FAQ: Uterine Fibroids

The cause of fibroids is unknown. Researchers believe that estrogen and progesterone levels can play a part in their development. They know when hormone levels are high, for example during pregnancy, fibroids can grow more rapidly. Alternatively, if someone is taking anti-hormone medication, or going through menopause, fibroids may stop growing or shrink. Family history is also thought to be one of the biggest factors in the development of fibroids

Fibroids are almost always benign (not cancerous). Rarely, a leiomyosarcoma will occur in women with fibroid tumors. However, doctors think these cancers do not arise from an already-existing fibroid.  Having fibroids does not increase your risk of developing a cancerous fibroid. Having fibroids also does not increase your chances of getting other forms of cancer in the uterus.

If you have small or medium-sized fibroid that causes no symptoms then it’s unlikely to pose significant risk or complications. If they grow larger due to high hormone levels it’s possible that discomfort of pressure or pain will occur.

Additionally, large or multiple fibroids can increase the risk of:

• Cesarean section: The risk of needing a cesarean section (C-section) is six times greater for women with fibroids.
• Breech presentation: The baby is positioned with its legs down and head up rather than head down.
• Placental abruption: The placenta breaks away from the wall of the uterus before delivery. When this happens, the fetus may not receive oxygen.
• Preterm delivery: The baby is born too soon, before the 37th week of pregnancy.

Talk to your obstetrician if you have fibroids and become pregnant. All obstetricians (OB) have experience dealing with fibroids and pregnancy. Most women who have fibroids and become pregnant do not need to see an OB who deals with high-risk pregnancies.

Symptoms vary depending on the size, number, and location of the fibroids. They include:

• Pelvic pain
• Heavy menstrual bleeding
• Bleeding between periods
• Frequent urination
• A feeling of fullness
• Abdominal bloating
• Lower back pain
• Pain during intercourse

Treatment often succeeds in addressing fibroids and providing relief. However, more fibroids may eventually grow. These fibroids may cause symptoms and require additional care.

The potential for fibroids to return happens with all treatments except hysterectomy. During a hysterectomy, surgeons remove the entire uterus.

Radiofrequency ablation is an FDA-approved surgical procedure. It aims to effectively treat fibroids with a minimally invasive outpatient procedure.

This uses radiofrequency energy to heat fibroid tissue and cause instantaneous cell death. The necrotic cells are then reabsorbed by the lymphatic system.  This causes a decrease in fibroid size and symptom relief.

Benefits of uterine fibroid embolization include:

• Effective alternative to surgery and hormonal treatment
• Completely noninvasive — no surgery and no blood loss
• Minimal hospital stay
• Quick return to normal activities
• Preserves the uterus, cervix, and ovaries
• Significant improvement in quality of life:
• Decrease in menstrual bleeding from symptomatic fibroids
• Decrease in urinary dysfunction, pelvic pain and/or pressure