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Uterine Fibroids: Symptoms & Treatment

Uterine fibroids affect three out of four women in their childbearing years. Many women though do not realize they have them because they don’t always cause symptoms. In fact, they’re often found during routine gynecologic exams.

Uterine fibroids, also called leiomyomas, are noncancerous (benign) growths in the uterus. The growths almost never develop into cancer. They range in size from that of a seed to large masses that distort the size and shape of the uterus. In some cases, fibroids can make it hard to get pregnant.

Types of Uterine Fibroids

Uterine fibroids are often classified by their location:

  • Intramural fibroids: located within the wall of the muscular uterus
  • Submucosal fibroids: located under the inner lining of the uterus and grow into the uterine cavity
  • Subserosal fibroids: grow under the outer lining of the uterus and appear on the outside surface of the uterus.
  • Pedunculated fibroids: grow on stalks into the cavity of the uterus or out from the surface of the uterus

Signs & Symptoms of Uterine Fibroids

Many women with uterine fibroids experience no symptoms. For those who do, abnormal menstrual bleeding is the most common. Fibroids can cause other symptoms depending on their size, location and proximity to other organs:

  • Heavy menstrual bleeding
  • Prolonged menstrual periods
  • Anemia
  • Pelvic pain
  • Lower back pain
  • Pain during sex
  • Difficulty urinating or frequent urination
  • Constipation

See a doctor if you have pelvic pain that doesn’t go away, unusually long or heavy periods or difficulty emptying your bladder. Our provider finder can help you connect with the right SSM Health provider for you.

Treating Uterine Fibroids

Depending on your symptoms, your doctor may perform a pelvic exam and order an ultrasound to create a clearer picture of the pelvic organs. Other imaging tests may be used to help your doctor determine if uterine fibroids are present.

The best treatment for uterine fibroids depends on the size and location of the growths, the severity of the symptoms you’re experiencing and whether you hope to get pregnant in the future.

Watchful Waiting

Many women with no symptoms choose to ‘watch and wait’ before pursuing treatment.  If you’re approaching menopause, you may also choose to delay treatment because the growths often shrink as your hormones change. If you choose the watch and wait approach, your doctor will routinely check to see if the fibroids have grown during an annual exam.

If the symptoms from fibroids are disrupting your life, causing anemia, making it difficult to get pregnant or if there’s any concern about whether the growths could be cancerous, you may elect for a more aggressive medical or surgical treatment.

Medical Treatment for Uterine Fibroids

Medication can be used to control symptoms and shrink or slow the growth of the tumors. Over-the-counter pain relievers and birth control pills can also help relieve pain and heavy bleeding.

Medications called gonadotropin-releasing hormone (GnRH) agonists can be used to turn off the production of estrogen in an effort to shrink the fibroids. These medications can cause side effects similar to the symptoms of menopause, so they’re usually only used for short periods of time (3 - 6 months). However, the fibroids often begin growing again once the medication is stopped and surgery may be needed later on.

Uterine Fibroid Embolization

Uterine fibroid embolization (UFE) is a minimally invasive, image-guided procedure. It is a safe and effective fibroid treatment option that may be used as an alternative to a hysterectomy. UFE shrinks the fibroids by stopping blood supply to the growths, relieving symptoms without surgery or side effects and preserving your uterus. It is performed as an outpatient procedure by a vascular interventional radiologist - a board-certified physician who is trained to perform minimally invasive procedures.

Our specialists perform UFE at SSM Health Saint Louis University and SSM Health DePaul Hospital. If you’re struggling with the symptoms of uterine fibroids, schedule a consultation with your gynecologist today to determine if you are a candiate for this procedure.

Surgery for Uterine Fibroids

There are two common types of surgery for uterine fibroids: myomectomy and hysterectomy.

Myomectomy surgically removes the fibroids, but leaves the uterus intact. Your doctor may suggest this option if you wish to get pregnant in the future. If you’ve struggled with fertility, removing the growths may improve your chances of having a baby. However, fibroids may grow back after myomectomy.

Hysterectomy, the surgical removal of the uterus, is the only way to make sure the fibroids do not return. This surgery will relieve your symptoms, but you will not be able to get pregnant afterwards.

Making the decision to have surgery can be a difficult one. If you’re unsure about whether surgery is right for you, consider getting a second opinion from an SSM Health provider. Our care team will help you weigh your options so you can move forward with confidence.

There is no best approach to the treatment of uterine fibroids, so our doctors will work with you to determine the best care plan for you. Your team at SSM Health is ready to help, so schedule an appointment today.

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