The majority of women develop uterine fibroids at some point, and most of these growths never cause problems or require treatment. Still, it’s important to be aware of the symptoms and the range of treatment options.
Uterine fibroids are noncancerous tumors that develop in the uterus (womb). In cases where they become a problem, symptoms include pelvic discomfort, heavy menstrual bleeding, and chronic pain. Below, two UAB Medicine experts discuss this common diagnosis and the available treatment options.
Common symptoms
Also known as myoma, fibroids are a type of tumor that involves muscle cells. They can occur alone or in groups, and they range from the size of an apple seed to as large as a grapefruit or even bigger.
According to the U.S. Office on Women’s Health, up to 80% of women develop uterine fibroids by age 50. Even when fibroids are found, most women won’t need treatment unless they cause serious symptoms or issues due to their size, number, or location. Some symptoms may be mistaken for other conditions.
Common symptoms include:
- Heavy menstrual bleeding or longer cycles
- Frequent urination
- Discomfort around the rectum
- Fertility issues
- Swollen abdomen
- Pelvic pain, pressure, or discomfort
If you are having any of these symptoms, tell your primary care doctor or OB/GYN. Fibroids can be diagnosed through a pelvic examination or imaging tests such as ultrasound, MRI, and CT scan.
Risk factors
Doctors aren’t sure what causes fibroids, but it seems to be a combination of hormones, age, and genetics.
- Women in their 40s and 50s are most likely to be diagnosed with fibroids.
- African American women have a higher risk.
- Your risk is higher if other women in your family have had them.
- Those with obesity have a higher risk.
- Your diet can increase your risk, especially if it is high in red meat and low in fruits and vegetables.
Treatment options
Treatment for fibroids can be complex. It may require you to communicate with multiple specialists to determine the best course of action, according to Todd Jenkins, M.D., an OB/GYN physician at UAB Medicine.
“Many women are only offered a hysterectomy – removing the entire uterus – as treatment for their uterine fibroids,” Dr. Jenkins said. “A hysterectomy can eliminate fibroids permanently, and it is an effective treatment option. But for many women, it may not be their only solution or their best option based on their personal situation or goals. For example, some women may want to become pregnant in the future, while other patients may need an option that allows for a quicker recovery and return to work. At UAB Medicine, we have several effective treatment options for uterine fibroids. Unfortunately, many women are not aware of all of their options.”
Considering family planning goals is one important factor in choosing a treatment plan. The course of treatment also may depend on the size, location, and number of fibroids.
“We have several viable options for fibroids beyond hysterectomy,” Dr. Jenkins said. “Choosing among these requires clear patient communication and discussions with our radiology colleagues. Also, we always consider the role medical management plays in the mix as well.”
UAB Medicine interventional radiologist Theresa Caridi, M.D., says fibroids are unique to each person.
“Just because a treatment was ideal for your friend or neighbor doesn’t mean it is the best for your fibroids and your needs,” Dr. Caridi said. “Your ideal solution may be either the most definitive solution or the one that offers the shortest recovery time, and those are very different options. We get to know our patients and their needs, to better understand what best suits them and offer potential solutions.”
In addition to hysterectomy, three of the most common treatments include:
- Myomectomy: Performed by an OB/GYN, this is a surgical option for removing fibroids, usually when they are larger and small in number. A myomectomy can be performed laparoscopically, which is a minimally invasive technique that involves inserting tiny instruments through small incisions (cuts). It can also be performed using traditional open surgery.
- Radiofrequency ablation: With this minimally invasive procedure, doctors use heat from radiofrequency waves to destroy fibroid tissue. For many women, this offers a good balance between symptom relief and short recovery time.
- Uterine fibroid embolization (UFE): Performed by an interventional radiologist, this minimally invasive procedure involves starving the fibroids of the blood flow they need to survive. UFE addresses all uterine fibroids at once by injecting tiny particles into the uterine arteries to block blood flow. Patients can return home the same day, and recovery often takes just a week or less.
“We have the advantage of being able to counsel our patients on all options, which we offer in house, whether they come in through a UAB OB/GYN, a referral from UAB Interventional Radiology, from another physician, or self-referral,” Dr. Caridi said.
If you have symptoms that could be uterine fibroids, please speak to your OB/GYN physician or call 205-996-3130 to make an appointment at the UAB Women & Infants Center. In some cases, online telehealth appointments may be available to discuss a diagnosis and treatment plan.