Overview of Uterine Fibroid Tumors

A very common growth in the uterus

Uterine fibroid tumors, also known as fibroids or leiomyomas, are fairly common, affecting between 20% to 80% of all women. These growths are benign (they are not cancerous) and they may be asymptomatic (without symptoms), or they can cause symptoms ranging from pelvic/abdominal discomfort to irregular bleeding to pregnancy issues.

There are several types of uterine fibroids and they can range in size. You may be diagnosed with a uterine fibroid based on a gynecologic examination or an imaging test. Depending on your symptoms, your treatment can include pain medication, hormonal therapy, and/or surgery.

Fibroid tumor symptoms and complications
Illustration by Cindy Chung, Verywell

Symptoms

Often, uterine fibroids do not cause any noticeable effects. However, you can experience bothersome symptoms intermittently. Many women notice a cyclical pattern, with worsening symptoms right before and during their periods. Yet, for some women, the symptoms are noticeable all the time.

Common symptoms of uterine fibroids include:

  • Metrorrhagia (bleeding when you aren't having your period)
  • Painful periods
  • Menorrhagia (heavy or prolonged menstrual bleeding)
  • Pelvic or abdominal pressure and/or discomfort
  • Swelling or enlargement of the lower abdomen
  • Pain while having sex
  • Trouble urinating or a frequent urge to urinate small amounts
  • Back pain
  • Diarrhea or constipation

You can experience some or all of these effects and they can range in severity from mild to severe and disabling.

Complications

Uterine fibroids can cause health complications, and women can experience these issues even without having any of the noticeable symptoms associated with these growths. If you are diagnosed with a uterine fibroid, your doctor will be careful to watch for these issues.

And, your doctor may check you for fibroids if you are having trouble getting pregnant.

Issues that may develop due to uterine fibroid tumors include:

  • Reproductive problems
  • Complications during pregnancy, such as miscarriage and preterm labor
  • The need to have a cesarean section

Causes

Uterine fibroid tumors are overgrowths of smooth muscle tissue. The uterine lining (endometrium) contains muscle so that the uterus can stretch during pregnancy and contract (squeeze) during delivery.

There are several known risk factors that increase your chances of developing a fibroid tumor. However, these tumors are common and you can develop one without any risk factors, and you also might not develop one even if you have risk factors.

Common risk factors include:

  • A family history of fibroids
  • A personal history of fibroids
  • Advancing age
  • Obesity
  • Nulliparity: Women who have not had children are at a higher risk
  • Race: fibroids are more common and develop at an earlier age among African American women

Estrogen

Fibroid tumors can occur any time after a woman starts menstruating, which is when the body begins producing the estrogen, a female hormone. These estrogen-dependent tumors develop and grow in response to the hormone.

Other estrogen fluctuations can affect fibroid tumors, including:

  • Pregnancy: During pregnancy, fibroids often grow extremely fast due to the extra estrogen your body produces.
  • Menopause: Uterine fibroid tumors may decrease in size once menopause occurs—due to the sharp decline in estrogen production.
  • Estrogen containing medications: Women who have fibroids or who have had them in the past need to pay particular attention to the potential side effects of estrogen-containing medications.

Obesity and nulliparity are conditions in which the body is exposed to high estrogen levels for a prolonged time, and this could explain their association with fibroid tumors.

Diagnosis

There are several methods that your medical team may use in diagnosing your fibroid tumor. If you have symptoms, you may need to undergo tests, including a pelvic examination, imaging studies and/or blood tests. In some instances, a fibroid tumor is detected incidentally if you are having a medical test for another reason.

Diagnostic Tests

A pelvic examination is an examination in which your doctor would do a physical examination of your vagina and cervix. This examination may include a Pap smear and can identify growths and abnormal structures of the vagina, cervix, and sometimes the lower portion of the uterus.

Depending on your symptoms and physical examination, you might need an imaging test, which can include a pelvic and/or abdominal ultrasound or computerized tomography (CT). A urinalysis is a test that is used to examine a sample of your urine. And blood tests can include estrogen levels, complete blood count (CBC), and/or thyroid function tests.

Types of Fibroid Tumors

Uterine fibroid tumors can range in size—they can be as small as a seed or a pea or as large as an orange or small melon. There are a few different types of uterine fibroids and you can have more than one type at the same time.

Fibroid tumor types include:

  • Subserosal (subserous) fibroids, grow on the outside of the uterus and usually do not cause symptoms unless they grow large enough to interfere with other organs. They may distort the outer layer of the uterus, and this may be seen on an imaging examination.
  • Pedunculated leiomyomas are subserous fibroids that grow a peduncle or stalk and extend away from the uterus. These fibroid tumors may enlarge and become twisted, causing severe pain.
  • Submucosal fibroids develop just below the lining of the uterus, and they may extend into the uterus, possibly causing menstrual problems. These fibroid tumors can cause the inside of the uterus to be distorted, which can be detected on an imaging examination.
  • Intramural uterine fibroid tumors are located within the uterine wall and they can enlarge the uterus.
  • Transmural fibroids are like intramural fibroids, except that they extend throughout the whole uterine wall, and may alter the uterine shape.
  • Parasitic uterine fibroids are the rarest type of leiomyomas, and they develop when a fibroid tumor attaches itself to another organ.

Treatment

Fibroid tumors can be treated surgically or medically. Generally, medical treatment can help alleviate symptoms, but it does not completely eradicate the tumors. Surgical removal may be beneficial, especially if your uterine fibroid is interfering with fertility or if it is a pregnancy risk. However, surgery can cause complications, and uterine fibroid tumors may recur.

Medication

Your doctor may recommend that you take pain medication such as Advil (ibuprofen) or Tylenol (acetaminophen) to relieve cramping and discomfort caused by your uterine fibroid tumor.

Gonadotropin-releasing hormone (GnRH) can cause fibroids to shrink. This may make surgery easier, or it may be enough to reduce the effects of your fibroid tumor without a surgical procedure.

Surgical Procedures

Surgical treatments for fibroids include hysterectomy, myomectomy, and embolization.

  • A hysterectomy is a complete removal of the uterus. If you have a hysterectomy before menopause, you will experience early menopause and you will not be able to get pregnant.
  • Embolization is a procedure in which the blood supply to the tumor is stopped so that the uterine growth will wither away.
  • Myomectomy is a surgical procedure used to remove a fibroid tumor without taking out the uterus. This means that pregnancy is still possible, although a Cesarean section may be necessary.

There are several methods that your doctor will consider when planning a myomectomy. The right procedure for you depends on the size, location, and the number of your uterine fibroid tumor (or tumors).

  • Laparoscopic surgery involves the use of a small incision to remove the uterine fibroid. This technique may be considered if your fibroid tumor is small and easily accessible.
  • Laser surgery uses high-intensity light to remove small fibroids.
  • hysteroscope is a thin tube that can be inserted through the vagina and into the uterus to remove your fibroid tumor.

It may take about 3 to 4 weeks for you to recover after a myomectomy. Sometimes adhesions (scar tissue) may develop in the months following surgery, causing pain, cramps, and/or menstrual irregularities. These complications are more likely to occur when there is more than one fibroid and when the fibroids are large.

Keep in mind that fibroid tumors may return after a myomectomy, and repeat surgery may be necessary.

A Word From Verywell

Uterine fibroid tumors are fairly common, but that does not mean that you can ignore it. If you have symptoms due to a uterine fibroid tumor, you and your doctor will have to discuss your treatment options. If you are not having symptoms, your medical team will need to monitor your fibroid tumor, especially if you plan on becoming pregnant.

Most women have a good prognosis and experience a good recovery after the treatment of uterine fibroid tumors.

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Article Sources

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  1. Uterine Fibroids. National Institutes of Health. Office on Women's Health. April 01, 2019

  2. What Are the Risk Factors for Uterine Fibroids? National Institutes of Health. 11/2/2018

  3. Wong JY, Gold EB, Johnson WO, Lee JS. Circulating Sex Hormones and Risk of Uterine Fibroids: Study of Women's Health Across the Nation (SWAN). J Clin Endocrinol Metab. 2016;101(1):123–130. doi:10.1210/jc.2015-2935

  4. Khan AT, Shehmar M, Gupta JK. Uterine fibroids: current perspectives. Int J Womens Health. 2014;6:95–114. Published 2014 Jan 29. doi:10.2147/IJWH.S51083

  5. Barra F, Seca M, Della Corte L, Giampaolino P, Ferrero S. Relugolix for the treatment of uterine fibroids. Drugs Today (Barc). 2019 Aug;55(8):503-512. doi:10.1358/dot.2019.55.8.3020179

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