Five things to know about uterine fibroids

St. Joseph’s/Candler Physician Network OB/GYN Dr. Katherine Bebeau discusses causes, symptoms and treatment of this very common reproductive condition

If you are a woman, there is a good chance at some point you will develop uterine fibroids. There’s no need to panic though. Nearly 99 percent of the time they are harmless, but they can cause symptoms that you don’t want to ignore because they are treatable.

Fibroids, also known as leiomyomas, are benign growths of the fibromuscular tissue of the uterus, explains Dr. Katherine Bebeau, OB/GYN with St. Joseph’s/Candler Physician Network. They come in all shapes and sizes, some as small as a pea and others as large as a grapefruit.

Most fibroids are found in the uterine cavity, within the muscle of the uterus or outside your uterus, Dr. Bebeau says. Where the fibroid is located can impact your symptoms. Location also helps with staging, typically between a stage 1 to 7, and determining the best course of treatment.

Just as important as knowing what fibroids are is what they are not.

“They are not a type of cancer and do not increase the risk for cancer,” Dr. Bebeau says. “If ever removed surgically, they have about a 0.25 percent chance of being a rare cancer.”

What’s not rare, however, is the occurrence of uterine fibroids. The quoted incidence has a wide range from 20 to 80 percent. Dr. Bebeau says the wide range is because nearly 50 percent of women don’t have symptoms and may not even realize they have them. It’s estimated that about 1 in 5 to 1 in 2 women of reproductive age have undiagnosed fibroids.

Because they are not cancerous, uterine fibroids are not life threatening. However, they can cause a variety of symptoms that can impact your quality of life and cause a variety of issues getting pregnant or during your pregnancy, Dr. Bebeau says. These are all manageable with several treatment options.

Let’s take a closer look at uterine fibroids:

What are some causes, risk factors that cause uterine fibroids?

There is no clear cause for fibroids, Dr.  Bebeau says. Hormones, such as estrogen and progesterone, certainly play a role as fibroids usually appear after a woman has started menstruating and stop growing following menopause.

Genetics and environmental factors, including increased weight and alcohol consumption, also likely play a role in their development, Dr. Bebeau says. African-American women and women who have not had any children also have an increased likelihood of developing fibroids.

What are symptoms associated with them?

There are a variety of symptoms that can occur when someone has fibroids including:

• Heavy menstrual cycles
• Pelvic pain
• Painful intercourse
• Infertility
• Pregnancy issues, such as pre-term labor and birth, growth restrictions or a breech baby

If the fibroid is pressing on other organs nearby, such as the bowel and bladder, symptoms can include constipation, frequent urination or urinary urgency.

How are fibroids diagnosed?

Fibroids can be detected during a pelvic exam, but are most typically diagnosed with imaging. If you see your doctor for any of the symptoms mentioned above – and you should – a pelvic ultrasound most likely will be ordered. MRI occasionally may be necessary, Dr. Bebeau adds.

Fibroids also can be found incidentally at the time of imaging or surgery for another reason.

How do you treat them?

Treatment depends on the symptoms you are having and the location of the fibroids, Dr. Bebeau says. For example, if the main symptom is heavy and long periods, your doctor may recommend medication to control and regulate them.

If medical therapy fails or the fibroid is so large, surgery is then discussed. Surgery can be performed to either just remove the fibroids, known as a myomectomy, or the entire uterus can be removed. The ovaries are typically unaffected.

Another way to help shrink the size of the fibroids and control the symptoms they cause is through a procedure called uterine artery embolization, Dr. Bebeau says. This is performed by an interventional radiologist who stops blood flow to the uterus through important arteries.

“Based on your symptoms and goals, your physician can help you find the right treatment,” Dr. Bebeau says. “The important thing is if you are having any of the symptoms discussed above, contact your doctor or practitioner. Fibroids are often underdiagnosed, but there are ways you can get help.”

Can you prevent uterine fibroids?

Unfortunately, there is no clear evidence that there is a way to prevent fibroids, Dr. Bebeau says. What may decrease your risk is eating a healthy and balanced diet, especially limiting red meat, avoiding smoking, limiting alcohol consumption and controlling your blood pressure.