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Uterine Fibroid DiseaseUterine fibroids are the most common tumors of the female genital tract. You might hear them referred to as "fibroids" or by several other names, including leiomyoma, leiomyomata, myoma and fibromyoma. Fibroid tumors are benign (non-cancerous) growths that develop in the muscular wall of the uterus. While fibroids do not always cause symptoms, their size and location can lead to problems for some women, including pain and heavy bleeding. The typically improve after menopause when the level of estrogen, the female hormone that circulates in the blood, decreases dramatically. However, menopausal women who are taking supplemental estrogen (hormone replacement therapy) may not experience relief of symptoms.
Fibroids range greatly in size from very tiny (a quarter of an inch) to larger than a cantaloupe (10 inches or more). In some cases they can cause the uterus to grow to the size of a five-month pregnancy and the woman looks as though she is pregnant. In most cases, there is more than one fibroid in the uterus. Fibroid tumors of the uterus are very common, but for most women, they either do not cause symptoms or cause only minor symptoms. Fibroids can cause very heavy menstrual bleeding, clotting and pelvic pain, leading many women to seek treatment. Fibroids often fail to respond to medical therapy and then surgical procedures are often recommended. The exact causes for fibroid development are unclear, but researchers have linked them to both a genetic predisposition and a subsequent development of susceptibility to hormone stimulation. Women may have a genetic predisposition to fibroid development and then subsequently develop factors that allow fibroids to grow under the influence of a number of hormones. This would explain why certain ethnic groups or racial groups are more likely to develop fibroids and also why there tends to be genetic predisposition in some families. Facts:Fibroids can be located in various parts of the uterus. There are three primary types:
Risk Factors:Uterine fibroids are very common. The number of women who have fibroids increases with age until menopause: about 20 percent of women in their 20s have fibroids, 30 percent in their 30s and 40 percent in their 40s. From 20 percent to 40 percent of women age 35 and older have uterine fibroids of a significant size. Fibroid tumors may start in women when they are in their 20s, however, most women do not begin to have symptoms until they are in their late 30s or 40s. Physicians are not able to predict if a fibroid will grow or cause symptoms. African-American women are at a higher risk: as many as 50 percent have fibroids of a significant size. It is not known why, although genetic variability is thought to be a factor. Fibroids can dramatically increase in size during pregnancy. This is thought to occur because of the increase in estrogen levels during pregnancy. After pregnancy, the fibroids usually shrink back to their pre-pregnancy size. Fibroids typically improve after menopause when the level of estrogen decreases dramatically. Fibroids can grow while a menopausal woman is taking estrogen supplements (hormone replacement therapy) or they may not be affected at all. Symptoms:Most fibroids don't cause symptoms — only 10 percent to 20 percent of women who have fibroids ever require treatment. Depending on location, size and number of fibroids, a woman might experience the following:
If you are experiencing these types of symptoms, consult with your personal physician. Diagnosis:Typically, fibroids are first diagnosed during a gynecologic internal exam, which enables the doctor to feel if the uterus is enlarged. The presence of fibroids is most often confirmed by an abdominal ultrasound. This is a painless procedure in which a radiologist or technician moves an instrument (transducer/receiver) about the size and shape of a computer mouse across the outside surface of the abdomen. Sound waves are transmitted through the skin and allow the technician to "see" the size, shape and texture of the uterus. A picture is displayed on a computer screen as the radiologist or technician takes the ultrasound. In some cases, a transvaginal ultrasound may be necessary. The radiologist inserts an ultrasound probe into the vagina so the inside of the uterus can be seen even more clearly than with the abdominal procedure. There is generally little if any discomfort associated with this procedure Magnetic Resonance Imaging (MRI) can confirm fibroids. MRI is a painless diagnostic test that can give accurate and clear information on the presence of fibroids. MRI lets your doctor see detailed pictures of the inside of your body. MRI does not use X-Rays. Instead, strong magnets and radio waves work together to form a sharp image. There is no X-Ray radiation and the magnets and radio waves are harmless. Diagnostic hysteroscopy also is an option, particularly to evaluate the presence of submucosal fibroids. A long, thin probe-like instrument is passed through the vagina and cervix into the uterus, where the physician can check for growths and take samples of tissue. The lighted hysteroscope illuminates the uterus. This procedure, which can cause some discomfort, is generally performed by a gynecologist, and can be done without anesthesia or with a local anesthetic in an office. Treatments:Uterine Artery Embolization is a fundamentally new approach to the treatment of fibroids that blocks the arteries that supply blood to the fibroids. It is a minimally invasive procedure, which means it requires only a tiny nick in the skin, and is performed while the patient is conscious but sedated — drowsy and feeling no pain.
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