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Uterine fibroids (also known as myomas or leiomyomas) are muscular growths that form in the walls of your uterus. They are surprisingly common, affecting anywhere from 20% to 50% of people with a uterus. The vast majority of uterine fibroids are benign, or non-cancerous, and do not impact your risk for developing uterine cancer.
Uterine fibroids vary widely in terms of size. Many of them are pea-sized or smaller and nearly impossible to see or feel during a pelvic exam.
Although rare, uterine fibroids can grow to the size of a softball and cause uncomfortable symptoms and complications.
Uterine fibroids should not be confused with uterine polyps. Polyps are precancerous growths made up of the same tissue that lines your uterus (the endometrium), while fibroids are made of muscle and connective tissues.
The two conditions do share symptoms, so polyps may be mistaken for fibroids. The best way to know for sure is to get an accurate diagnosis from your doctor.
Experts don’t know exactly what causes uterine fibroids. Multiple factors likely play a role in their development and growth.
Hormones. While we don’t know the exact cause of fibroids, we do know that hormones play a big role. Fibroid cells appear to be directly controlled by hormones – specifically estrogen and progesterone. They may even have more estrogen and progesterone receptors than normal muscle cells. This is why you’re more likely to develop fibroids during your reproductive years and as you approach menopause (perimenopause), times when these hormones fluctuate the most.
It is also why uterine fibroids tend to grow during pregnancy, which brings about high progesterone levels, and shrink following menopause, when your body stops producing high levels of estrogen and progesterone.
Genetic changes. Many fibroids contain genes that differ from those of the normal muscle cells in the uterus. These differences might be what causes uterine fibroids to develop and grow.
There is evidence that uterine fibroids run in families, meaning there is likely a genetic component to them.
There are also several types of uterine fibroids, depending on their location:
Most uterine fibroids do not cause symptoms, so you may have a fibroid without realizing it. Often, fibroids are discovered during a regular pelvic exam or an ultrasound during pregnancy.
If you do have symptomatic fibroids, however, it can be very uncomfortable. Common symptoms include:
A risk factor is anything that increases your chance of developing a condition. Risk factors for uterine fibroids include:
Just because you are at risk for uterine fibroids does not mean you will develop them. However, you should talk to your doctor about your risks and pay attention to any symptoms you’re feeling.
Fibroids are most often found during a routine pelvic exam. Your healthcare provider may feel a firm, painless lump on the uterus. They may want to perform additional tests, which can include:
Endometrial biopsy. If your doctor sees any suspicious tissue during an imaging exam, they may want to take a small sample, or a biopsy, for further examination. The tissue sample will be removed using a small tube inserted into the uterus. The tissue is then examined in a lab for signs of cancer or other problems.
Treatment for uterine fibroids depends on the size, location, and type of thyroid, as well as your symptoms and goals. If you have uterine fibroids that aren’t causing symptoms, you may not need any treatment. Fibroids are rarely cancerous, slow-growing, and usually shrink after menopause, so your doctor might recommend just keeping an eye on things. This is known as “watchful waiting.”
If your symptoms are mild but manageable, your doctor might recommend taking non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. These pain medications are effective for mild pain associated with uterine fibroids, although they won’t lessen symptoms like heavy menstrual bleeding.
Medications cannot cure fibroids. However, certain hormone medications can help regulate symptoms like heavy menstrual bleeding and may even be able to shrink your fibroids.
If your fibroids are causing severe symptoms or do not respond well to medications, your doctor may recommend surgery. There are many different types of surgery available to remove or shrink fibroids. They include:
If you are diagnosed with uterine fibroids, you may be concerned about how it could impact your fertility or pregnancy. In many cases, uterine fibroids are benign and cause no problems during pregnancy.
However, a submucosal fibroid – the type that grows into the uterine cavity – can cause infertility, pregnancy complications, or even miscarriage. Additionally, pregnancy causes many hormonal changes that can feed fibroid growth.
In general, the most common complications seen with uterine fibroids during pregnancy are:
Pregnancy complications are scary. But, by working with your healthcare providers and closely monitoring your pregnancy, you should be able to manage complications and come up with a birth plan that meets your needs.
If you are trying to become pregnant and are at risk for uterine fibroids, you may want to talk to your doctor about your risks and options.