How do I know that I have uterine fibroids?

by National Institute of Health

(Page 2 of 2)

Unless you start to have symptoms, you probably won't know that you have uterine fibroids. Sometimes, health care providers find fibroids during a routine gynecological exam. During this exam, the health care provider checks out the size of your uterus by putting two fingers of one hand into the vagina, while applying light pressure to your abdomen with the other hand.

If you have fibroids, your uterus may feel larger-than-normal; or, if you have fibroids, your uterus may extend into places that it should not. If your health care provider thinks that you have fibroids, he or she may use imaging technology - machines that create a "picture" of the inside of your body without surgery - to confirm the diagnosis. Some common types of imaging technology include:

Ultrasound, which uses sound waves to form the picture;

Magnetic resonance imaging or MRI, which uses magnets and radio waves to build the picture; X-rays, which use a form of electromagnetic radiation to "see" into the body; and CT or "cat"-scan, which takes x-rays of the body from many angles to provide a more complete image. Sometimes, health care providers use a combination of these technologies. Sometimes, however, the only way to confirm the presence of uterine fibroids is through surgery. Laparoscopy - In this procedure, the surgeon makes a small cut into the abdomen, after inflating it with a harmless gas; then, using a small viewing instrument with a light in it, the doctor can look for fibroids.

Your health care provider may suggest a procedure called a hysteroscopy, which involves inserting a camera on a long tube through the vagina directly into the uterus to see the fibroids. Keep in mind that because these are surgical procedures, you will need time to recover from them. However, the amount of recovery time you'll need may vary.

What are the treatments for uterine fibroids?

Health care providers consider a number of things when recommending treatment for fibroids, including:

Does the woman have symptoms of uterine fibroids? Does she want to become pregnant? How large are the fibroids? What is the woman's age?

If you have uterine fibroids, but show no symptoms or problems, you may not need any treatment. Your health care provider will check the fibroids at your routine gynecological exam to see if they have grown. Also, because fibroids rely on hormones to grow, your fibroids may decrease in size during/after menopause.

If you have pain now-and-then or feel mild symptoms, your health care provider may suggest pain medication, ranging from over-the-counter remedies to stronger prescription drugs.

Medical Therapy

If you have many symptoms or feel pain often, you may benefit from medical therapy - that is, therapy using certain medications rather than surgery. Keep in mind that many medications have side effects, some of them serious.

One way to reduce symptoms of uterine fibroids is using one of a group of hormones called gonadotropin releasing hormone agonists (GnRHa). These hormones block the body from making the hormones that cause women to menstruate or have their periods. If you have symptoms, have health conditions that make surgery less advisable, and are near menopause or do not want children, you may receive GnRHa therapy to treat your fibroids.

Antihormonal agents, such as mifepristone, also slow or stop the growth of fibroids. Medical therapy is often used before a woman has surgery for her fibroids. This therapy offers only temporary relief from the symptoms of fibroids; once you go off the therapy, fibroids often grow back.

Surgical Therapy

If you have moderate symptoms of fibroids, surgery may be the best form of treatment. Surgery can be a major or a minor procedure. Talk to your health care provider about the different types of surgery, the possible risks of the procedure, and the side effects.

Myomectomy removes only the fibroids and leaves the healthy areas of the uterus in place. This procedure can preserve your ability to have children. Sometimes a laparoscope is used to see inside the abdomen during this procedure. A hysteroscope may be used to see the size, shape, and location of the fibroids inside the uterine lining. The surgeon may also use the instrument to remove the fibroid.

Hysterectomy is used if your fibroids are large, you have heavy bleeding, and you are either near or past menopause or don't want children. Hysterectomy is the only sure way to cure uterine fibroids. In general, recovery time from a hysterectomy is one to two months. Health care providers now have hysterectomy options that differ in how invasive they are. If you are pre-menopausal, talk to your doctor about keeping your ovaries. The ovaries make hormones that help maintain bone health and sexual health. Sometimes surgeons use a laparoscope to see inside the uterus during hysterectomy.

Abdominal hysterectomy is a procedure that involves a cut into the abdomen to remove the uterus.

Vaginal hysterectomy is less invasive because the doctor reaches the uterus through the vagina, instead of making a cut into the abdomen. This procedure may not be an option if the fibroids are very large.

Uterine Artery Embolization (UAE) - also called Uterine Fibroid Embolization or UFE - cuts off the blood supply to the uterus and the fibroids, which makes them shrink. Recovery time for UAE is much shorter than for hysterectomy. Because this procedure can affect how the ovaries function and can limit fertility, health care providers do not recommend UAE for women who want to have children.

Are there developing treatments for uterine fibroids?

Currently, researchers are looking into other methods of treating uterine fibroids. Keep in mind that these methods are not yet standard treatments for uterine fibroids, which means your health care provider may not offer them, or your insurance company may not pay for them. But, it's possible that research to confirm the safety and effectiveness of these "experimental" treatments may advance our ability to treat uterine fibroids. These developing treatments include:

MRI-guided ultrasound surgery uses a highintensity ultrasound beam to send high temperatures to the fibroids to make them shrink. The MRI scanner helps to visualize the fibroid, and the ultrasound sends out sound waves to destroy the fibroid.

Some health care providers use lasers to remove a fibroid or to cut off the blood supply to the fibroid, making it shrink.

Do uterine fibroids lead to cancer?

Uterine fibroids are not cancerous. Fibroids are not associated with cancer; they rarely develop into cancer (in fewer than 0.1 percent of cases). Fibroids do not increase your risk for uterine cancer.

Do uterine fibroids ever go away?

In most cases, fibroids stop growing or shrink once a woman passes menopause. But, this is not the case for all women. Some studies suggests a relationship between hormone replacement therapy or HRT, used to reduce the symptoms of menopause, and uterine fibroids, but the nature of this relationship is still unclear. More research is needed in this area.

About the Author

NIH is the nation's medical research agency - making important medical discoveries that improve health and save lives. The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.