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What are fibroids?

Fibroids are growths on the walls of the uterus. Sometimes, a fibroid is attached to the outside of the uterus by a stalk. Fibroids can be as small as a seed or a pea or as large as an orange or small melon. Although fibroids are called "tumors," they are not cancer. They are smooth muscle growths. About two of every 10 women who have not gone through menopause have fibroids. The technical term for a fibroid tumor is leiomyoma.

What symptoms do fibroids cause?

Fibroids may cause no symptoms at all, or they may cause pain or bleeding. Fibroids may make it hard to pass urine if they grow large enough to press on the bladder. They also may cause abdominal swelling, pain during intercourse, lower abdominal and pelvic discomfort or pain, and increased uterine cramping before and during menstrual periods. Fibroids also can make it hard for you to get pregnant. Sometimes fibroids can cause problems with pregnancy, labor or delivery, including miscarriage and premature birth.

How are fibroids diagnosed?

Usually, fibroids are found by abdominal or pelvic examination or pelvic ultrasound. Less frequently, magnetic resonance imaging (MRI) or computerized tomography (CT) scans are used.

What happens to fibroids after menopause?

Fibroids usually shrink substantially and symptoms may be significantly reduced. Larger fibroids may remain symptomatic if estrogen replacement therapy is used.

How are fibroids treated?

If you have fibroids, you may have several treatments from which to choose. The choice depends on how big the fibroids are, where they are, and whether you are pregnant or want to become pregnant.

Watchful waiting may be all the treatment you need if your fibroid is small and you do not have any symptoms. You will need regular visits to your doctor for a pelvic exam to monitor the growth of the fibroid.

Non-surgical treatments for fibroids include hormones and pain relief medicines.

Surgical treatments for fibroids include hysterectomy and myomectomy. Hysterectomy is usually recommended when the fibroids are causing symptoms, when they have grown rapidly or when the fibroids are large (as large as a grapefruit).

Myomectomy is an operation to remove a fibroid tumor without taking out the uterus. The growths may come back after a myomectomy, and repeat surgery may be necessary. If you are considering a myomectomy, be sure to ask the doctor how likely it is that new fibroids might grow after the surgery. You also should ask your doctor how much experience he or she has in doing this procedure. Not all gynecologists have been trained to perform myomectomies.

Another option is laser surgery, which usually is an outpatient procedure. With laser surgery, the doctor uses a high-intensity light to remove small fibroids. Depending on the location of the fibroid, it may be possible to remove it during a laparoscopy. Or, the doctor may put a thin tube called a hysteroscope with a laser through the vagina and into the uterus. The tube may have a small scraper to scrape away the fibroid from the wall of the uterus.