Uterine fibroids are common in women and are benign growths of the uterus which often occur during childbearing years. Uterine fibroids, also known as myomas or leiomyomas, aren’t linked to an increased risk of developing uterine cancer and are not usually a sign of serious illness. Your doctor might discover fibroids during an ultrasound or pelvic exam.
Fibroids come in a variety of sizes, from tiny seedlings that are not visible to the naked eye to large, bulky masses that can distort or enlarge the uterus. One fibroid can be present or several. Multiple fibroids may cause extreme uterine expansion, which can lead to weight gain and a restraining effect on the rib cage.
Fibroids: Signs and Symptoms
Symptoms can vary with the location, size, and number of fibroids. The most common symptoms of uterine fibroids in women with symptoms include:
- Heavy menstrual bleeding
- Menstrual periods lasting over 7 days
- Pelvic pressure or pain
- Frequent urination
- Difficulty emptying the bladder
- Backache or leg pains
Rarely, a fibroid can cause acute pain when it outgrows its blood supply, and begins to die. Fibroids are generally classified by their location. Intramural fibroids grow within the muscular uterine wall. Submucosal fibroids bulge into the uterine cavity. Subserosal fibroids extend outside of the uterus.
When to see a doctor:
- Pelvic pain that doesn’t go away
- Overly heavy, prolonged or painful periods
- Spotting or bleeding between periods
- Difficulty emptying your bladder
- Unexplained low red blood cell count (anemia)
Doctors don’t know the cause of uterine fibroids, but research and clinical experience point to these factors:
- Genetic changes – Many fibroids contain changes in genes that differ from those in typical uterine muscle cells.
- Hormones – Estrogen and progesterone, two hormones that stimulate development of the uterine lining during each menstrual cycle in preparation for pregnancy, appear to promote the growth of fibroids. Fibroids contain more estrogen and progesterone receptors than typical uterine muscle cells. Fibroids tend to shrink after menopause due to a decrease in hormone production.
- Other growth factors – Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth.
- Extracellular matrix (ECM) – ECM is the material that makes cells stick together, like mortar between bricks. ECM is increased in fibroids and makes them fibrous.The growth patterns of uterine fibroids vary; they may grow slowly or rapidly, or they may remain the same size. Some fibroids go through growth spurts, and some may shrink on their own.
There are few known risk factors for uterine fibroids, other than being a woman of reproductive age. Factors that can have an impact on fibroid development include:
- Race – Although all women of reproductive age could develop fibroids, black women are more likely to have fibroids than are women of other racial groups. In addition, black women have fibroids at younger ages, and they’re also likely to have more or larger fibroids, along with more severe symptoms.
- Heredity – If your mother or sister had fibroids, you’re at increased risk of developing them.
- Other factors – Starting your period at an early age; obesity; a vitamin D deficiency; having a diet higher in red meat and lower in green vegetables, fruit and dairy, and drinking alcohol, including beer, appear to increase your risk of developing fibroids.
Although uterine fibroids usually aren’t dangerous, they can cause discomfort and may lead to complications such as a drop in red blood cells (anemia), which causes fatigue, from heavy blood loss. Rarely, a transfusion is needed due to blood loss.
Pregnancy and fibroids
Fibroids usually don’t interfere with becoming pregnant. However, it’s possible that fibroids, especially submucosal fibroids, could cause infertility or pregnancy loss.
Fibroids may also raise the risk of certain pregnancy complications, such as placental abruption, fetal growth restriction and preterm delivery.
Many fibroids that have been present during pregnancy shrink or disappear after pregnancy, as the uterus goes back to its usual size.
Although researchers continue to study the causes of fibroid tumors, little scientific evidence is available on how to prevent them. Preventing uterine fibroids may not be possible, but only a small percentage of these tumors require treatment.
But, by making healthy lifestyle choices, such as maintaining a healthy weight and eating fruits and vegetables, you may be able to decrease your fibroid risk. Also, some research suggests that using hormonal contraceptives may be associated with a lower risk of fibroids.
When should you see a doctor?
- Pelvic pain that won’t go away
- Too heavy, long or painful periods
- Bleeding or spotting between periods
- If it is difficult to empty your bladder
- Anemia (unexplained low red blood cells count)
If you experience severe bleeding from the vaginal or pelvic areas, it is important to seek immediate medical attention. Call Iowa Women’s Health Center to schedule an appointment.
New minimally invasive myomectomy, da Vinci® Myomectomy, combines the best of open and laparoscopic surgery. With the assistance of the da Vinci® Surgical System – the latest evolution in robotics technology – surgeons may remove uterine fibroids through small incisions with unmatched precision and control.
OB/GYN Dr. Jason Rexroth is our in-house surgeon and was one of the first doctors in Iowa to use the da Vinci robotic system and first in Cedar Rapids. He’s skilled and adept in minimally invasive gynecologic surgeries and procedures.
Another option is Acessa. This allows us to pass radio frequency energy directly to fibroids under ultrasound guidance, effectively melting the fibroids. Dr. Rexroth was the first physician in Iowa to offer this treatment.
Some fibroids can be removed hysteroscopically with no abdominal incisions. Contact us to see where the fibroid is located and go over treatment options.