Fibroids are noncancerous growths that develop on the inner or outer walls of the uterus or in the inner layer of the organ’s muscle. An estimated one in five women develops fibroids during her childbearing years, and half of all women have them by age 50. They vary widely in size, from microscopic to as large as 12 inches in diameter.
Many fibroids do not cause symptoms. If they do, symptoms often include bloating; chronic pelvic pain; heavy, painful, and prolonged menstrual periods; infertility; pain with defecation, urination, or sex; and pressure in the pelvic area. Even small fibroids can cause symptoms.
No one knows exactly what causes fibroids, but hormones such as estrogen seem to fuel their growth. Symptoms sometimes go away with menopause, when estrogen decreases, causing them to shrink gradually. Risk factors include being African American, over 40 years old, or obese; and having a family history of fibroids. NYU Langone doctors have extensive experience in diagnosing and treating fibroids.
Your NYU Langone gynecologist takes a medical history, performs a pelvic exam, and orders tests. He or she may ask about your menstrual flow. This is because fibroids can cause heavy periods, which can lead to anemia, a condition in which the body has too few oxygen-rich red blood cells.
Sometimes fibroids can be felt during a pelvic exam, depending on their size and location. During the pelvic exam, your doctor checks for an enlarged uterus and lumps on the uterine wall, which can indicate fibroids.
If your doctor notices that your uterus is enlarged or detects an abnormal mass during the pelvic exam, he or she may order a pelvic ultrasound to check for fibroids. In this type of imaging, sound waves create images of the pelvic organs on a computer monitor.
After an ultrasound indicates that you have fibroids, your doctor may order an MRI to pinpoint their number and size, as well as where they are located in the uterus. An MRI uses a magnetic field and radio waves to create computerized, three-dimensional images of the uterus.
The results of the MRI can help your doctor decide which treatment is best for you. It also helps to rule out adenomyosis, a condition in which the lining of the uterus grows into the muscular wall, causing symptoms similar to those caused by fibroids, such as pelvic pain and heavy menstrual flow.
During a hysteroscopy, your doctor inserts a thin, lighted scope through the vagina into the uterus. This procedure allows him or her to diagnose fibroids and surgically remove them during the same procedure.
A hysteroscopy is performed on an outpatient basis using local or general anesthesia; you and your doctor decide which type of anesthesia is used. Recovery typically takes one to three days and depends on the number, size, and location of the fibroids. You may experience light vaginal bleeding and cramping immediately after the procedure.