Common Gynecological Problems & Procedures

Fibroid tumors

What makes them grow is not known. Most fibroids occur in women of reproductive age, and according to some estimates, they are diagnosed in black women two to three times more frequently than in white women. They are seldom seen in young women who have not begun to menstruate and they usually stabilize or shrink during menopause.

Are they common?

Fibroids are the most frequently diagnosed tumor of the female pelvis. It is important to know that these are benign tumors. They are not associated with cancer, they virtually never develop into cancer, and they do not increase a woman's risk for uterine cancer.

Symptoms

Most fibroids do not cause any symptoms and do not require treatment other than regular observation by a physician. Fibroids may be discovered during routine gynecologic examination or during prenatal care. Some women who have uterine fibroids may experience symptoms such as excessive or painful bleeding during menstruation, bleeding between periods, a feeling of fullness in the lower abdomen, frequent urination resulting from a fibroid that compresses the bladder, pain during sexual intercourse, or low back pain. Certain reproductive symptoms such as infertility, recurrent spontaneous abortion, and early onset of labor during pregnancy have been attributed to fibroids. In rare cases, a fibroid can compress and block the fallopian tube, preventing fertilization and migration of the ovum (egg); after surgical removal of the fibroid, fertility is generally restored.

Treatment

Until very recently, a woman with growing uterine fibroids was considered a candidate for hysterectomy (removal of the uterus). However, treatment by hysterectomy in a woman of reproductive age means that she will no longer be able to bear children and hysterectomy may have other effects, both physical and psychological, as well. A woman considering hysterectomy should discuss the pros and cons thoroughly with her physicians.

More and more, physicians are beginning to realize that uterine fibroids may not require any intervention or, at most, limited treatment. For a woman with uterine fibroids that are not symptomatic the best therapy may be watchful waiting. Some women never exhibit any symptoms nor have any problems associated with fibroids, in which case no treatment is necessary. For women who experience occasional pelvic pain or discomfort, over-the counter anti-inflammatory or pain-reducing drug often will be effective. More bothersome cases may require stronger drugs available by prescription.