Fibroids

Fibroids are noncancerous growths in or on the uterine wall. They’re very common.

Types of fibroids

Fibroids come in a variety of types and sizes. They include: 

  • Intramural – Grow within the muscle wall of the uterus 
  • Submucosal – Grow from the uterine wall into the uterine cavity. 
  • Subserosal – Grow from the uterine wall to the outside of the uterus and may push on the bladder, bowel or other pelvic organs 
  • Pedunculated – Grow on stalks out from the uterine wall into the uterus.

Symptoms

Only 20% of women with fibroids experience symptoms. Common symptoms include: 

    • Back pain
    • Bloating
    • Constipation

    Lifestyle tips

    Your doctor may recommend managing symptoms with these lifestyle habits.

    Pain management
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    Use over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen.

    Diet
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    • Include enough iron in your diet to avoid anemia. Good dietary sources of iron include beans, lentils, tofu, baked potatoes, cashews, dark green leafy vegetables (e.g., spinach and kale), fortified cereals, clams, mussels, oysters, beef, pork, poultry and fish.
    • Eat a healthful diet high in fruits and vegetables, whole grains and lean proteins.
    Exercise
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    Aim for at least 30 minutes of moderate exercise three times a week.

    Treatment options

    You have options. Speak up, our specialists are ready to listen. If you think you may have fibroids, or have already been diagnosed and are looking for a second opinion, schedule an appointment with an OB/GYN to get started.

    Monitoring fibroids
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    If you have fibroids, get regular pelvic examinations and ultrasounds to monitor them and determine if you need additional treatment.

    Medication
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    • Hormonal contraceptives, such as birth control pills – Help manage heavy bleeding
    • Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists – Shrink fibroids by blocking hormone production by the ovaries
    • Progestin therapy, such an intrauterine device (IUI) with levonorgestrel – Help manage heavy bleeding and pain
    • Tranexamic acid – Decreases menstrual flow on heavy bleeding day
    Minimally invasive procedures
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    • Myomectomy – Removes fibroids while leaving the uterus in place; may help improve odds of pregnancy
      • Laparoscopic or robotic myomectomy – Removes fibroids through small incisions in the abdomen; robotic myomectomy gives the surgeon a magnified, 3D view of the uterus, offering more precision, flexibility and dexterity.
      • Hysteroscopic myomectomy – Removes the fibroids using instruments inserted through the vagina and cervix into the uterus.
    • Uterine artery embolization – Shrinks fibroids by blocking blood vessels to the uterus; best for women who are not concerned with preserving fertility
    • Endometrial ablation – Uses heat, microwave energy, hot water or electric current to destroy the lining of the uterus, either ending menstruation or reducing menstrual flow; best for women who are not concerned with preserving fertility
    • Hysterectomy – Removes the uterus through the vagina or a small incision in the abdomen; a permanent solution to fibroids, but also women’s ability to become pregnant
    Traditional surgical procedures
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    • Abdominal myomectomy – Removes multiple or very large fibroids through an incision in the abdomen; scarring may affect fertility
    • Hysterectomy – Removes the uterus through an incision in the abdomen; a permanent solution to fibroids, but also women’s ability to become pregnant

    Frequently asked questions

    How common are fibroids?
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    Fibroids are extremely common. Eighty percent of women have had a fibroid by the time they are 50 years old—but many never know it.

    What causes fibroids?
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    Genetics and the hormones estrogen and progesterone play a role in fibroid growth. But no one knows for sure what causes fibroids. One theory is that fibroids develop from misplaced cells present in the body before birth.

    How can I prevent fibroids?
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    Because we don’t know the exact causes of fibroids, there’s little evidence on prevention. However, you take these steps to reduce your risk:

    • Achieve and maintain a healthy weight
    • Eat a diet high in fruits and vegetables

    Some research suggests that using hormonal contraceptives may be associated with a lower risk of fibroids, but these results are not consistent across all study populations and more research is needed.

    What are the risk factors for fibroids?
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    Risk factors include:

    • Age (older women are more likely to develop fibroids)
    • Family history of fibroids
    • High blood pressure
    • Obesity
    • Race (Black women are more likely than white women to develop fibroids)
    Can fibroids cause cancer?
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    Uterine fibroids are not associated with an increased risk of uterine cancer. Cancerous fibroids—called leiomyosarcoma—are rare (less than 1 in 1,000 fibroids).

    Can fibroids cause infertility?
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    Fibroids may cause infertility. About 10% of infertile women have fibroids. Many women with fibroids can become pregnant after the fibroids are treated or removed. However, most infertility is due to other factors.

    Can fibroids affect pregnancy?
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    Most of the time, fibroids do not cause pregnancy complications. In rare cases, large or multiple fibroids may contribute to miscarriage, preterm birth (delivery before 37 weeks gestation) and breech birth (in which the baby is delivered in a position other than head-down).

    What causes fibroids to shrink during menopause?
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    Fibroids shrink during menopause due to lower estrogen and progesterone levels. Hormone therapy during menopause will not make fibroids grow, but it may delay shrinkage of fibroids.

    What’s the difference between surgery and minimally invasive surgery?
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    Robotic-assisted surgery might be a great option for you. It’s less invasive than other conventional methods and offers benefits such as: 

    • Quicker recovery times. You want to get back to living your life. Robotic-assisted surgery is often referred to as minimally invasive because it offers smaller incisions, which means quicker recovery time. 
    • Less pain. Because there are fewer, smaller incisions involved in robotic-assisted surgeries than conventional open surgeries, most patients experience less pain. 
    • Lower risk for surgical site side effects. Minimally invasive surgeries are associated with less scarring and a decreased risk for blood clots, blood loss and infections. 
    • Fewer hospital re-admissions. Patients who undergo minimally invasive surgeries have a lower rate of hospital readmission than patients who undergo more traditional surgical methods.

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