Uterine fibroids, also known as Leiomyomas, are solid, non-cancerous tumors that vary in size and location, made of smooth muscle cells inside the muscle that makes up the uterus. It is estimated that up to 70% of women have fibroids by the time they enter menopause.

The prevalence of fibroids is 2-3 times higher in black women compared to white women, a fact still not completely understood but that may involve many factors aside from race itself such as systematic racism and environmental exposure among other factors. We do know that for some women with fibroids, there is a genetic aspect going back generations. Additional risk factors have been studied including the role of diet, obesity, smoking, alcohol, and more.

Many women with fibroids do not have any symptoms and live their entire lives without knowing they even have them. For women who are symptomatic, however, the most common symptoms are heavy menstrual periods, pelvic pressure and pelvic pain

Fibroids and fertility

While fibroids are harmless, they can sometimes affect fertility depending on their location within the uterus. They may also impact a pregnancy. Some women experience constipation and urinary issues due to larger fibroids pressing down on the bowel or putting pressure on the bladder.

 While we are sometimes able to feel fibroids on the uterus during a physical exam in the office, the size and location of fibroids is determined by imaging using a pelvic ultrasound or MRI.

Preventing fibroid tumors

Unfortunately, there is nothing to prevent fibroids. However, if you have them, there are various treatment options to discuss with your care provider.

• Therapies using medications:  Hormonal and non-hormonal medications are available for those who suffer from heavy bleeding due to fibroids. Other medications may slow the growth of fibroids or decrease their size.
• Interventional therapies: The options available are uterine artery embolization, radiofrequency ablation, and focused ultrasound, which are treatments that are non-surgical and help reduce the size of the fibroids.
• Surgical management: There are surgical options available that include removing each fibroid from the uterus. This is called a myomectomy. We can also remove the entire uterus, known as a hysterectomy. Both surgeries can be performed with minimally invasive laparoscopy.

Minimally invasive laparoscopy involves making small incisions on the abdomen and performing the surgery using a camera. This technique allows you to go home the same day with a shorter recovery time compared to open abdominal surgeries.  

Women who have fibroids inside the cavity of the uterus are candidates for hysteroscopic removal of fibroids. Hysteroscopy is a technique in which an instrument with a camera is placed into the uterus through the vagina allowing us to perform surgery of the uterine cavity.

Talk to your gynecologist

It is important to talk with your gynecologist regarding all treatment options to find the best management option for you. Every patient is on a different life journey with different needs. You need a treatment option tailored specifically for you.