables into your diet are a good idea if you think you may be at risk for developing uterine fibroids.  

Additionally, some doctors may prescribe certain birth control pills to help prevent or even treat symptoms of uterine fibroids.