About Uterine Fibroids
All women are at risk of getting fibroids (also called myomas, leiomyomas, fibromyomas). Uterine fibroids are the most common tumors of the female genital tract. They are non-cancerous and occur in 20 to 25% of women of childbearing age. The presence of fibroids is the most common reason for a woman to have a hysterectomy in this country, totaling approximately 200,000 each year. In addition, many patients suffer symptoms from fibroids but never undergo a hysterectomy.
 
African-American women are as much as 3.2 times as likely to develop fibroids as Caucasians— as many as 50% have fibroids of a significant size. The reason for this increased risk is not known. While fibroids may appear in patients in their twenties, most patients do not have any symptoms until their late thirties or forties. The rate increases with age and decreases after menopause.

What are the Symptoms?
The majority of fibroids do not cause symptoms. For those women with symptoms the severity of symptoms can vary greatly depending on the location, size and number of fibroids.

Symptoms may include:

• Heavy, prolonged menstrual periods and unusual monthly bleeding, sometimes with clots. This might lead to anemia.
• Pelvic pain
• Pelvic pressure or heaviness
• Pain in the back or legs 
• Pain during sexual intercourse (dyspareunia) 
• Bladder pressure leading to a constant urge to urinate 
• Pressure on the bowel, leading to constipation and bloating

Symptoms typically improve after menopause when the level of estrogen, the female hormone that circulates in the blood, decreases dramatically. However, menopausal women who are taking supplemental estrogen (hormone replacement therapy) may not experience a relief of symptoms.

Symptoms can be related to the location of fibroids.

• Subserosal fibroids develop in the outer portion of the uterus and expand outward. They typically do not affect a woman's menstrual flow, but can become uncomfortable because of their size and the pressure they cause.
• Intramural fibroids develop within the uterine wall and expand, making the uterus larger than normal. These are the most common fibroids. This can result in heavier menstrual flows and pelvic pain or pressure. 
• Submucosal fibroids are deep within the uterus, just under the lining of the uterine cavity. These are the least common fibroids, but they often cause symptoms, including very heavy and prolonged periods.

How are Uterine Fibroids Diagnosed?
Fibroids are usually diagnosed during a gynecologic examination. The presence of fibroids is most often confirmed by a pelvic ultrasound. Fibroids also can be confirmed using computed tomography (CT) imaging and magnetic resonance (MR) techniques.

Ultrasound, MR and CT are painless diagnostic tests. They allow for the detection of the fibroid tumor, as well as location and size. Finally, they serve as a baseline examination for the follow-up after treatment.

What are the Treatment Options?
Many women live with fibroids without knowing it and have no symptoms. For those women who do have symptoms there are various levels of treatment available depending on the severity of the fibroids.

• Medical management with drug therapy
• GnRH (gonadotropin-releasing hormone) therapy
• Total or subtotal hysterectomy
• Endometrial ablation
• Myomectomy
• Uterine fibroid embolization (UFE)

Click here for a fact sheet of treatment options offered at the Fibroid Clinic