05/24/2025

Fibromes Utérins

Understanding Uterine Fibroids: What You Need to Know

Uterine fibroids, also known as leiomyomas or myomas, are noncancerous growths that develop in or around the uterus. Though they are common—affecting up to 70-80% of women by age 50—the majority of people with fibroids DO NOT experience symptoms. For around 25%, fibroids can significantly impact their quality of life. If you’re diagnosed with fibroids or suspect you may have them, understanding the condition and knowing your options can help you make informed decisions about your health. However, simply being told you have fibroids does NOT mean that you need to do something aboutthem, since you may be in the 75% of women who are asymptomatic.

What Are Uterine Fibroids?

Uterine fibroids are muscular tumors that grow on the walls of the uterus. They can vary in size, from as small as a pea to as large as a grapefruit, or even larger in some cases. The location of the fibroids within the uterus can also vary, and this can influence the types of symptoms experienced. There are four main types of fibroids:

Intramural fibroids: Located within the muscular wall of the uterus.
Submucosal fibroids: Grow just underneath the lining of the uterus and can extend into the uterine cavity.
Subserosal fibroids: Develop on the outside of the uterus.
Pedunculated fibroids: Grow on stalks extending from the outer or inner surface of the uterus.

Symptoms of Uterine Fibroids

Many women with fibroids may not experience any symptoms, but when they do, symptoms can vary based on the size, number, and location of the fibroids. Common symptoms include:

Heavy or prolonged periods: One of the most common symptoms, fibroids can cause excessive menstrual bleeding, sometimes leading to anemia.
Pelvic pain or pressure: Fibroids can cause discomfort or a feeling of fullness or pressure in the pelvic region.
Frequent urination: Large fibroids may press on the bladder, causing frequent urination or difficulty emptying the bladder.
Constipation: Fibroids that press on the rectum may result in difficulty with bowel movements.
Lower back or leg pain: Depending on their size and location, fibroids may cause pain in the back or legs.
Pain during intercourse: Some fibroids, particularly those located near the cervix or in the uterine cavity, can cause discomfort during sex.

What Causes Uterine Fibroids?

The exact cause of fibroids is unknown, but several factors are believed to contribute to their development:

Hormonal factors: Estrogen and progesterone, hormones that stimulate the development of the uterine lining, also seem to promote fibroid growth.
Genetics: Family history of fibroids increases the likelihood of developing them.
Age: Fibroids are most common during a woman’s reproductive years, particularly in her 30s and 40s, and tend to shrink after menopause.
Other factors: Obesity, high blood pressure, and early menstruation have also been linked to an increased risk of developing fibroids.

Treatment Options for Uterine Fibroids

The best treatment for fibroids depends on factors such as the severity of symptoms, the size and location of the fibroids, and your plans for future pregnancy. Treatment options range from monitoring to medical or surgical intervention.

1. Watchful Waiting

For women with small fibroids and minimal symptoms, no immediate treatment may be necessary. In many cases, fibroids may shrink after menopause due to the drop in estrogen levels. Regular check-ups with your healthcare provider can help monitor the growth of the fibroids.

2. Medications

Several medications can be used to manage symptoms of fibroids:

Hormonal therapy: Birth control pills, patches, or hormonal IUDs can help regulate heavy bleeding and reduce pain, though they won’t shrink the fibroids.
GnRH agonists: These drugs reduce estrogen and progesterone levels, causing fibroids to shrink. They are often used to reduce the size of fibroids before surgery.
Non-hormonal medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can relieve pain but do not affect the fibroids themselves.

3. Minimally Invasive Procedures

If medications aren’t effective, minimally invasive procedures might be an option:

Uterine Fibroid Embolization (UFE): This procedure blocks blood flow to the fibroids, causing them to shrink.
Myolysis: This technique involves using heat, electrical energy, or freezing to destroy fibroids.
Endometrial Ablation: This procedure destroys the lining of the uterus and is an option for women who do not wish to have children in the future. It reduces heavy bleeding but does not remove fibroids.

4. Surgical Options

In cases where fibroids are large or causing severe symptoms, surgery may be recommended:

Myomectomy: This surgery removes fibroids while preserving the uterus. It’s often recommended for women who want to maintain fertility.
Hysterectomy: For women who have completed childbearing or whose symptoms are severe, a hysterectomy (removal of the uterus) may be considered. This is the only treatment that guarantees fibroids will not return.

When Should You Seek Consultation?

If you have fibroids but are not experiencing symptoms, regular monitoring may be all that’s needed. However, it’s important to consult a healthcare provider if you experience:

Heavy or prolonged menstrual bleeding: If your periods are unusually heavy or last longer than usual, seek medical advice.
Pelvic pain or pressure: Any persistent pain or discomfort in the pelvic region should be evaluated.
Difficulty urinating or constipation: If fibroids are pressing on your bladder or rectum, it could lead to problems with urination or bowel movements.
Fertility concerns: If you’re having difficulty conceiving or have experienced multiple miscarriages, fibroids may be a contributing factor, and it’s important to seek medical advice.
Rapid growth or sudden pain: If you notice rapid growth of the fibroids or experience sudden pain, seek immediate medical attention as this could indicate complications like fibroid degeneration.

Conclusion

While uterine fibroids are common and often harmless, they can cause significant symptoms for some women. If you have fibroids or suspect you may have them, it’s essential to understand your treatment options and when to seek consultation. With the right care and guidance, you can manage your symptoms and maintain your health and well-being.

If you’re experiencing symptoms or have concerns about fibroids, don’t hesitate to schedule a consultation with your healthcare provider. Early diagnosis and treatment can help prevent complications and improve your quality of life.