Uterine Fibroids

Uterine Fibroids are Noncancerous Growths that Occur in & on the Uterus.

Also called fibromyomas, leiomyomas or myomas, uterine fibroids are not usually associated with an increased risk of uterine cancer but can affect a women’s chance for conception. It is thought that fibroids can affect conception by decreasing the supply of blood flow to the endometrium preventing the attachment of an embryo. They may also obstruct the fallopian tube openings into the uterus and certain types of fibroids may increase the risk of miscarriage or pregnancy complications.

No one knows what causes uterine fibroids, but their growth seems to depend on estrogen and progesterone levels. Fibroids tend to shrink or disappear after menopause when estrogen levels fall. Fibroids also appear to have some family history or genetic connection. Women whose mothers and sisters have uterine fibroids are more likely to have them as well. African-American women tend to get uterine fibroids two to three times as often as other women and also tend to have more symptoms.

Fibroids come in all sizes and shapes. They can vary in size from a few millimeters to the size of a basketball.

Types of Fibroids

where-fibroids-grow

  • Intramural fibroids are in the muscular wall of the uterus.
  • Submucosal fibroids grow just under the inside surface of the uterus, and may protrude into the uterine cavity where the baby is supposed to be.
  • Subserosal fibroids grow on the outside wall of the uterus.
  • Pedunculated fibroids usually grow outside of the uterus, attached to the uterus by a base or stalk.

Symptoms of Uterine Fibroids
Most often, uterine fibroids cause no symptoms at all and most women don’t realize they have them. When women do experience symptoms from uterine fibroids, they can include:

  • Prolonged menstrual periods (7 days or longer) with heavy bleeding
  • Bloating, fullness or pain in the belly or pelvis
  • Constipation
  • Pain during intercourse or bowel movements
  • Anemia

Diagnosis of Uterine Fibroids
There are different ways to determine if someone has fibroids. Large to moderate fibroids can be felt during a manual pelvic examination. Smaller fibroids require imaging tests to confirm their presence and their location in the uterus. Dr. Douglas uses an ultrasound probe, inserted into the vagina to look for fibroids. Ultrasound machines use high-frequency sound waves that reflect off the uterus and pelvic structures. Fibroids are displayed on a video screen and can be measured and evaluated for position within the uterus. Hysterosalpingograms and sonohysterograms can be used to see if the fibroids are inside the uterine cavity.

Treatment of Uterine Fibroids
Most fertility specialists consider the location and size to be the deciding factor whether or not to remove the fibroid. Dr. Douglas considers the physical characteristics of the fibroid, the size and the location in the uterus as well as patient specific conditions before deciding the best course of action for the treatment of fibroids.

Read more about the causes of Infertility with ASRM Guides & Fact Sheets

Abnormal Uterine Bleeding- an ASRM Guide