Uterine fibroids—also called leiomyomas (lie-o-my-O-muhs) or myomas—are noncancerous growths of the uterus. They can be one or many and may range in size from so small they cannot be seen by the human eye, to large masses. There are four types:
1) intramural, which grow within the muscular uterine wall;
2) submucosal, which bulge into the uterine cavity;
3) subserosal, which project to the outside of the uterus; and
4) cervical, which are in the cervix.
Fibroids may cause no symptoms at all, but about one in three women who have them will experience some combination of the following:
• heavy, painful periods
• pain during intercourse
• anemia, as a result of heavy periods
• backache or leg pain
• discomfort in the lower abdomen
• frequent urination
The cause of uterine fibroids is unknown, but it may be related to estrogen levels. Most fibroids occur during childbearing years, and estrogen levels are high. These years are also when women are most likely to be taking birth control pills that contain estrogen. When estrogen levels are high, fibroids tend to swell. Heredity may also play a role, and so may intake of red meat, alcohol, and caffeine.
Most fibroids — especially in patients with no symptoms—are diagnosed during routine vaginal examinations. They may also be detected through ultrasound, MRI, hysteroscopy, and laparoscopy, which can all also rule out other conditions.
Treatment options include medications and surgery. Medications used are over-the counter anti-inflammatory medications like ibuprofen; birth control pills; and intrauterine devices which release a progestogen hormone called levonorgenstrel, which stops the lining of the uterus from growing too fast, thus reducing bleeding.
Surgery may be required if the symptoms are severe and medications have not provided relief. Several types of procedures may be considered:
• MRI-guided per-cutaneous laser ablation (shrinking fibroids via needles and fiber-optic cable)
• MRI-guided focused ultrasound surgery (shrinking fibroids via sound waves)
• Uterine artery embolization (UAE) or uterine fibroid embolization (UFE) (cutting off the blood supply to the area via catheter)
• Myomectomy (removal of the fibroids)
• Edometrial ablation (removal of the lining of the uterus)
• Hysterectomy (removal of the uterus)
A uterine fibroid research study conducted by experts from the Mayo Clinic, the Cleveland Clinic, and the University of North Carolina in 2013 found that fear and lack of knowledge about treatment options may be preventing women from seeking treatment. It found that women delayed seeking treatment for an average of 3.6 years, with nearly a third waiting more than 5 years. “Our study shows that women suffer too long before seeking treatment. This can narrow their range of effective options,” said Dr. Elizabeth A. Stewart, lead author of the study, said. “Women are concerned about missing work and not reaching their career potential due to their symptoms…”
Research is critical to improving the education, prevention, early diagnosis, and treatment of uterine fibroids. Meridien Research has studies that are enrolling now at our St. Petersburg clinic. For more information or to see if you or someone you know may qualify to participate, please contact us today at 727-347-8839 or visit our individual study pages.