Fibroids Overview

Fibroids are very common, 25% of women have some fibroids. Fibriods usually do not cause problems or symptoms but for some women fibroids can cause significant abnormal bleeding or pain. Fibroids are not cancerous and do not turn into cancer. The treatment for fibroids can be either medical or surgical.

The Uterus is made out of smooth muscle tissue. This tissue is arranged in an organized fashion allowing the uterus to contract. This is one of the mechanisms that the uterus has to stop bleeding. Fibroids are these same types of muscle tissue that grow into hard balls instead of the nice organized tissue that makes up the rest of the uterus. When the uterus contracts the fibroids do not contract with the uterus. Fiboids can be found anywhere in the uterus cervix, or even in the ligaments that connect the uterus to the pelvic side walls. They are most often in the body of the uterus but sometimes can even grow in a little stalk. These are pedunculated fibroids. Women that make fibroids tend to continue to make fibroids until menopause. Removing a fibroids from the uterus tends to be a temporary solution as they tend to grow back. Because fibroids are stimulated by the female hormones, menopause tends to stop the growth of fibroids and often causes them to go away completely.

Fibroids can cause abnormal vaginal bleeding. They can make the periods heavier, longer, more frequent, or irregular. Fibroids can be found in different areas of the uterus. Fibroids can sometimes impinge on the endometrium. The endometrium is the tissue that gets shed every month with the menses. If the fibroid disrupts the endometrium it can disrupt this normal shedding and that can cause abnormal bleeding. Sometimes the number or bulk of the fibroids can decrease the effectiveness of the uterus to contract, this can also cause increased bleeding.

Fibroids can cause significant pelvic pain. If the fibroids are decreasing the uterus’ ability to contract effectively, the uterus may need to contract harder to achieve the same effect. This can cause painful cramping.  Occasionally the fibroids can grow out towards other structures in the pelvis and this can cause pain as well.  Rarely fibroids can become very large and become the size of a pregnant uterus. This can cause discomfort simply from taking up so much space in the abdomen. Occasionally fibroids can grow rapidly and outgrow the blood supply. This can cause them to necrose or die. When tissues such as fibroids necrose, this can cause a lot of pain.

Fibroids can be treated either medically or surgically. Medical treatment of fibroids involves either an oral, injectable, or transuterine medication to control the bleeding, reduce the pain, or even shrink the fibroids. There are several options for the surgical treatment of fibroids. These include stopping the blood supply to the fibroid, surgical removal of the fibroid, or surgical removal of the entire uterus.