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Severe abdominal cramps. Incontinence. Infertility. Excessive bleeding. Little can be more frightening to a woman than to know that something is wrong with her cycle or with her reproductive organs. The immediate thoughts turn to cancer – ovarian, uterine, cervical, which is it? Rarely, and understandably, does a woman think first about a benign and relatively common possibility: uterine fibroids.
Uterine fibroids are noncancerous growths that can develop in a woman’s uterus and that occur in 20 percent to 25 percent of all women. Until biopsied, however, the diagnosis of any growth in the body sends fear through everyone. Fibroids are most common in women age 30 to 40, but they can occur at any age. They also tend to occur more frequently and grow more quickly in black women than in white women. Symptoms include the following:
• Changes in menstruation
- Excessive bleeding
- Longer or more frequent periods
- Excessive menstrual cramps
- Vaginal bleeding at times other than menstruation
- Anemia
• Pain
- In the abdomen or lower back, usually a dull, heavy ache, but may be sharp
- During sex
• Pressure
- Difficulty in urinating or frequent urination
- Constipation, rectal pain, or difficult bowel movements
- Abdominal cramps
• Miscarriage and infertility
Many women develop small fibrous growths in their uterus and experience few problems. They may live their entire lives unaware of these growths. For others, however, the fibroids may grow over a period of time into masses large enough to place pressure on internal organs or interfere with normal functioning. They may even be the cause of infertility in some women. When fibroids interfere with functioning, some form of treatment is usually necessary. The treatment selected depends on a number of factors, including the woman’s child-bearing status (age and desire), the size of the fibroids, and complications due to the fibroids.
The options available to women with fibroids fall into two categories: surgical or nonsurgical. Little is known about what causes fibroids to develop or what causes them to grow so large in some women, although some studies indicate that the hormone estrogen appears to increase their growth. As such, after menopause, fibroids tend to shrink. Therefore, women beyond childbearing age and with tolerable symptoms may opt to let nature take its course. Medication may also help to shrink the fibroids before the onset of menopause. Women who opt for surgery also have a couple of choices: a hysterectomy or a myomectomy. A hysterectomy is the removal of the uterus, the cervix, and surrounding tissue, including the fibroids. A myomectomy is the removal of only the fibroids, with everything else left intact. The decision as to which surgery to have is up to the woman and, again, depends greatly on her desire to have children and on the severity of any problems caused by the fibroids.
Fibroids can be detected during an annual pelvic exam and verified by an ultrasound or other methods, such as a laparoscopy, magnetic resonance imaging (MRI), or computerized tomography (CT) scans when a more detailed image is necessary. Paying attention to changes or unusual events with the menstrual cycle and paying attention to general body health are important components of every woman’s prevention profile. Although little can be done to prevent fibroids, regular checkups are important for early detection and care before they develop into a greater problem.
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