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Uterine Fibroids

Uterine Fibroids

What are fibroids? — Fibroids are tough balls of muscle that form in the uterus (figure 1). The uterus, also called the womb, is the part of the woman's body that holds a baby if she is pregnant.
People sometimes refer to fibroids as "tumors." But fibroids are not a form of cancer. They are simply abnormal growths in the muscle of the uterus.
What are the symptoms of fibroids? — Fibroids often cause no symptoms at all. When they do cause symptoms, they can cause:
Heavy periods
Pain, pressure, or a feeling of "fullness" in the belly
The need to urinate often
Too few bowel movements (constipation)
Difficulty getting pregnant
How are fibroids treated? — There are several treatment options. Each option has its own pros and cons. The right treatment for you will depend on:
The symptoms you have
Your age (because most fibroids shrink or stop causing symptoms after menopause)
Whether you are done having children
Whether your fibroids cause so much bleeding that you have a condition called anemia
The size, number, and location of your fibroids
How you feel about the risks and benefits of the different options
If you are thinking about treatment, ask your doctor or nurse which treatments might help you. Then ask what the risks and benefits of those options are. Ask, too, what happens if you do not have treatment. And be sure to mention whether or not you would like to have children.
Here are the options:
Medicines – The pills, patches, vaginal rings, injections, and implants used for birth control can all reduce how much you bleed during your period. A device known as the intrauterine device, or IUD, can also make your periods lighter. There are also other medicines that can reduce the amount a woman bleeds during her period. If bleeding is your main symptom, birth control methods or medicines might help you.
Surgery to remove the fibroids (doctors call this surgery "myomectomy") – During this operation, the doctor removes the fibroids but leaves the uterus in place. It is effective, but it is not always a permanent fix, because fibroids can come back. Myomectomy is often a good choice for women who might want (more) children.
Treatment to destroy the lining of the uterus (doctors call this procedure "endometrial ablation") – During this procedure, the doctor inserts a thin tube into the vagina, through the cervix and into the uterus. Then he or she uses tools inserted through that tube to destroy the lining of the uterus. This procedure reduces bleeding from heavy periods. But it is not an option for all women. It is also not appropriate for women who might want to get pregnant.
Treatment to cut off the blood supply to the fibroids (doctors call this procedure "uterine artery embolization" or "uterine fibroid embolization") – During this procedure, the doctor inserts a thin tube into an artery in the leg and threads it up to the uterus. Then he or she uses tiny plastic beads to block the artery that brings blood to the fibroid. After the procedure, the fibroid no longer gets blood, so it shrinks. This procedure is not appropriate for women who might want to get pregnant.
Surgery to remove the uterus (doctors call this surgery "hysterectomy") – This surgery gets rid of fibroids and the problems they cause forever. Women who have this surgery cannot have fibroids come back. But they can never bear children.
How do I choose which option is right for me? — You work with your doctor to understand how the different treatment options would affect you. Then the two of you work together to choose the option that's right for you. For women who might still want to have children, medicines or myomectomy is often the best choice. Women who do not want to have (more) children can often choose from all the options. They need to consider how invasive each surgery is and whether they prefer surgery over taking medicines. One thing to consider is that fibroid-related symptoms often go away with menopause.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15421 Version 11.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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