Also known as uterine fibroids, are benign, noncancerous growths or tumors that develop in the wall of the uterus. They are often referred to as leiomyoma, leiomyomata, myomas and fibromyomsa. Although they are benign, they can cause discomfort, pelvic pain, frequent urination and excessive menstrual bleeding. Usually starting out at the size of a pea, they are the most common tumors found in the female reproductive tract and often grow when women are in their 30s and 40s. At MedStar Health, our physicians have extensive experience in diagnosing and treating women with symptomatic fibroids using several methods, including a new, minimally invasive procedure known as Uterine Fibroid Embolization (UFE).
Types of fibroids
- Intramural: These are buried in the muscular wall of the uterus and can cause pain and abnormal bleeding.
- Pedunculated: These are connected to the outside of the uterus by a stalk. A woman may feel it moving around, or may have pain if the stalk becomes twisted and blood supply to the fibroid decreases.
- Submucosal: These tumors project into the uterine cavity and often cause heavy menstrual bleeding and bleeding between periods.
- Sub-serosal: These growths lie on the outside of the uterus and usually cause few symptoms unless they become very large.
Fibroid symptoms
Although these tumors can affect women from a variety of age groups, African-American women are at a higher risk of developing them, as well as women of child-bearing age and those who are considered obese. As many as 50 percent of women who are diagnosed have fibroids that are considered significant in size.
Often, women don't experience any symptoms, but in some cases, they may experience pelvic pain, heavy menstrual bleeding, bleeding between menstrual periods, frequent urination and infertility problems. These tumors are normally found during a physical examination, most often detected in patients with an enlarged uterus. The diagnosis is then confirmed with the use of ultrasound and magnetic resonance imaging (MRI).
Treatment options
If you are diagnosed with this condition, your doctor will thoroughly review your individual medical history and discuss your specific symptoms during your initial consultation. Prescribed treatment may include medications, endometrial ablation (laser removal of fibroids), surgery or Uterine Fibroid Embolization (UFE). Other options include observation, pain relievers, hormones, a change in diet and exercise or complimentary and alternative medicine. In any case, you and your doctor will determine what's best for you.
When surgery is determined as the best option, traditionally the most common procedures performed are a myomectomy (surgical removal of the tumor from the uterus) or a hysterectomy (removal of the uterus and possibly ovaries). Find out more on urogynecology treatments.
UFE is minimally invasive and involves injecting microscopic particles into particular targeted arteries to selectively block blood flow to the tumors, causing them to gradually and consistently shrink over time. The treatment depends on your age, the location of the tumor and how rapidly it is growing. UFE is a well-established alternative to surgery and is minimally invasive for the patient. During your initial visit, we will discuss any risks associated with UFE and how appropriate it is for your condition. Patients experience very few side effects or complications with UFE. More importantly, research has shown that the risks and complications are significantly lower than surgery. As with any procedure, we focus on a treatment plan geared toward your speedy recovery so you can return to work and daily activities. With UFE, recovery has been shown to be faster and less painful, when compared to surgical options such as hysterectomy or myomectomy.
How to prevent fibroids
Although there is no single cause, research indicates that certain dietary habits may increase the likelihood of these tumors. Those at a higher risk include women who maintain a diet that is high in fat, sugar or caffeine. All three of these factors encourage the growth of the tumors in the wall of the uterus. Substituting fresh fruits and vegetables, nuts and whole grains for less healthier foods is recommended. Find out more about nutrition counseling.
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Watch the video below to see interventional radiologist Brian Swehla, MD explain a new fibroid treatment, using arteries in the wrist.