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  • Women's Health: Uterine Fibroids Fibroid Qandamp;A: Causes, Risks andamp; Treatment

  • Women's Health: Uterine Fibroids
    Fibroid Q&A: Causes, Risks & Treatment

    • What causes fibroids?
      The exact cause of uterine fibroids remains unknown. Hormones, most notably estrogen, stimulate the growth of fibroids. Lack of such hormones will often cause fibroids to shrink. This explains the tendency for fibroids to enlarge during the years of menstruation (when estrogen levels are high) and to decrease in size after menopause (when estrogen levels are low). Since fibroids are sensitive to hormones, medications that alter hormone levels may be used as treatment. Such medications include oral contraceptives and GnRH agonists.

    • Who is most likely to have fibroids?
      Any woman may have fibroids. The overall likelihood of having fibroids increases with age. Approximately 20% of women in their 20's have fibroids, 30% of women in their 30's, and 40% of women over age 40. Fibroids are known to be more common in African-American women and as many as 50% will have significant fibroids. Fibroids also tend to be familial, meaning that they are more common in certain families.

    • What problems can fibroids cause?
      Most women with fibroids will have little or no symptom related to them. Unfortunately, 20-40% of women do have significant symptoms related to fibroids. These symptoms vary according to the size and location of the fibroid (see previous discussion). The most common symptom is heavy, prolonged, or irregular menstrual bleeding. This bleeding often results in iron-deficiency anemia. Pelvic pain and a sensation of pelvic fullness or bloating are also very common symptoms. Some women report that their clothes no longer fit because fibroids have caused such enlargement of their uterus. Less commonly, fibroids can result in frequent urination, painful intercourse, and inability to achieve or sustain pregnancy. Other conditions, such as endometriosis, can often mimic the symptoms produced by fibroids or coexist with fibroids in the same woman. This fact makes it imperative that a woman has a complete physical examination and full imaging evaluation prior to any planned treatments.

    • What should I do if I think I may have fibroids?
      First, talk with your primary care physician. In most cases this will be an internist, family doctor, or gynecologist. He or she will carefully review your current symptoms along with your medical history and will most likely perform a pelvic exam to evaluate your uterus. If your doctor does not provide gynecological services he or she will refer you to a qualified physician who does. A pap smear will be performed for most women, especially those with bleeding problems. More extensive evaluation of the uterine lining (such as endometrial biopsy) will vary according to a woman's history and age. Most women will require a study to examine the appearance of the uterus, ovaries, and pelvic structures. Ultrasound or MRI may be used to accomplish this. Both tests are performed on an outpatient basis and cause minimal discomfort. Your doctor will help decide which test is best for you.

    What treatments are available for fibroids?

    Information in this section is provided by Rhode Island Hospital's department of radiology, which offers a complete range of diagnostic and interventional procedures for women, including uterine artery embolization, a leading treatment for fibroid tumors.

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