Uterine fibroids are benign (noncancerous) tumors that grow in the uterus. Fibroids can range in size from tiny to as large as a grapefruit. They can also exist as a single fibroid or in multiples. Most women (up to 80% of them) will have a fibroid at some point in their lifetime, but are unaware because they don’t experience any symptoms. Fortunately, fibroids generally do not increase a woman’s risk of developing any cancers of the reproductive system.
Cause. The exact cause of fibroids is unknown, but there is a possible link to genetics, increased levels of the hormones estrogen and progesterone, and increased levels of insulin.
Risk Factors. A family history of fibroids, increased age (30s through menopause), African American ancestry, early-onset of menstruation, use of birth control, obesity, vitamin D deficiency, frequent use of alcohol, and a diet high in red meat all seem to increase a woman’s risk of developing fibroids.
Symptoms. Common symptoms of fibroids are pain in the abdomen, lower back, or pelvis; heavy, painful, or irregular periods; frequent urination; difficulty urinating; constipation; and abdominal cramps.
Complications. Though rare, fibroids may cause infertility. If able to get pregnant despite the presence of fibroids, miscarriage, breeching of the baby, fetal growth restriction, and preterm delivery may result.
Diagnosis. Most often, uterine fibroids are first identified with a manual pelvic exam at your annual gynecological visit. The presence of fibroids may be confirmed with an ultrasound, MRI, x-ray, cat scan, hysterosonogram, or hysterosalpingogram.
Treatment. If the fibroids are small or painless, your doctor will usually just recommend “watchful waiting.” This means no interventions will be done unless symptoms worsen at some point in the future. Regular exercise and eating a diet high in fresh fruits and cruciferous vegetables (arugula, broccoli, cabbage, cauliflower, and greens) may help lower risk of developing further fibroids. OTC pain medication such as Tylenol or Motrin can help treat mild-to-moderate pain. Iron supplements can help prevent anemia in women who suffer from heavy periods. Hormonal medications such as oral contraceptives, the Depo-Provera shot, and the Mirena IUD can all help to shrink fibroids and/or relieve heavy periods. Surgery at varying levels of intensity can remove fibroids. And in the most extreme cases, a hysterectomy may be done to remove all female reproductive organs.
