Mark Kellum, MD
Fibroids are growths on the uterus. They are not cancerous. They can cause problems in some people but in others they may cause absolutely no problems at all. This condition is very common. While the scientific name for them is leiomyoma, most people refer to them as fibroids or myomas. (I have heard some refer to them as ‘fireballs of the Eucharist’, instead of fibroids of the uterus.)
The normal uterus is made up of muscle cells. Uterine fibroids are abnormal collections of these muscle cells. These abnormal collections of muscle cells can be as small as ½ inch in diameter or as large as a foot (or more) in diameter. Sometimes there can be one in the uterus and sometimes there can be more like ten. They can be located at several different areas within the uterus.
We really don’t understand what causes fibroids. Sometimes fibroids grow and other times they remain the same or even shrink. As a rule, when a woman enters the menopause, fibroids tend to shrink, but this is not always the case. Hormone replacement therapy and the birth control pill may cause fibroids to grow, but not always.
Many times fibroids are found during a routine pelvic examination. These fibroids might be causing absolutely no problems. When fibroids do cause problems, problems with the menses are perhaps the most common symptom. Menses may become longer, heavier, or more painful as a result of fibroids. Bleeding between menses is a common symptom. Sometimes the heavy bleeding can result in anemia. In addition to problems with menses fibroids can cause some pain or pressure between menses and sometimes pain with sex. Sometimes infertility or miscarriages can be traced to fibroids.
Most of the times uterine fibroids are suspected based on a pelvic exam, but other tests help confirm them. The most common test we use is called an ultrasound (also called a sonogram). This is a sound wave test done in our office. Most of the time a vaginal probe is used to get a good look at the uterus at the time of a sonogram. Sometimes other tests are needed to visualize the fibroids
Many times no treatment will be necessary, but at other times it will be important to do some type of therapy. That treatment might be as easy as taking iron to combat the anemia or taking Birth Control Pills or an IUD to control the bleeding. It is possible that surgery could be necessary. Surgery could include removing the uterus with the fibroids in it or just removing the fibroids. The type of treatment (or not treatment at all) will be made based on several things. These things include your desire for future childbirth as well as the amount of problems that the fibroids are causing.