Although fibroids are common, what causes them isn't fully understood. The majority of them are benign, but they can grow to be very large.
Fibroid types
There are three primary types of fibroids:
- Submucosal fibroids, which grow into the uterus. Prolonged, heavy periods are more common with this type of fibroid.
- Subserosal fibroids, which grow outside the uterus. Subserosal fibroids can place pressure on the bladder, leading to urinary symptoms. This type of fibroid can also put pressure on the rectum or spinal nerves, causing a backache.
- Intramural fibroids, which grow within the uterine wall. If they become large, they can alter the shape of the uterus and lead to long, heavy periods.
Causes
The causes of uterine fibroids aren't fully known, but research has shown several possible contributing factors:
- Genetics. Some research has shown that fibroids run in families.
- Race. Black women are more likely to have fibroids. They also tend to have them at a younger age.
- Diet. There is an increased relative risk of fibroids in people who consume a diet high in beef, low in fruits and vegetables and high in alcohol.
- Growth factors. Other substances in the body that help maintain tissues can influence the growth of fibroids.
Symptoms
Symptoms of uterine fibroids aren't always present. The location of the fibroids, as well as their size and number, tend to influence the symptoms. The most common signs of uterine fibroids include:
- Heavy periods
- Periods lasting seven days or more
- Pain or pressure in the pelvis
- Frequent urination
- Difficulty emptying bladder
- Constipation
- Backache
- Pain in the legs
You should see your doctor if you are experiencing:
- Heavy, painful periods
- Pain with intercourse
- An enlarged abdomen or uterus
- Pelvic pain that doesn't go away or is very sharp
Our specialists offer a variety of therapies to treat this troublesome condition. The treatment you receive will depend on your condition and the extent of the fibroids.
Medications
Birth control pills, progesterone, progesterone-releasing IUD, NSAIDS and Lysteda can help control menstrual bleeding, but they do not help reduce the size of the fibroids.
GnRH agonists such as Depo Lupron can help temporarily reduce the size of fibroids. The medication works by causing a dramatic reduction in estrogen and progesterone levels to a temporary postmenopausal state. It can be used to decrease the size of fibroids and correct anemia in preparation for surgery.
UCI Medical Center gynecologists were among the first in the country to use the following nonsurgical techniques to eliminate the symptoms of fibroid tumors while preserving the uterus:
Myomectomy
A myomectomy is a surgical procedure that removes fibroids, leaving the uterus intact. Depending on the location and size of the fibroids, removal can be approached in one of three ways:
- Laparoscopic or robot-assisted myomectomy
During a laparoscopic myomectomy, a small incision is made in or near your bellybutton. A narrow tube fitted with a camera, called a laparoscope, is inserted into your abdomen. The surgery is then performed through other small incisions in your abdominal wall.
During a robotic myomectomy, instruments are inserted through similar small incisions in your abdomen. The surgeon controls the movements of the instruments from a separate console.
- Hysteroscopic myomectomy
If the fibroids are located only inside the uterine cavity, then they can be removed through the cervix without making any incisions on the abdomen.
- Abdominal myomectomy
Depending on the patient's history as well as the size and location of the fibroids, myomectomy may be performed through a 3- to 4-inch incision on the abdomen.
Radiofrequency ablation
The use of radiofrequency ablation is a new treatment option for fibroids. It uses radiofrequency energy to destroy fibroids while preserving the uterus.
It is a minimally invasive, same-day surgery procedure that allows patients to return to their normal activities soon after treatment.
Learn more about radiofrequency ablation ›
Uterine artery embolization (UAE)
UAE entails shrinking fibroids by cutting off their blood supply. Tiny particles are delivered through the femoral artery to the two uterine arteries that nourish the tumors. As a result, the growths are deprived of their blood supply, destroying them while the uterus remains intact. Patients can expect a hospital stay of up to 48 hours to control pain. This procedure is not recommended for women who are planning to become pregnant.
The interventional radiologists at UC Irvine Medical Center were among the first physicians in the country to perform this procedure.
Hysterectomy
Our surgeons are capable of performing this procedure in a minimally invasive manner using laparoscopy or with the da Vinci robot. It may also be performed abdominally.
