These masses are the most common type of tumor found in the female genital tract. Roughly 1 in 3 women over age 35 will develop them in the uterine wall. The four types of fibroids are classified by their location:
Submucous (submucosal): These develop just under the endometrial lining of the uterus.
Intramural: These tumors appear in the muscular wall.
Subserosal: These fibroids develop under the outside covering of the uterus.
Pedunculated: These tumors grow on stalks. They either project from the uterine surface and can be confused with ovarian masses or they project from the uterine interior and extend through the cervix.
Fibroids develop from single uterine wall cells that transform. Although the cause for the transformation is unknown, we do know there is a genetic link. The female hormones estrogen and progesterone, as well as other growth factors, are related to fibroid growth.
Any woman of childbearing age can develop uterine fibroids. However, African American women have a higher incidence – up to 75 percent. Uterine fibroid risk also increases with obesity.
A lower incidence has been associated with women who:
Most uterine fibroid cases are asymptomatic. Between 60-90 percent of women don’t experience any symptoms at all.
If symptoms appear, they show up in the late 30s and 40s and worsen during perimenopause, the years immediately preceding menopause when your hormones and menstrual cycle begin to change. Some women may develop only one fibroid, but the average is six or seven. Most tumors are golf-ball size, but they can grow to the size of a melon.
Whether a woman experiences symptoms can depend on the number, location, and size of her fibroids.
Diagnosing uterine fibroids usually begins with an internal pelvic exam. During this exam, your doctor will determine if you have an enlarged or irregularly shaped uterus. The diagnosis can be confirmed in one of five ways:
The best treatment option for you depends on what symptoms you have and how bad they are. Your doctor will also consider the size, number, and location of the fibroids, as well as whether you want to preserve your fertility.
TREATMENT OPTIONS INCLUDE:
Watchful waiting: Most fibroids don’t cause symptoms. They can be managed by checking their growth during an annual physical exam.
Medication: The first line of therapy for patients with symptoms, particularly abnormal bleeding.