Frequently Asked Questions About Uterine Fibroids
What are uterine fibroids?
The uterus is a thick-walled muscular organ with an inside lining called the endometrium (“metri” means uterus; “endo” refers to inside lining). Although the uterus is primarily a thick-walled muscle, it is the lining that bleeds, not the uterine wall. To cause heavy uterine bleeding, fibroids need to involve, or be up against, the uterine lining. Fibroids are muscle tumors, called myomas (“myo” means muscle; “oma” means new growth or tumor). Leiomyoma refers to the smooth muscle of an organ as opposed to the striated muscle of the skeleton. Myomas are generally benign, but can become malignant in approximately 0.5% of cases.
Where are uterine fibroids typically found?
Fibroids can be on the outside of the uterus (sub-serosal) or the inside of the uterus (sub-mucosal or intra-cavitary). Small fibroids can be just in the uterine wall (intra-mural) or they can be large enough to extend from inside the uterine cavity through the uterine wall to the outside of the uterus (trans-mural).
What are common symptoms of uterine fibroids?
Uterine fibroids, when large, can cause pelvic pressure, back/hip/leg pain, urine frequency and/or urinary incontinence. The bony pelvis is a fixed amount of space, and the uterine muscle tumors are solid and relatively heavy, so that normal organs (bowels, bladder, and ureters) can be pressed upon. But when a person with fibroids has too much pain, then you need to consider the possibility of an additional cause for pain, such as endometriosis.
What is the relationship between uterine fibroids and endometriosis?
There is no cause-and-effect relationship between endometriosis and uterine fibroids. Endometriosis and uterine fibroids tend to occur together only because they both do well in the same environment of estrogen and blood flow.
When would I know it's time to deal with my uterine fibroids?
There are four indications to intervene on uterine fibroids: 1) discomfort, 2) heavy bleeding, 3) uterine size greater than a three month pregnancy (because the fibroid tumors may press on other organs), 4) rapid uterine growth (because of the small risk of malignant change).
What are some treatment options for uterine fibroids?
Treatment options for uterine fibroids: 1) hysteroscopy to shave fibroids from inside the uterine cavity, 2) laparoscopic myomectomy to remove remove fibroids through an incision and repair of the uterine wall, 3) laparoscopic hysterectomy for large and/or multiple fibroids. Cervix and ovaries can be conserved.