Uterine fibroids are one of the most common conditions affecting women’s health. Up to 80% of women will develop fibroids by the time when they become 50 years old,1and yet it’s rare to hear them being discussed. For many women, these are harmless – but in other cases, fibroids can contribute to severe bleeding, pain and even infertility. Let’s clear up some of the facts on uterine fibroids, what causes them, and what you can do about them.
What are uterine fibroids?
Uterine fibroids (also called leiomyomas) are a form of benign tumor that grow on the smooth muscle walls of the uterus. Don’t let the word “tumor” scare you too much, though: fibroid growths hardly become cancerous, and they don’t increase your odds of other uterine cancers. However, they can grow to the point that it makes it more difficult to fall pregnant, and can increase the risk of complications in labor.
Symptoms of uterine fibroids
In most cases, fibroids don’t cause any symptoms. In fact, many women don’t even realize they have fibroids until they show up in a routine ultrasound or pelvic exam. However, for the minority of patients who do suffer symptoms, fibroids can be quite debilitating. Symptoms can include:
- Heavy bleeding during menstrual periods
- Heavy or full sensation in the abdomen
- Needing to use the toilet frequently
- Severe menstrual pain
- Pain during sexual intercourse
What causes uterine fibroids?
Scientists aren’t sure exactly what causes some women to develop fibroids, but one factor seems to be changes in the hormone levels of estrogen and progesterone. Genetic factors also seem to play a role. Also, although it’s not clear why, African-American women appear to have a higher chance of developing fibroids.
Uterine fibroids and infertility: What’s the link?
First things first: rest assured, you can still conceive and give birth naturally even if you have fibroids. Whether or not fibroids decrease your fertility chances depends on their size and their location in the uterus. Fibroids can form at various locations in the uterus, but they can cause infertility if they block or put pressure on the fallopian tubes (the tubes leading to the womb, where the sperm and egg meet) or at the exit of the fallopian tubes.
If they distort the shape of the uterus, it could be difficult for a fertilized egg to successfully implant and establish a pregnancy, and even it does, the risk of miscarriage increases. However, keep in mind that infertility as a result of fibroids is very rare.
Fibroids treatment: Surgery, medication to preserve fertility
Uterine fibroids are generally benign, so watchful waiting may be all the you need if yours are small and asymptomatic. However, if it’s clear that they’re posing a risk to your fertility, or they’re causing you severe symptoms, then your OB-GYN may recommend the following treatments.
Surgical treatments for fibroids include hysterectomy, in which the entire uterus is removed, and myomectomy, in which only the fibroids are removed and the healthy uterine tissue is left in place. While hysterectomies are suitable for large or rapidly growing fibroids that are causing severe symptoms, myomectomy is often the preferred option for women who want to go on to have children.
If surgery isn’t right for you, relatively small fibroids can be treated with medication. The medication decreases the levels of hormones that contribute to fibroid growth, with the intention of halting their growth or shrinking them back down. However, the hormone changes mean you won’t be able to get pregnant during the treatment. Going off the medication will allow you to get pregnant, but then the fibroids may simply grow back. Talk this over with your doctor to see what’s the best option for you.
Talk to your doctor about uterine fibroids
Although fibroids are common, you may not even know that you are affected by them. Next time, consider asking your doctor about an assessment for uterine fibroids. In most cases, they’re harmless, but if you think yours are causing you problems, then treatment is available. Talk over your treatment options with your healthcare provider to find out the best option for your personal situation.
- Uterine fibroids fact sheet ↩