By: Kathy Hubbard
The first thing women need to know about uterine fibroids is what they’re not. They are not cancer and almost never turn into cancer. They’re very common and most often cause little to no discomfort. But when they do, they can be very uncomfortable. You know the word “uncomfortable,” that’s medical speak for they hurt like the dickens.
“Fibroids are growths made of smooth muscle cells and fibrous connective tissue,” explains Johns Hopkins Medicine’s website. These growths develop in the uterus and appear alone or in groups. They range in size from as small as a grain of rice to as big as a melon.”
Mayo Clinic adds that a “fibroid that gets very big can distort the inside and the outside of the uterus. In extreme cases, some fibroids grow large enough to fill the pelvis or stomach area. They can make a person look pregnant.”
Between 20 to 50 percent of women of reproductive age have fibroids and around 77 percent of women will get them at some point in their lives. “Only about one-third of these fibroids are large enough to be detected by a healthcare provider during a physical exam, so they are often undiagnosed,” Johns Hopkins says.
I’ll go out on a limb and say that if they’re undetected and don’t cause any problems, you probably don’t give them a thought. You will want to think about them if you experience heavy or prolonged periods, bleeding between periods, abdominal discomfort and/or fullness, pelvic pain, lower back pain particularly when having sex, bladder symptoms such as frequent urination or difficulty emptying the bladder, bowel issues such as constipation or having to strain with bowel movements.
Women with fibroids may have fertility issues and they can cause complications during pregnancy. Mayo says that “rarely, a fibroid can cause sudden, serious pain when it outgrows its blood supply and starts to die.”
Ongoing tiredness and weakness, a sign of anemia, may be the result of excessive bleeding due to fibroids, so that’s another reason besides those listed above to talk to your primary care provider or your gynecologist. Mayo says, “Get medical care right away if you have severe bleeding from the vagina or sharp pelvic pain that comes on fast.”
Johns Hopkins says, “Fibroids are most often found during a routine pelvic exam. During this exam, your healthcare provider will press on your abdomen and may feel a firm, irregular mass that might indicate a fibroid.”
If fibroids are suspected, a pelvic ultrasound and/or magnetic resonance imaging (MRI) may be ordered. There are other tests utilized. Hysterosalpingography (no I can’t pronounce it) is a type of x-ray exam of the uterus and fallopian tubes. A hysteroscopy uses a viewing instrument inserted through the vagina to look at the cervix and interior of the uterus.
“Since the growth of most fibroids slows as you approach menopause, your healthcare provider may simply suggest ‘watchful waiting’ if your symptoms are tolerable. With this approach, the healthcare provider closely monitors your symptoms with frequent follow-up visits and ultrasounds to make sure there are no significant changes in your condition,” Johns Hopkins says.
However, if your fibroids cause significant symptoms there are treatment options including medications and surgery. “Your doctor will recommend treatment based on your symptoms, location and size of the fibroids, your age and medical history, and your health goals such as a desire for pregnancy.”
The first option is to treat the pain with anti-inflammatory painkillers. Ibuprofen or naproxen may reduce menstrual bleeding caused by fibroids and is, obviously, the most conservative approach. There are a few hormone therapies, that I won’t take up space to detail, but you can look up online if you like. The same is true for surgical options, of which there are many.
I will tell you that fibroids are the number one reason hysterectomies are performed in the U.S. That’s when the entire uterus is removed. This is major surgery and is only performed on women who are not interested in preserving their fertility.
Both Sandpoint Women’s Health (208-263-2173) and Bonner General Family Practice (208-265-2221) are accepting new patients. Call today for an appointment.
Kathy Hubbard is a member of the Bonner General Health Foundation Advisory Council. She can be reached at kathyleehubbard@yahoo.com. This article was written for publication in the Bonner County Daily Bee on August 21, 2024.
