Most women are not familiar with fibroids or their associated symptoms unless they or a loved one is diagnosed with them. Uterine fibroids (aka uterine leiomyomas) are almost always noncancerous but can cause heavy periods, painful sex, and pelvic and lower back pain. Here’s what you need to know about uterine fibroids before making an appointment with leading experts Drs. Miklos and Moore:
Q: Can uterine fibroids turn into cancer?
Fibroids are almost always benign, or non-cancerous. It is extremely rare for this non cancerous tumor to have a cancerous component. When it does occur this is called leiomyosarcoma, and it occurs in less than one in 1,000 patients who have been diagnosed with fibroids. Doctors think that these cancers do not arise from an already-existing fibroid but instead are an independent occurrence not directly related to the fibroid or benign tumor. The point is that having fibroids does not increase the risk of developing a cancerous fibroid. Having fibroids also does not increase a woman’s chances of getting other forms of cancer in the uterus. It has been documented that approximately 50% of all women have fibroids but unless they cause a symptom or a problem for the patient there is not need to address them.
Q: What if I become pregnant and have fibroids?
Asymptomatic small or medium sized fibroids alone are unlikely to present significant risk to pregnancy. However, fibroids can possibly increase in size as a result of increased levels of hormones and blood flow to the uterus during pregnancy. The growth of fibroids may cause discomfort, feelings of pressure, or pain. Additionally, large or multiple fibroids can increase the risk of:
Cesarean Section: The risk of needing a C-section is six times greater for women with fibroids.
Breech Presentation: The baby is positioned with its legs down and head up, rather than the head down.
Placental Abruption: The placenta breaks away from the wall of the uterus before delivery. When this happens, the fetus may not receive oxygen.
Preterm delivery: Talk to your obstetrician if you have fibroids and become pregnant. All obstetricians have experience dealing with fibroids and pregnancy.
Q: Could the fibroids come back after the treatment?
Although treatment may be successful in destroying or removing the fibroids (aka myomectomy) , it is possible more fibroids may grow, become symptomatic and require additional treatment. This is true for all fibroid treatments, except hysterectomy where the entire uterus is removed. However, many women are successfully treated and never have a recurrence of symptomatic fibroids.
Q: How do I know for sure that I have uterine fibroids?
Your doctor may find that you have fibroids when you see them for a regular pelvic exam to check your uterus, ovaries, and vagina and for an annual cervical PAP smear. They may be able to feel the fibroid during an ordinary pelvic exam or most commonly they will order an ultrasound for a definitive diagnosis.
Q: What are the options to remove uterine fibroids?
Sometimes, surgery is required to treat symptomatic fibroids or fibroids which cause abnormal bleeding, uncomfortable pain, pelvic pressure, overactive bladder and painful intercourse. There are three general surgical approaches the first two are the least invasive:
Laparoscopy: During laparoscopy a tiny incision is made in or near the navel, a long, thin scope connected to a camera is inserted into the abdomen and pelvis. The scope has a bright light and a camera and allows your doctor to see the uterus and surrounding structures to determine the location as well as allows him/her to remove the fibroid mass.
Hysteroscopy: For suspected abnormalities inside the uterine cavity, a long, thin scope with a camera and the light is passed through the vagina and cervix into the uterus. No incision is needed. The doctor can look inside the uterus for cavity fibroids or endometrial polyps. If they are present they can be resected (i.e. removed) from this transvaginal approach
Laparotomy: During a laparotomy, not to be confused with laparoscopy, a large incision is made on the abdomen and the fibroids are removed through this 5-6 inch incision versus the smaller incisions of the laparoscopic approach.
Q: Who is at risk for uterine fibroids?
There are various factors that can increase a woman’s risk of developing fibroids:
Age: Fibroids become more common as women age, especially during the 30’s and 40’s through menopause. After menopause, fibroids usually shrink.
Family history: Having a family member with fibroids increases your risk. If a woman’s mother had fibroids, her risk of having them is about three times higher than average.
Ethnic origin: African-American women are more likely to develop fibroids than Caucasian women.
Obesity: Women who are overweight are at higher risk for fibroids. For very heavy women, the risk is two to three times greater than average.
Eating habits: Eating a lot of red meat and ham is linked with a higher risk of fibroids. Eating plenty of green vegetables seems to protect women from developing fibroids.
So if you think or know you have fibroids which are causing you problems then contact Drs. Miklos and Moore to schedule an upcoming appointment! You can be assured you are in the best of surgical hands.