General Illness Information
FIBROID TUMORS OF THE UTERUS
Common Name: None Specified
Description: A fibroid is a benign growth of cells in the muscular wall of the uterus. Cells are composed of mainly muscle cells, but with varying amounts of fibrous connective tissue. They may be present as solitary or multiple tumors. The size of the tumor may range from size of a pea to as large as a small melon.
It is a common condition, and is not cancerous. It may be present in 20 to 25% of women of child-bearing age.
Causes: The cause is unknown. However, they need estrogen for maintenance, as they are extremely rare before puberty or after menopause, and they sometimes grow rapidly in pregnancy and with use of oral estrogen , and with estrogen producing tumors. Fibroids regress after pregnancy and after menopause.
Prevention: Cannot be prevented at present.
Signs & Symptoms
- Often no symptoms. Discovered on a routine pelvic examination.
- About 30% of patients report heavier and more frequent menses.
- Increased menstrual discomfort.
- Bleeding between periods.
- Painful sexual intercourse or bleeding after intercourse.
- Anemia (weakness, fatigue, and paleness).
- Feelings of pressure on the urinary bladder or rectum.
- May cause infertility
- Use of estrogen replacement therapy and use of oral contraceptives with high estrogen content.
- Genetic factors. Fibroid tumors are 3 to 9 times more common in black women than Caucasian women.
Diagnosis & Treatment
Diagnosis is usually made during a pelvic exam and confirmed by ultrasound. Other diagnostic tests may include laboratory blood studies, MRI, laparoscopy; or hysterosalpingogram.
- For minimal symptoms, no treatment may be needed. Follow-up every 6-12 months.
- Treatment will be individualized depending on symptoms, diagnostic tests, age of the patient and desire for future pregnancy
- Record dates of bleeding and number of pads used each day.
- Surgery may be recommended for certain situations and several different surgical procedures are possible. If surgery is recommended, be sure you understand all aspects of it before making a decision. Surgery to remove a fibroid (myomectomy) may be necessary if the fibroid increases in size or produces unacceptable symptoms. In some instances, a hormone may be prescribed for a few weeks prior to surgery to shrink the tumor.
- Removal of the uterus (hysterectomy) may be necessary if menstrual bleeding is very heavy, symptoms such as pressure or severe pain develop, a fibroid is growing rapidly, or a large fibroid gets twisted or infected.
- If you have a small fibroid, don’t take contraceptive pills with a high estrogen content. Estrogen may cause fibroids to enlarge. Consider other forms of contraception, such as a diaphragm, cervical cap, IUD, condom, or contraceptive foam, sponge or jelly.
- Iron supplements if you are anemic from excessive blood loss.
- Estrogen must be used with caution in post-menopausal women with fibroids.
No restrictions unless surgery performed. Then you may need bed rest for a period of time, some restricted activity, and no sexual intercourse for approximately one month.
No special diet.
Possible Complications :
- Malignant change in the fibroid tumor (occurs in less than 0.5%). This rare complication is usually signaled by very rapid growth.
- Complications can occur in pregnancy such as spontaneous abortion and premature labor.
- Fibroids may return following surgery to remove them.
- If surgery is not necessary prior to menopause, these tumors usually decrease in size without treatment after menopause.
- Hospitalization, if surgery is necessary. Fibroids are generally removed surgically if they cause excessive bleeding, become malignant, or produce symptoms that interfere with conception or pregnancy.
- Fibroids can often be removed surgically without removing the entire uterus. The ability to conceive continues as long as the uterus remains.