Fibroids

What are uterine fibroids?

Uterine fibroids are noncancerous growths made from the muscle and connective tissue of the uterus. They can vary in size, number, and location.

Types include:

• Submucosal fibroids, which grow toward the uterine cavity
• Intramural fibroids, which grow within the uterine wall
• Subserosal fibroids, which grow toward the outside of the uterus
• Pedunculated fibroids, which are attached to the uterus by a stalk

Many fibroids cause no symptoms and do not require treatment.

What symptoms can fibroids cause?

Depending on their size and location, fibroids may cause:

• Heavy or prolonged menstrual bleeding
• Passing large blood clots
• Pelvic pain, pressure, or fullness
• Abdominal enlargement
• Frequent urination or difficulty emptying the bladder
• Constipation
• Lower back pain
• Pain during intercourse
• Anemia-related fatigue, weakness, or dizziness
• Difficulty becoming pregnant in selected cases

Because these symptoms may also occur with other gynecologic conditions, an evaluation is important.

How are fibroids diagnosed?

Your provider reviews your menstrual history, symptoms, medical history, and pregnancy goals. Evaluation may include:

• A pelvic examination
• Pelvic or transvaginal ultrasound
• Bloodwork to check for anemia
• Saline infusion sonography or hysteroscopy
• MRI in selected cases
• Endometrial sampling when indicated

Ultrasound is commonly the first imaging test used to determine the number, size, and location of fibroids.

How are fibroids treated?

Fibroids that do not cause symptoms may only require observation.

Treatment for symptomatic fibroids depends on the severity of your symptoms, fibroid size and location, overall health, and pregnancy goals. Options may include:

• Anti-inflammatory medication for pain
• Tranexamic acid for heavy bleeding
• Hormonal birth control or progestin therapy
• A hormonal intrauterine device
• Medications that temporarily reduce bleeding or fibroid size
• Myomectomy to remove fibroids while preserving the uterus
• Uterine artery embolization or radiofrequency ablation in selected patients

Myomectomy may be performed through hysteroscopic, laparoscopic, robotic-assisted, or abdominal surgery, depending on the fibroids.

When is hysterectomy considered?

Hysterectomy removes the uterus and permanently prevents fibroids from returning. It may be considered when symptoms are severe, other treatments have not helped, fibroids are especially large or numerous, or the patient prefers definitive treatment and does not desire future pregnancy.

Hysterectomy does not automatically require removal of the ovaries.

Schedule a fibroid evaluation

Fibroids do not always require treatment, but heavy bleeding, pelvic pressure, anemia, pain, or fertility concerns should be evaluated.

Call Bayard Street Obstetrics & Gynecology or request an appointment online to schedule a uterine fibroid consultation.