Uterine fibroids are tumors that grow underneath the uterine lining, inside the uterine wall or outside the uterus. Only rarely (less than 1%) are cancerous. Fibroids are very common in women during their reproductive years and can be at cause for infertility. 20% – 80% of women develop fibroids by the time they reach 50.
Many women don’t feel any symptoms with fibroids. But for others fibroids can be hard to live with causing excessive menstrual bleeding (also called menorrhagia), abnormal periods, uterine bleeding, pain, discomfort, frequent urination and infertility. The diagram below depicts different types of fibroids that can occur. If the fibroids get very large, they can cause the stomach area to enlarge, making a women look pregnant.
Medications — for those mildly symptomatic.
Myomectomy — removes the fibroids and leaves the healthy tissue of the uterus. This is a good option for women still wishing to have children. After a myomectomy, new fibroids can grow and cause trouble later.
Hysterectomy — This surgery removes the uterus and is the only sure way to cure uterine fibroids. Hysterectomy is used when fibroids are large, if there is heavy bleeding, if you are either near or past menopause and do not want children.
Endometrial Ablation — The lining of the uterus is removed or destroyed to control very heaving bleeding. This is usually done in the office setting. This is not an option if you still want to have children.
Myolysis — Myolysis is a less common treatment for fibroids. A needle is inserted into the fibroids, guided by laparoscopy and and electric current or freezing is used to destroy the fibroids.
Uterine Fibroid Embolization and Uterine Artery Embolization — This is an option for women that have fibroids that are causing heaving bleeding, fibroids are causing pain or pressing on the bladder or rectum, don’t want to have a hysterectomy and don’t want to have children in the future. It’s done by a radiologist in an outpatient setting.