An estimated 50-77% of females will, at some point between their first period and the onset of menopause, develop a uterine fibroid.
The presence of fibroids in the uterus can alter a woman’s menstrual cycle and can impact her fertility.
So, what is a fibroid?
Fibroids, sometimes referred to as myomas or fibromas, are benign tumors that form in a woman’s uterus. They’re composed of muscle cell and tissue that grows too quickly because of high estrogen levels. Fibroids can range in size from too small to detect to about grapefruit-sized. The tumors are classified based on where they’re found.
According to US Department of Health and Human Services’ Office on Women’s Health, fibroids that grow inside the cavity of the uterus are “submucosal,” fibroids inside and between the uterine wall are “intramural,” and fibroids found outside of the uterus are “subserosal.”
Fibroids that grow in a stalk-like formation are known as “pendulcated fibroids.” Though technically tumors, fibroids are masses of tissue that are hardly ever cancerous. The Mayo Clinic reports that the growths “aren’t associated with an increased risk of uterine cancer and almost never develop into cancer,” so, though the word “tumor” is anxiety-provoking, women with fibroids need not panic.
How do I know if I have fibroids?
Some fibroids are so small that they never become symptomatic and are even too tiny to be identified in an exam. “Depending on the location of fibroid tumors, pain can [range from] minor to excruciating,” explains Janet Fisher, a Chicago-based nurse. Fisher adds that some women don’t show any symptoms, and “may never know they have them.” For many women, the presence of fibroids alters their menstrual cycle, lengthening their period and causing them to bleed and cramp more. Heavy and lengthy menstruation is often linked to the onset of iron-deficiency anemia, a condition that requires monitoring and treatment. If you notice your period becoming abnormally heavy, or see an increase in the number of days you menstruate, it’s worth a quick trip to the doctor. Other symptoms of fibroids include lower back pain, pain during sex or urination, consistent pelvic discomfort, and increasingly uncomfortable periods.
Who develops fibroids?
According to the University of California – Los Angeles’ Office of Obstetrics and Gynecology, women who are between 30 and 40 years old are most likely to be diagnosed with fibroids. Doctors see a higher incidence of fibroids in African-American women who are also more likely to suffer from fibroids from an earlier age. The production of hormones estrogen and progesterone often encourages fibroid growth, so fibroids are more likely in individuals with imbalanced hormone levels and less common in women who have gone through menopause. Fibroids are often hereditary, so it’s a good idea to mention any family history to your medical care provider.
Do fibroids affect fertility?
For many women, fibroids do not limit fertility. Since fibroid treatments can affect a woman’s ability to conceive, it’s important patients share their plans and desires with medical professionals. Where possible, doctors will help guide patients towards treatments that are in-line with these wishes and will help protect fertility as best they can. The NIH reports that “submucosal and intramural fibroids…seem to affect a woman’s ability to get pregnant” and carry a fetus. These fibroids, because of their location in the uterus, alter the uterine cavity itself and can make pregnancy impossible. Depending on their size and location, fibroids can also lead to miscarriages, fetal health problems, and may make natural delivery very dangerous. Hormone fluctuations during pregnancy may cause fibroids to change size, which can also lead to complications and discomfort. It’s hard to say for certain how fibroids will impact a woman’s ability to conceive, but conversations with medical professionals on a case-by-case basis can help hopeful parents navigate their best options.
How are fibroids diagnosed and treated?
The larger and closer to the surface a fibroid is, the easier it is for a doctor to detect. Usually, fibroids can be identified through standard pelvic exams. If not, a doctor will use an ultrasound or MRI to look deeper or to be certain of the diagnosis. According to a fact sheet compiled by The National Insitute of Child Health and Human Development, treatment depends on how much pain fibroids are causing a patient. For mild discomfort or menstrual pain, doctors recommend over-the-counter pain relievers and anti-inflammatories. Hormonal birth control pills and IUDs, which release progestin and reduce frequency of menstruation, can treat correlated menstrual problems but are also sometimes thought to increase fibroid occurrence by altering hormone levels. Endometrial ablation, myomectomies, and hysterectomies are all invasive surgeries that destroy the uterine lining or remove all or part of the uterus. These options, which are viable solutions for severe cases, leave women infertile. The women’s health organization Women to Women‘s online Health Library includes resource guides and personal accounts for women to read as they consider surgery.
If you think you might have fibroids, or if you’re experiencing painful or inconsistent periods, keep track of how you’re feeling and make an appointment with your doctor. If you’re looking for more information or for support, particularly if you’re dealing with fibroids and trying to conceive, the National Uterine Fibroids Foundation, Fibroid Relief, and The Fibroid Network provide trustworthy resources and emotional support.