Fibroids are common – and a common cause of pelvic pain

Uterine fibroids affect many women at some point in their lives. While fibroids typically don’t cause any symptoms or health problems, when they do, pelvic pain may be one of them. Understanding this common condition can help women know what to watch for, when to seek help and what to expect when you do.

What are fibroids?

Fibroids are benign (not cancerous) growths in the uterus. Uterine fibroids are also referred to as leiomyomas. Their cause is unknown. A woman may have a single fibroid or multiple fibroids. Fibroids can also vary widely in size. In most cases, they occur in women during their reproductive years – rarely are fibroids found before puberty or after menopause.

Five signs you may have fibroids

When fibroids do cause problems it’s usually because of their size, number or location. There are five main signs and symptoms of fibroids:

• Pelvic pain
• Heavy menstrual bleeding
• Compression on the bladder, causing more frequent urination
• Compression on the bowels, causing constipation
• Infertility

Straightforward diagnosis

Your OB/GYN might detect signs of fibroids during your physical exam while palpating (feeling) your abdomen and pelvis. Fibroids also may be visible during a pelvic exam.

In general, fibroids are easily diagnosed with an ultrasound. Advanced imaging, such as an MRI, may be necessary in some cases to get more detailed information on the number, size and exact location of fibroids.

When is treatment necessary?

If fibroids are diagnosed on ultrasound but you have no symptoms, typically no treatment is necessary, only monitoring. A follow-up ultrasound may be performed in six to 12 months to determine if the fibroid is growing.

If you are experiencing symptoms, your treatment will depend on the type and severity of those symptoms. If medical treatments aren’t effective, surgery may be necessary to remove the fibroids, a procedure known as a myomectomy. There are several minimally invasive treatment options if surgery is required.

Fibroids, infertility and pregnancy

Depending on where fibroids are located, they can increase the risk of infertility and pregnancy loss and may need to be removed. The decision to remove them may also depend on factors such as their size and other potential causes of infertility.

Fibroids can grow on the outside of the uterus (subserosal). They can grow inside the uterine cavity (submucosal). Most commonly, they are found growing inside the uterine wall (intramural).

Fibroids can also cause other health issues during pregnancy that may make it necessary to remove them.

Fibroids after menopause

Fibroids feed on hormones. In rare cases when a fibroid develops or continues growing after menopause – when estrogen and progesterone levels are reduced – we watch these patients closely, monitoring their growth and the need to remove them.

Get answers to your questions

Fibroids affect women throughout their lifespan, leading to wide-ranging questions on this common condition. Some of the more common questions I hear include:

• Why do fibroids cause pelvic pain?
• Do I need to have my fibroid removed before becoming pregnant?
• I have a fibroid after menopause, what should I do?
• Should I take hormone therapy after menopause if I have fibroids?
• If I have constipation should my fibroid be removed?
• Are certain women at higher risk of developing fibroids?

For answers to these and any specific questions you may have about fibroids or pelvic pain, join us at our free pelvic pain patient seminar Thursday, July 21. Our team of experts will share the facts on pelvic pain that all women need to know. To reserve your spot, call 832-826-7376 or register online.

Dr. Joseph Nassif is a minimally invasive gynecologic surgeon and an associate professor in the Department of Obstetrics and Gynecology at Baylor College of Medicine and Texas Children’s Pavilion for Women.