Uterine fibroids are benign growths of the uterus. Benign means that the growths are not cancerous, and it's very unlikely that a fibroid will turn into cancer. They can also be called myomas or leiomyomas. Fibroids can occur inside the uterus, but they can also be found on the outer surface of the uterus, within its wall, or attached to it. They also greatly vary in size and shape, and have the potential to grow either rapidly or slowly over time. Some women may only have one fibroid, while others have many fibroids of different sizes. Fibroids do occur more frequently in Black women, and the typical age is 30-40, although they can certainly develop earlier. We are not quite sure why Black women are at greater risk for this, but there does appear to be a genetic component.
So how do I know I have them?
Sometimes, you may have no symptoms at all and may only find out you have them as an incidental finding on an ultrasound. If you do have symptoms, you will more than likely experience:
Longer, more frequent, or heavier periods (some women even develop anemia due to the excessive bleeding)
More painful menstrual cramps
Spotting in between periods
Pelvic pain even when it's not time for your period
Pain during sex
Frequent urination (fibroids cause your uterus to grow, which then places more pressure on your bladder)
Difficulty urinating
Constipation
Enlarged uterus/abdomen
Miscarriages
Infertility
What can I do about them?
If the fibroids are small and not causing you any discomfort, you can actually leave them alone. However, if they are affecting your daily life, you can consider conservative or surgical management.
Conservative Treatment - Hormonal birth control methods can be used to regulate periods, control heavy bleeding, and reduce menstrual cramps. I talk about birth control in this blog post here. You can also try Gonadotropin-releasing hormone (GnRH) agonists, which stop your periods and can shrink the fibroids. Due to the many side effects associated with this medication, these would only be used for about 6 months, sometimes before surgery to reduce the risk of bleeding.
Surgical Treatment - If you are still having issues, you can consider surgical management, especially if the fibroids are preventing you from successfully conceiving. A myomectomy is a surgery that removes the fibroids. Be sure to check with your provider if you will still be able to have a vaginal birth after your surgery, as some incisions require a C-section for all future deliveries. Also, its important to understand that new fibroids can develop and that a myomectomy isn't a permanent solution. If you are done having kids or have no interest in conceiving, you can consider a hysterectomy, which is a surgery that removes the entire uterus. This is used as a last resort but definitely a permanent solution.
Other Treatments - You could also consider a uterine artery embolization. This is when tiny particles are injected into the blood vessels that lead to the uterus, cutting off the blood flow to the fibroids and causing them to shrink. This is an outpatient procedure. Some women also report that changing their diet to consist of more vegetables, fruits, and lean protein has helped their symptoms, but there is no current evidence to support this.
It's always best to speak with your provider, as the location and size of your fibroids will determine the best treatment option for you.
xoxo, Global Midwife
Disclaimer: This is only to be used for educational purposes, not as medical advice. Always check with your individual healthcare provider.
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