Benign Uterine Fibroid Tumors Types and Treatments

Uterine fibroid tumors are almost always benign. They are found in the uterus and occur mostly in women who are in their 30s and 40s.

Fibroid tumors are solid tumors that are made of fibrous tissue, hence the name fibroid tumor. Most often fibroids occur as multiple tumor masses which are slow-growing and often cause no symptoms.

The size of fibroids varies immensely among women, and some are so small that a microscope is required to see them. However, some women experience a single large fibroid tumor the size of a grapefruit or a fibroid which is so large it encompasses the entire abdominal area. Such large tumors can weigh as much as 50 pounds; the largest reported fibroid ever recorded weighed in at 140 pounds.

Causes

No one is sure why fibroid tumors develop, but some facts seem clear:

• Fibroid tumors do not develop before the body begins producing estrogen during the onset of menstruation
• Fibroid tumors will continue to grow while estrogen is present
• They will grow very quickly during pregnancy when the body is producing extra estrogen
• The tumors often shrink and disappear after menopause when the body stops producing estrogen
• A woman will almost never develop fibroid tumors after menopause.

The estrogen connection appears to be quite clear, although there are still some who doubt the role estrogen plays in the development of fibroid tumors because women with fibroids often have blood levels that reveal normal amounts of estrogen.

Types of Fibroid Tumors

• Submucous fibroids: These fibroids occur just below the lining of the uterus and can cause menstrual problems, including pain as they grow and move around the pelvic area.
• Intramural fibroids: Round fibroids, most often within the uterine wall, that can cause enlargement of the uterus as they grow.​
• Subserous fibroids: This fibroid grows on the outer wall of the uterus and usually causes no symptoms until it grows large enough to interfere with other organs.
• Pedunculated fibroids: These fibroids develop when a subserous fibroid grows a peduncle (stalk). As they grow larger, they may become twisted and cause severe pain.
• Interligamentous fibroid: A fibroid that grows sideways between the ligaments supporting the uterus in the abdominal region. This type of fibroid is especially difficult to remove without the possibility of interfering with the blood supply or other organs.
• Parasitic fibroid: The rarest form of fibroid tumor occurs when a fibroid attaches itself to another organ.

Diagnosis

Diagnosis of fibroids is generally made by your physician during your annual gynecological exam when your physician feels a mass. They often are found when your physician is looking for something else, or may even never be discovered if you do not experience symptoms. However, larger fibroids can make an examination of your ovaries impossible if they grow near your ovaries.

An ultrasound scan is often ordered when such masses are felt by your physician to determine the cause of the mass. However, some fibroids appear on sonograms as ovarian tumors, and surgery is the only way an accurate diagnosis can be made.

Larger fibroids may cause frequent urination or an inability to control your bladder—either the ability to control the urge or, in severe cases, a woman may find that she is unable to urinate at all. If a fibroid extends toward a woman's back, it may push on the bowels, causing constipation and backache.

Surgical Treatment

If your fibroid tumors are severe enough that they cause certain symptoms, surgery is often the recommended treatment. However, before you consent to hysterectomy, learn about your treatment options. Factors that justify surgery include extremely heavy bleeding during your menstrual cycle, which causes anemia that does not respond to treatment; pain that has become intolerable or discomfort caused by the pressure of the fibroids on another organ; or a tumor location likely to cause further problems.

Surgery for fibroid tumors includes myomectomy and hysterectomy. Myomectomy is the surgical removal of each individual tumor without damage to the uterus, preserving a woman's ability to conceive. However, fibroids will often grow back, and although it is possible to have a myomectomy repeated, multiple myomectomies can cause other problems, such as the walls of the uterus growing together due to scarring.

Uterine Artery Embolization

Women should also consider uterine artery embolization, which leaves the uterus intact. In this nonsurgical procedure, polyvinyl particles are placed into the uterine artery at a point just before the nexus of vessels spread out into the uterine tissue. The particles flow into the vessels and clog them. This prevents the fibroids from receiving the constant blood supply they require and causes them to shrink over time. In addition, it almost immediately significantly reduces symptoms of heavy bleeding and pelvic pain.

Hysterectomy 

Because fibroids do often grow back, many women will eventually have to face a hysterectomy.

Hysterectomy is, most often, the procedure of choice for fibroid tumors when a woman with severe symptoms has completed her family and her uterus has grown to the size of a uterus at twelve weeks of pregnancy; a woman has excessively large fibroid tumors; severe abnormal bleeding occurs; or when the fibroids are causing problems with other organs, such as the bladder and bowels.

Science is starting to evaluate other options for treating fibroids, including the use of Lupron, which may be beneficial for those who want to become pregnant or for women approaching menopause, when fibroids often shrink naturally. Lupron shrinks fibroids in most women with continued use, but though the fibroids will quickly grow back once treatment is stopped.

If you have fibroid tumors, investigate your options before deciding what treatment you want to try. There are many alternatives to hysterectomy currently available, and science is creating more options for women every day.