What Women Should Know About Fibroids: 10 Questions Answeredby Robin Elise Weiss, Ph.D. Health Professional
Most women will develop a uterine fibroid at some point in their lifetime. According to research, about 30 percent of women aged 25-44 will seek treatment for fibroid-related pain alone. And by age 50, 70-80 percent of women will have a fibroid. Read on to learn more about these growths in the uterus, their symptoms, and how they can be treated.
What are fibroids?
Fibroids are muscular tumors that grow in the wall of the uterus. Technically, all fibroids are benign (meaning not cancerous), and they can either grow as a single tumor, or there can be many of them in the uterus. They also range in size — some can be very small, and some can be as large as a grapefruit. If a fibroid is cancerous, it's really leiomyosarcoma, which is a cancerous tumor of uterine muscle cells, but not of a fibroid.
Who's at risk for fibroids?
There are several risk factors for fibroids you should know. Family history, eating habits, older age, weight, and ethnicity can all affect a woman's chances of getting a fibroid. About 20-80 percent of women develop fibroids by the time they reach age 50, and African-American women are more likely to develop fibroids than white women.
What helps prevent fibroids?
While you can’t be certain that you will prevent fibroids, there are some things that make them less likely to develop. One study found that the risk of developing fibroids was 70 percent lower in women who were taking birth control pills compared with women who had never taken them. Pregnancy is also protective against fibroids, though we aren’t sure whether that’s because of the hormonal effects of pregnancy, the remodeling of the uterus in pregnancy, or something else.
What causes fibroids?
Doctors aren't really sure what causes fibroids, but it's certain that they are under hormonal control. They grow rapidly during pregnancy when hormone levels are high, and they shrink when anti-hormone medication is used. They also stop growing or shrink once a woman reaches menopause.
What are the symptoms of fibroids?
Generally, most people with fibroids don't notice any symptoms, but some women may experience heavy bleeding or painful periods, bloating in the abdominal area, pain during sex, lower back pain, or problems with infertility. It is also not unheard of to experience bladder dysfunction.
How are fibroids detected?
If you aren’t having symptoms, you may be diagnosed during your annual visit or during a routine ultrasound in pregnancy, according to the American College of Obstetricians and Gynecologists. Your practitioner may be able to feel the fibroid with their fingers during an ordinary pelvic exam as a (usually painless) lump or mass on the uterus. Your health care provider can also do imaging tests, like an ultrasound or MRI, to confirm that you have fibroids.
How are fibroids treated?
If you have fibroids but do not have any symptoms, you may not need treatment, according to the American College of Obstetricians and Gynecologists. If you have fibroids and have mild symptoms, your doctor may suggest taking medication. Several drugs commonly used for birth control can be prescribed to help control symptoms of fibroids. If you have fibroids with moderate or severe symptoms, surgery may be the best way to treat them. About 200,000 women have this surgery every year to treat fibroids.
Can you still use an IUD with fibroids?
Some people believe that if you have fibroids, you can’t have an intrauterine device (IUD). However, that is false. In fact, the levonorgestrel-releasing IUD can be useful for women with fibroids in terms of controlling bleeding, preventing pregnancy, and decreasing the likelihood that they become anemic. While there is a higher risk of IUD expulsion in women with fibroids, the risk still falls within the rates of some other studies where women do not have fibroids. Talk to your provider to see what they suggest.
How do fibroids affect pregnancy?
Many women go on to have uneventful pregnancies despite fibroids, while some studies show an increased risk of miscarriage, preterm labor, malpositioned babies, and other complications. If you have had a myomectomy prior to pregnancy that entered the uterus, you may need to have a cesarean birth before labor begins. Most fibroids do not grow during pregnancy, but about one-third do increase in size in the first trimester.
What’s the link between vitamin D and fibroids?
Research shows there may be a link between vitamin D and fibroids. The potential link was discovered when researchers found that African American women had three to four times the number of fibroids as white women. Because African American women are also about 10 times more likely to have a vitamin D deficiency, it was studied and found to be potentially a link to fibroid risk. This continued research may lead to a new way to treat fibroids.