Uterine Fibroids

GENERAL INFORMATION:

What are uterine fibroids?

• Uterine fibroids, also called fibromyomas or myomas, are benign tumors (lumps) of the uterus (womb). A benign tumor means that it is not cancer and does not spread to other parts of your body. Uterine fibroids occur when the cells grow and divide without control or order. This causes the growth of too much tissue on the inside, outside, or within the muscle wall of the uterus. Sometimes, uterine fibroids may reach down to the cervix (bottom part of the uterus). Uterine fibroids are usually pale, hard, and feel like a rubbery mass. They may vary in size and are most commonly seen in African-American women.
  
  
• The uterus is a female organ found in the lower stomach (abdomen) and is attached to the vagina. The uterus is where a baby grows when a woman is pregnant.

What causes uterine fibroids? Caregivers do not exactly know what causes uterine fibroids. It is thought that uterine fibroids form when there is an increase in the estrogen hormone. The following may put you at a higher risk for having uterine fibroids:

• Age: Women above 30 years of age or in their childbearing age are usually affected. Uterine fibroids are more likely to occur as women age.
  
  
• Chemicals: Certain chemicals, such as pesticides or herbicides, may contain high levels of estrogen. These chemicals are also found in certain foods, such as meat fat, fish, dairy products, and egg yolks.
  
  
• Early menstruation: Women who may have started their monthly period at an early age.
  
  
• Genetic: You may have been born with genes that may cause uterine fibroids. A gene is a piece of DNA that tells your body what to do or what to make.
  
  
• Infertility: Not having children may increase your risk of having uterine fibroids.
  
  
• Obesity: Weighing more than what is suggested by your caregiver.

What are the signs and symptoms of uterine fibroids? Most uterine fibroids do not have any symptoms. If symptoms are present, you may have any of the following:

• Abdominal and lower back pain before or during your monthly period
  
  
• Feeling full or bloated.
  
  
• Heavy monthly periods or vaginal bleeding at times other than your monthly period.
  
  
• Infertility (unable to get pregnant).
  
  
• Pain during or after sex.
  
  
• Pain when passing urine or with bowel movements (BM).

How are uterine fibroids diagnosed? You may be given dye through an IV in your vein in some of these tests. The dye helps the uterus show up better in the pictures. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell your caregiver if you are allergic to any of these foods. You may have any of the following tests:

• Pelvic exam: This is also called an internal or vaginal exam. During a pelvic exam, feel free to ask for a woman to be present if one is not. Your caregiver gently puts a warmed speculum into your vagina. A speculum is a tool that opens your vagina. This lets your caregiver see your cervix (bottom part of your uterus). With gloved hands, your caregiver will check the size and shape of your uterus and ovaries.
  
  
• Hysteroscopy: This test uses a scope that is put into your uterus through your vagina and cervix. This helps your caregiver look into your uterus and see the fibroids.
  
  
• Imaging tests:
  
  
  • Hysterosalpingography: This test, also called HSG, uses x-rays to take pictures of the inside of the uterus. A dye may be injected so your caregivers may have a better view.
    
    
  • KUB x-ray: An x-ray machine takes pictures of your kidneys (K), ureters (U), and bladder (B). The ureters are tiny tubes that carry urine from your kidneys to your bladder. The bladder is where the urine is stored before leaving your body. Caregivers use these pictures to check for problems with your intestines , kidneys, or abdomen.
    
    
  • Magnetic resonance imaging scan: This test is also called an MRI. During the MRI, pictures are taken of your abdomen and pelvic (hip) areas. You will need to lie still during a MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury.
    
    
  • Ultrasound: Sound waves are used to show pictures of the inside of your abdomen. A small handle with lotion on it is gently moved around your abdomen. The handle may also be placed in your vagina. Pictures of your uterus, tubes, cervix, vagina, rectum, or other organs are seen on a TV-like screen.
  
  
• Laparoscopy: This is surgery to look inside your abdomen using a laparoscope. A laparoscope is a thin, lighted tube with a camera at the tip. Caregivers may remove a piece of tissue from your uterus, cervix, or other organs. The tissues are sent to a lab for tests to see if the growths found are uterine fibroids.

How are uterine fibroids treated? Treatment of uterine fibroids depends on how fast and how large they are growing. You may have any of the following:

• Watchful waiting: Your caregiver may want you to have regular checkups to see if your uterine fibroids continue to grow.
  
  
• Medicines: Hormones, pain medicines, or steroids may be given. These are used to treat pain, swelling, unusual monthly periods, or difficulty getting pregnant. Hormone therapy may help make uterine fibroids smaller. Iron supplements may also be given to avoid anemia (low red blood cell count) due to heavy monthly periods.
  
  
• Surgery: You may need surgery to remove your uterine fibroids, the muscles of your uterus, or your entire uterus. Surgery to treat uterine fibroids is usually done in women who are not pregnant.
  
  
• Other procedures:
  
  
  • Ablation: Uterine fibroids may be made smaller by using a special thermal (heat) ultrasound or freezing ablation treatment. You may also have a laser procedure to remove the uterine fibroids. Ask your caregiver about these different treatment options for uterine fibroids.
    
    
  • Embolization: This is a procedure that closes off or decreases blood flow to the uterine fibroids. Without a blood supply, uterine fibroids will get smaller and may even disappear. One or more fibroids may be treated in the same session.

Where can I find support and more information? Uterine fibroids can be a life-changing condition for you and your family. Accepting that you have uterine fibroids may be hard. You and those close to you may feel scared, angry, or sad. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Contact the following for more information:

• American Academy of Family Physicians
  PO Box 11210
  Shawnee Mission, KS 66207-1210
  Phone: 1-913-906-6000
  Web Address: http://www.aafp.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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