Uterine fibroids are difficult to diagnose due to the similarities they share with heavy menstrual cycles, and some women may not experience symptoms at all. Uterine Fibroids are very common; in fact, according to Paul Indman, MD, 30% of women have fibroids too small to be detected.
While the cause of fibroids is not certain, there is a genetic factor at play, since DNA found in fibroids shows abnormalities. Though there is some belief that too much estrogen causes fibroids, this is not the case as fibroids are sensitive to estrogen and progesterone and both hormones may play a role in the growth of uterine fibroids.
Uterine fibroids have shown to become symptomatic between the ages of 35 and 50, with symptoms decreasing after menopause.
Although the main cause of fibroids is unknown, obesity has been associated with the onset of uterine growths. However, it is not clear whether fibroids cause weight gain, or weight gain increases the chances of fibroids. Women who have never given birth, or who began their menstrual cycles before the age of ten seem to be more likely to experience the growth of uterine fibroids.
Other symptoms of fibroids include experiencing irregular and heavy bleeding with clots and pressure on the bladder with an urgency to urinate or take frequent trips to the bathroom. There could be pressure on the rectum, accompanied by constipation and pelvic pressure with lower abdominal pain. Women may experience an increase in their waistline, and may also experience infertility. Some women will have no symptoms at all except when the fibroids are detected through a pelvic exam.
Seek medical advice if you experience any of the following:
• Fever or night sweats
• Increasing abdominal girth
• The inability to become pregnant after one year of trying
• Menstrual soaking through 3 pads per hour
• Severe or prolonged pelvic and abdominal pain
• Dizziness or lightheadedness
• Shortness of breath
• Chest pain
• Vaginal bleeding associated with pregnancy
Generally, a doctor can determine the presence of fibroids with a pelvic exam; however, abdominal, transvaginal, or pelvic ultrasounds may be required to identify the fibroids. Some doctors may consider conducting an endometrial biopsy, during which a piece of tissue is taken from the uterus. This procedure can be performed in the doctor’s office, without a trip to the OR, and is known as a hysteroscopy. A small fiber optic camera is passed through the opening of the cervix and is used to closely examine the uterus. Sometimes a dye is injected into the uterus and fallopian tubes and is then x-rayed to identify the anatomy of the structures. This is called a hysterosalpingography.
Once these examinations are complete, and if the need presents itself, a surgical procedure called a laparoscopy may be required. A laparoscopy also requires the use of a fiber optic camera, though it differs from a hysteroscopy because the camera enters the uterus through the abdomen to directly examine the internal organs.
Dependent upon the patient’s symptoms, size, and plans for pregnancy, treatment for uterine fibroids is not always necessary. Observation is often required, and vaginal bleeding can often be controlled with hormone medications.
Speak with your health care provider if you suspect that you may have uterine fibroids or have any questions regarding their diagnosis and treatment.