Definition A fibroid is a non-cancerous growth in the wall of the uterus. A fibroid can be any size from microscopic to as large as a football.
What is going on in the body? Fibroids are firm, round lumps that often occur in groups. They are made up of muscle and fibrous tissue. Fibroids usually grow very slowly in the wall of the uterus. They respond to increased levels of oestrogen. Fibroid tumours can grow rapidly when a woman is pregnant, taking oral contraceptives, or using hormone replacement therapy. After menopause, fibroids may shrink or disappear completely.
Fibroids are very common, especially in women over 35 years old. They rarely become malignant or cancerous. Fibroids that grow near the outer surface of the uterus can be felt as lumps during a pelvic examination. Fibroids growing in the lining of the uterus may be harder to detect during a pelvic examination.
What are the signs and symptoms of the condition? Some women have no symptoms with uterine fibroids. Symptoms depend on the number, size, and location of fibroids, and may include:
pain or pressure in the lower abdomen or lower back
anaemia, or a low red blood cell count, from heavy bleeding
frequent urination, caused by tumour pressure on the bladder
What are the causes and risks of the condition? No clear cause of uterine fibroids is known. Research indicates that fibroids may be influenced by oestrogen and progesterone, but hormones are not the cause of fibroids. African and Asian women seem to have a higher risk for fibroid tumours.
What can be done to prevent the condition? Since the cause of uterine fibroids is not yet known, no way is known to prevent them.
How is the condition diagnosed? Uterine fibroids can often be found during a pelvic examination. The diagnosis can be confirmed by an ultrasound. Sometimes a hysteroscopy will be performed. This is a minor surgical procedure in which tissue is scraped from the inside of the uterus. A hysteroscopy, in which a fibre-optic tube is used to examine the inside of the uterus, is also done. These procedures are needed to rule out other problems, such as uterine cancer or polyps.
What are the long-term effects of the condition? Fibroids can make it difficult to conceive a baby. During pregnancy, a fibroid can cause a miscarriage or difficulty with delivery. A fibroid can also become twisted and need emergency surgery. Although rare, it is possible for a fibroid to become cancerous.
What are the risks to others? Fibroids are not contagious. A fibroid may pose a risk to the foetus during pregnancy. Women with fibroids may be monitored closely during pregnancy.
What are the treatments for the condition? Most fibroids do not cause symptoms and don't need treatment. Sometimes, medications are used to shrink the tumour by decreasing the level of oestrogen in the blood.
Women with symptoms like heavy bleeding and pain may need surgery. If the woman is not planning on having any more children, a hysterectomy may be recommended. This is surgery to remove the uterus. If the woman would like to become pregnant in the future, a myomectomy may be done instead. This is surgery to remove only the fibroid. The uterus is left intact.
Another procedure that may be performed is an arterial embolisation. A tube is threaded into a uterine artery. Small beads are injected into the artery leading to the tumour. This blocks the blood flow to the artery, shrinking the fibroid.
What happens after treatment for the condition? If a hysterectomy was done, no more fibroids can develop. If the ovaries were removed with the uterus, hormone replacement may be necessary. After a myomectomy, monitoring may be needed to see if the tumour grows back. Fibroids do grow back about 10% of the time after a myomectomy.
How is the condition monitored? Women with fibroids should be examined every 6 months to monitor the size of the fibroid. Any unusual symptoms or concerns should be reported to the doctor.
Author: Eileen McLaughlin, RN, BSN Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
