Fibroids are non-cancerous growths of the womb (uterus). They are also known as uterine myomas or leiomyomas. Fibroids are very common - around 70-80 percent of women have fibroids by the time they're 50. However, most of these women don't ever get any symptoms.
Fibroids are growths enclosed in capsules attached to the wall of your womb. They don't spread to other parts of your body.
You may have only one fibroid or you may have many fibroids of different sizes. Fibroids range from being too small to be seen with the naked eye to around the size of a basketball in some cases.
Fibroids are named according to where they are found in your womb:
Fibroids don't usually cause symptoms. However, you may get one or more of the symptoms listed below, often depending on where the fibroid is within your womb.
You can get severe pain if a fibroid that is growing on a stalk twists or if a fibroid outgrows its blood supply causing it to break down, but this is rare.
Most women with fibroids can have a normal pregnancy and delivery; however there can be some complications.
Watch a video on the symptoms of fibroids and polyps, which are common female conditions, and how they can be treated to help achieve a pregnancy.
The reasons why women get fibroids aren't known. Although oestrogen seems to make fibroids grow, it's not thought to be responsible for their initial development. You're more likely to get fibroids if you:
Most women with fibroids have no symptoms, so the fibroids often go undetected. Sometimes they are found during a routine gynaecological examination. If you have symptoms, such as pain or heavy periods, your doctor may do the following tests:
Your doctor may also order a blood test to see if you've become anaemic from the increased bleeding.
If you don't have any symptoms, or if your symptoms are mild, you won't need treatment.
If you have more severe symptoms, there's a range of treatments available. Discuss with your doctor which treatment is most suitable for you.
There is no medicine that cures fibroids.
Hormone-based treatments such as the oral contraceptive pill can help regulate your periods and relieve your symptoms. While there have been previous reports of fibroids growing in response to use of the pill, this is more likely with older, high-dose formulations.
There are medicines that lower your oestrogen level to try and shrink fibroids. However, they have side effects similar to that of menopause, such as hot flushes and vaginal dryness. And if these medicines are used for more than six months, they increase your risk of osteoporosis (thinning of the bones). These medicines are most likely to be used for the three to four months prior to surgery, to try and reduce the size of the fibroids to make it easier for the surgeon to remove them.
Non-steroidal anti-inflammatory drugs (NSAIDs) may be effective in relieving pain related to fibroids.
Talk to your doctor regarding whether a medicine will be able to help you.
There are a number of surgical options for treating fibroids, including those outlined below.
A myomectomy is an operation to remove fibroids, leaving your womb in place. It may be done through a cut in your tummy, or sometimes it may be possible for your surgeon to use keyhole surgery. Myomectomy is usually only offered to women who would like the option to become pregnant in the future. Because your womb isn't removed there is a chance that more fibroids will grow in the future, so you may need to have further treatment.
Uterine artery embolisation (UAE)
This procedure blocks the blood supply to a fibroid, causing it to shrink. It's performed under local anaesthesia, meaning that feeling in the area will be completely blocked but you will stay awake during the operation. UAE gives relief from symptoms such as bleeding and pain for at least six in every 10 women treated. It's only recommended to be used for treating women with infertility related to fibroids as part of a clinical trial.
Endometrial ablation or resection
Endometrial ablation is a procedure to remove most of the lining of your womb or to destroy or remove an individual fibroid using energy such as microwaves or heat. During an endometrial resection, the lining of your womb or the fibroid is cut away. Endometrial ablation helps stop heavy and prolonged bleeding, but doesn't affect fibroids sitting outside the inside lining of the womb.
A hysterectomy is a major operation to remove your entire womb, usually via a 'bikini-line' cut in your abdomen or, if the fibroids aren't too large, via your vagina. You and your doctor may also choose to remove your fallopian tubes and ovaries. You no longer have periods after a hysterectomy and you can't become pregnant. Discuss with your doctor which of these options is right for you.
The Jean Hailes Foundation: Health for Women
The Jean Hailes Foundation for Women's Health. Fact Sheet: Fibroids. [online] Clayton South, VIC: The Jean Hailes Foundation for Women's Health. c2011 [Last updated Jun 2010, accessed 14 Jul 2011] Available from: http://jeanhailes.org.au/
Lethaby A Hickey M Garry R et al. Endometrial resection/ablation techniques for heavy menstrual bleeding. Cochrane Database of Systematic Reviews 2009, Issue 4. [online] 2009 [Accessed 14 Jul 2011] Available from: http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD001501/frame.html
Mayo Clinic. Uterine Fibroids. [online] Mayo Foundation for Medical Research and Education. c1998-2011 [last updated 11 Jun 2011, accessed 14 Jul 2011] Available http://www.mayoclinic.com
National Institute for Health and Clinical Excellence (NICE). Uterine artery embolisation for fibroids. [online] Nov 2010 [accessed 14 Jul 2011] Available from: http://guidance.nice.org.uk/IPG367
Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the Australasian CREI Consensus Expert Panel on Trial evidence group. Fibroids in Infertility. [online] East Melbourne, VIC: RANZCOG. Mar 2011 [Accessed 14 Jul 2011] http://www.ranzcog.edu.au/
Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). Uterine Artery Embolisation for the treatment of Uterine Fibroids. [online] East Melbourne, VIC: RANZCOG. Mar 2008 [Accessed 14 Jul 2011] http://www.ranzcog.edu.au/
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