Uterine Fibroids

Symptoms

Uterine fibroids can cause a variety of symptoms, including:

• Heavy menstrual bleeding or prolonged periods
• Pelvic pain or pressure
• Frequent urination
• Pain during intercourse
• Difficulty getting pregnant
• Miscarriage

It’s important to note that many women with fibroids have no symptoms at all.

Causes

The exact cause of uterine fibroids is unknown, but several factors are believed to play a role:

• Hormones: Estrogen and progesterone seem to stimulate the growth of fibroids. This is why fibroids often shrink after menopause when hormone levels decline.
• Genetics: Having a family history of fibroids increases your risk.
• Other factors: Obesity, race (African American women are more likely to develop fibroids), and early menstruation may also be contributing factors.

Diagnosis

Diagnosing uterine fibroids typically involves a pelvic exam, imaging tests such as ultrasound, MRI, or sonohysterography, and sometimes a biopsy to rule out cancer.

Treatment

Treatment for uterine fibroids depends on the severity of symptoms, a woman’s age and desire for future pregnancy, and other factors. Not all fibroids require treatment. Here are some common treatment options:

• Watchful waiting: If symptoms are mild or nonexistent, monitoring the fibroids with regular checkups may be the best course of action.
• Medication: Medications can help manage symptoms like heavy bleeding or pain. These include hormonal medications like GnRH agonists, which shrink fibroids by putting the body into a temporary menopause-like state.
• Minimally invasive procedures: These procedures offer less invasive alternatives to surgery. Options include myomectomy (surgical removal of fibroids) and uterine artery embolization (UAE) (Click here to read more on Uterine artery embolization for fibroids, adenomyosis), which reduces blood flow to the fibroids causing them to shrink. 
• Surgery: Hysterectomy, the removal of the uterus, is typically a last resort for severe symptoms or fibroids that don’t respond to other treatments.