Why uterine fibroids grow

How are uterine fibroids diagnosed? Your doctor may also do blood tests to look for anemia or other problems. How are they treated? Surgery to take out the fibroids is called myomectomy. Your doctor may suggest it if you hope to get pregnant or just want to keep your uterus. It may improve your chances of having a baby. But it does not always work, and fibroids may grow back.

Surgery to take out your uterus is called hysterectomy. It is the only way to make sure that fibroids will not come back. Your symptoms will go away, but you will not be able to get pregnant. Health Tools Health Tools help you make wise health decisions or take action to improve your health. Decision Points focus on key medical care decisions that are important to many health problems. Cause The exact cause of uterine fibroids is not known. Symptoms Uterine fibroid symptoms can develop slowly over several years or rapidly over several months.

Uterine fibroid symptoms and problems include: Abnormal menstrual bleeding , such as: Heavier, prolonged periods that can cause anemia. Painful periods. Spotting before or after periods. Bleeding between periods. Pelvic pain and pressure , such as: Pain in the abdomen, pelvis, or low back.

Pain during sexual intercourse. Bloating and feelings of abdominal pressure. Urinary problems , such as: Frequent urination. Leakage of urine urinary incontinence. Kidney blockage following ureter blockage rare. Other symptoms , such as: Difficulty or pain with bowel movements. Sometimes, fibroids make it difficult to become pregnant.

Problems with pregnancy, such as placental abruption and preterm labor. What Happens Uterine fibroids can grow on the inside wall of the uterus, within the muscle wall of the uterus, or on the outer wall of the uterus. Complications of uterine fibroids aren't common.

They include: Anemia from heavy bleeding. Problems with the urinary tract or bowels, if a fibroid presses on them. Infertility , especially if the fibroids grow inside the uterus and change the shape of the uterus.

Ongoing low back pain or a feeling of pressure in the lower abdomen pelvic pressure. Infection or a breakdown of uterine fibroid tissue. Fibroids can cause problems during pregnancy, such as: The need for a cesarean section delivery. This is the most common effect of fibroids on pregnancy. Pain during the second and third trimesters. An abnormal fetal position, such as breech position , at birth. Placenta problems. Fibroids become more common as women age, especially from the 30s and 40s through menopause.

After menopause, fibroids usually shrink. Family history. Having a family member with fibroids increases your risk. Ethnic origin. Black women are more likely to develop fibroids than white women. When should you call your doctor? Call to make an appointment if you have possible symptoms of a problem from a uterine fibroid, including: Heavy menstrual bleeding. Periods that have changed from relatively pain-free to painful over the past 3 to 6 months. Frequent painful urination, or an inability to control the flow of urine.

A change in the length of your menstrual cycle over 3 to 6 menstrual cycles. New persistent pain or heaviness in the lower abdomen or pelvis. Watchful waiting Unless you have bothersome or severe symptoms, you will probably only need to have a fibroid checked during your yearly gynecological exam. During a pregnancy, your doctor will check for changes in fibroid size and position.

Who to see Uterine fibroids can be diagnosed and treated by any of the following health professionals: Family medicine physician Gynecologist Internist Nurse practitioner Physician assistant You may need to see a gynecologist for further testing or treatment. Exams and Tests Your doctor may suspect that you have a uterine fibroid problem based on: The results of a pelvic exam. The history of your symptoms and your menstrual periods.

Additional testing If you have severe pain, bleeding, or pelvic pressure or have had repeat miscarriages or trouble becoming pregnant, you will probably have other tests to look for other possible causes of your symptoms.

Treatment Overview Most uterine fibroids are harmless, do not cause symptoms, and shrink with menopause. Watchful waiting for minimal fibroid symptoms or when nearing menopause If you have uterine fibroids but you have few or no symptoms, you don't need treatment. For heavy menstrual bleeding or pain If you have pain or heavy menstrual bleeding, it may be from a bleeding uterine fibroid. The following medicines are used to relieve heavy menstrual bleeding, anemia, or painful periods, but they do not shrink fibroids: Nonsteroidal anti-inflammatory drug NSAID therapy improves menstrual cramping and reduces bleeding for many women.

Birth control hormones pill, patch, or ring lighten menstrual bleeding and pain while preventing pregnancy. An intrauterine device IUD that releases small amounts of the hormone progesterone into the uterus may reduce heavy menstrual bleeding.

A progestin shot Depo-Provera every 3 months may lighten your bleeding. It also prevents pregnancy. Based on different studies, progestin may shrink fibroids or may make them grow. Iron supplements, available without a prescription, are an important part of correcting anemia caused by fibroid blood loss.

For infertility and pregnancy problems If you have fibroids, there is no way of knowing for certain whether they are affecting your fertility. For severe fibroid symptoms If you have fibroid-related pain, heavy bleeding, or a large fibroid that is pressing on other organs, you can consider shrinking the fibroid, removing the fibroid myomectomy , or removing the entire uterus hysterectomy. GnRH-a therapy can help to: Shrink a fibroid before it is surgically removed. This lowers your risk of heavy blood loss and scar tissue from the surgery.

Provide short-term relief as a "bridge therapy" if you are nearing menopause. Fibroids naturally shrink after menopause. Prevention There is no known treatment that prevents uterine fibroids. Home Treatment Home treatment can ease menstrual period pain and anemia that may be linked to uterine fibroids.

Tips for relieving menstrual pain Painful menstrual periods dysmenorrhea are one of the most common symptoms of fibroids. Try one or more of the following tips to help relieve your menstrual pain: Nonsteroidal anti-inflammatory drugs NSAIDs , such as ibuprofen, help relieve menstrual cramps and pain. Be safe with medicines. Read and follow all instructions on the label. Apply heat to the lower abdomen by using a heating pad or hot water bottle or taking a warm bath.

Heat improves blood flow and may improve pelvic pain. Most women with uterine fibroids have an enlarged uterus.

This typically causes abrupt, severe pain and tenderness. There is no known treatment that prevents uterine fibroids, but you can take some precautionary steps that may slow their growth or minimize symptoms, such as adopting a fibroid-friendly diet.

A study showed that women who consumed milk, cheese, ice cream, or other dairy products at least once a day were less likely to develop fibroids than women who consumed dairy less frequently. Additionally, artificial hormones, such as those used in birth control pills, tend to slow fibroid growth.

There are minimally invasive alternatives to surgery , including uterine fibroid embolization. Of the conservative treatments for uterine fibroids, uterine fibroid embolization has the longest track record and has a significantly lower rate of major complications compared with surgery.

Because no one knows for sure what causes fibroids, we also don't know what causes them to grow or shrink.

We do know that they are under hormonal control — both estrogen and progesterone. They grow rapidly during pregnancy, when hormone levels are high. They shrink when anti-hormone medication is used.

They also stop growing or shrink once a woman reaches menopause. Rarely less than one in 1, a cancerous fibroid will occur. This is called leiomyosarcoma. 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. Women who have fibroids are more likely to have problems during pregnancy and delivery. This doesn't mean there will be problems.

Most women with fibroids have normal pregnancies. The most common problems seen in women with fibroids are:. Talk to your obstetrician if you have fibroids and become pregnant. All obstetricians have experience dealing with fibroids and pregnancy.

Most women who have fibroids and become pregnant do not need to see an OB who deals with high-risk pregnancies. Your doctor may find that you have fibroids when you see her or him for a regular pelvic exam to check your uterus, ovaries, and vagina.

The doctor can feel the fibroid with her or his fingers during an ordinary pelvic exam, as a usually painless lump or mass on the uterus. Often, a doctor will describe how small or how large the fibroids are by comparing their size to the size your uterus would be if you were pregnant. For example, you may be told that your fibroids have made your uterus the size it would be if you were 16 weeks pregnant.

Or the fibroid might be compared to fruits, nuts, or a ball, such as a grape or an orange, an acorn or a walnut, or a golf ball or a volleyball. Your doctor can do imaging tests to confirm that you have fibroids. These are tests that create a "picture" of the inside of your body without surgery.

These tests might include:. You might also need surgery to know for sure if you have fibroids. There are two types of surgery to do this:.

A second opinion is always a good idea if your doctor has not answered your questions completely or does not seem to be meeting your needs. Most women with fibroids do not have any symptoms. For women who do have symptoms, there are treatments that can help. Talk with your doctor about the best way to treat your fibroids. She or he will consider many things before helping you choose a treatment.

Some of these things include:. If you have fibroids but do not have any symptoms, you may not need treatment. Your doctor will check during your regular exams to see if they have grown. If you have fibroids and have mild symptoms, your doctor may suggest taking medication. Over-the-counter drugs such as ibuprofen or acetaminophen can be used for mild pain. If you have heavy bleeding during your period, taking an iron supplement can keep you from getting anemia or correct it if you already are anemic.

Several drugs commonly used for birth control can be prescribed to help control symptoms of fibroids. Low-dose birth control pills do not make fibroids grow and can help control heavy bleeding. The same is true of progesterone-like injections e. Other drugs used to treat fibroids are "gonadotropin releasing hormone agonists" GnRHa. These drugs, given by injection, nasal spray, or implanted, can shrink your fibroids. Sometimes they are used before surgery to make fibroids easier to remove.

Side effects of GnRHas can include hot flashes, depression, not being able to sleep, decreased sex drive, and joint pain.

Most women tolerate GnRHas quite well. Most women do not get a period when taking GnRHas. This can be a big relief to women who have heavy bleeding. They may remain the same size for years. They can also shrink on their own, and those that are present during pregnancy often disappear afterward.

Your risk of developing new fibroids typically decreases with menopause and tumors already present may shrink. Fibroids were once the leading reason for performing hysterectomies. Advances in medical technology and treatment techniques allow us to choose less drastic measures for treating these benign growths these days.

We may recommend medications that manipulate your hormones enough to control excessive bleeding due to the fibroids. Birth control pills can also control bleeding but have little effect on the size of your fibroids.

If fibroids are interfering with your ability to become pregnant or maintain a pregnancy, we can consider surgical removal of the fibroids while leaving your uterus and other reproductive organs intact. This type of surgery can often be done laparoscopically, which requires just a few small incisions and offers a faster healing time than traditional, open surgery.

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