My provider told me I have fibroids. “What does this mean?”
April 1, 2019
Uterine fibroids, also known as “uterine leiomyomas”, are the most common benign pelvic tumors found in women. These benign growths arise from the smooth muscle cells of the uterus, the myometrium. Fibroids can grow in different locations within the myometrium, and oftentimes a woman’s symptoms are related to the location and size of these benign tumors. The most common imaging tool used to identify and determine size and location of fibroids is a pelvic ultrasound. If a provider suspects their patient has a fibroid, an ultrasound is oftentimes the first recommendation.
Treatment for fibroids depend on a woman’s symptoms, age, and desire for future fertility. Common symptoms associated with fibroids include: heavy menstrual bleeding (menorrhagia), painful menstrual bleeding (dysmenorrhea), irregular menstrual bleeding, pain with intercourse (dyspareunia), and/or generalized pelvic pain or discomfort. Some women may experience none of these symptoms while still having known uterine fibroids. If a woman is asymptomatic and does not desire future fertility, it is an appropriate treatment option to closely monitor the size, location, and symptoms of the fibroid (i.e. with annual ultrasound imaging) without treatment or intervention. Depending on the size and location of fibroids for women who desire future fertility, treatment may be warranted. Oftentimes, symptoms of fibroids subside when a woman enters menopause and no longer has a menstrual cycle. Choice of treatment is individualized for the patient and all of these factors should be included in the discussion a woman has with her provider.
Treatment options for women with symptomatic fibroids vary based on risk factors and desire for future fertility. Common medication treatment options for fibroids include: hormonal therapies (including hormonal birth control pills and Intrauterine Devices [IUDs]), antifibrinolytic agents (such as tranexamic acid) and NSAIDs (nonsteroidal anti-inflammatory drugs). Surgical options for women with fibroids include: myomectomy (a surgery to remove the fibroids for women who are not done with childbearing), endometrial ablation (a minimally invasive surgery to destroy the uterine lining after completion of childbearing), uterine arterial embolization (a surgery to occlude uterine vessels after completion of childbearing), and hysterectomy (remove of the entire uterus for a woman who is done with childbearing). The type of treatment a patient chooses for their uterine fibroids is based on many factors. It is important women talk to their providers about their symptoms and future health goals while creating their individualized treatment plan.