What Are the Symptoms of Fibroids?
The good news is that the great majority of women with uterine fibroids have absolutely no symptoms what-so-ever. When symptoms do develop however, the most common complaints are:
- Heavy periods (often with clotting)
- Prolonged periods, generally lasting longer than 8 days
- Spotting or bleeding between periods
- Painful periods.
- Pelvic pain and/or pressure.
- Dyspareunia: Pain with intercourse.
- Urinary frequency and leakage of urine.
- Constipation.
- Recurrent miscarriages or problems conceiving.
- Abdominal distension.
- Back pain.
- Anemia due to heavy and/or prolonged periods.
How Are Fibroids Diagnosed?
Fibroids can usually be diagnosed by your OB/GYN with a simple, in-office pelvic examination. Generally however, a pelvic ultrasound will also be ordered to confirm the diagnosis. Sometimes a special type of ultrasound called a sonohysterogram, may be performed to look inside of the uterine cavity for fibroids.
How Do You Treat Fibroids?
Remember, up to 80% of women will develop fibroids, so they only need to be treated if they are either symptomatic (see symptoms above) or if they grow rapidly. Very rarely fibroids can become cancerous, an entity known as a leiomyosarcoma, which only occurs in 1 of every 10,000 cases.
There are multiple treatment options for uterine fibroids including expectant management, medical management and surgical management.
1. Expectant management is the option of doing nothing at all. If the fibroids are not causing problems, we frequently recommend expectant management since they will shrink after menopause.
2. Medical management includes all of the medications used to treat fibroids. These medications will not cure fibroids but they will reduce their symptoms while hopefully at least slowing their growth:
- Oral Contraceptive Pills (OCPs)
- Depo Provera: An injection given every 3 months that reduces or eliminates periods
- Mirena IUD: A 5-year intrauterine contraceptive device that is also FDA approved to reduce or eliminates periods
- Lupron: An injection that mimics the effect of menopause, resulting in reduction of fibroid symptoms and size. Lupron cannot be used long-term because of side effects, but it is a good medication for women close to menopause or for women considering surgery who want to reduce the size of the fibroids allowing a minimally invasive procedure.