Fibroids

Fibroids are the most frequently seen tumors of the female reproductive system. Fibroids, also known as uterine myomas, leiomyomas, or fibromas, are firm, compact tumors that are made of smooth muscle cells and fibrous connective tissue that develop in the uterus. It is estimated that between 20 to 50 percent of women of reproductive age have fibroids, although not all are diagnosed. Some estimates state, that upto 30 to 77 percent of women develop fibroids sometime during their childbearing years, although only about one-third of these fibroids are large enough to be detected by a health care provider during a physical examination.

How are fibroids diagnosed?

Fibroids are most often found during a routine pelvic examination. This, along with an abdominal examination, may indicate a firm, irregular pelvic mass to the physician. In addition to a complete medical history and physical and pelvic and/or abdominal examination, diagnostic procedures for uterine fibroids may include:

X-ray- Electromagnetic energy used to produce images of bones and internal organs onto film.

Transvaginal ultrasound (also called ultrasonography)- An ultrasound test using a small instrument, called a transducer, that is placed in the vagina.

Magnetic resonance imaging (MRI)- A non-invasive procedure that produces a two-dimensional view of an internal organ or structure.

Hysterosalpingography- X-ray examination of the uterus and fallopian tubes that uses dye and is often performed to rule out tubal obstruction.

Hysteroscopy- Visual examination of the canal of the cervix and the interior of the uterus using a viewing instrument (hysteroscope) inserted through the vagina.

Endometrial biopsy- A procedure in which a sample of tissue is obtained through a tube which is inserted into the uterus.

Blood test (to check for iron-deficiency anemia if heavy bleeding is caused by the tumor).

How Are Fibroids Treated?

Your specialist will develop a treatment plan based on your age, the size of your fibroid(s), and your overall health. You may receive a combination of treatments.

Medications

Medications to regulate your hormone levels may be prescribed to shrink fibroids. Gonadotropin-releasing hormone (GnRH) agonists, such as leuprolide (Lupron), will cause your estrogen and progesterone levels to drop. This will eventually stop menstruation and shrink fibroids.

Other options that can help control bleeding and pain, but will not shrink or eliminate fibroids, include:

• an intrauterine device (IUD) that releases the hormone progestin
• over-the-counter anti-inflammatory pain relievers, such as ibuprofen
• birth control pills

Surgery

Surgery to remove very large or multiple growths (myomectomy) may be performed. An abdominal myomectomy involves making a large incision in the abdomen to access the uterus and remove the fibroids. The surgery can also be performed laparoscopically, using a few small incisions into which surgical tools and a camera are inserted.

Your specialist may perform a hysterectomy (removal of your uterus) if your condition worsens, or if no other treatments work.