There’s still a lot to be discovered about fibroid tumors. Underlying causes remain unknown, but there is some evidence that certain factors can increase your risk of developing fibroid tumors. We will discuss the types of fibroid tumors, signs and symptoms of the condition, and different management techniques.

Defining fibroids

Fibroids are abnormal, yet benign growths that develop in or on your uterus. Several names exist for the same condition. Fibroid tumors are also called leiomyomas, myomas, uterine myomas, and fibromas. Hormones, specifically estrogen and progesterone, are thought to be on of the main contributors to fibroid growth. Fibroids are also known to genetic with several female members in a family having them. Fibroid tumors can also appear when you can become pregnant (the childbearing years) because levels of estrogen and progesterone are higher, though can occur at any time throughout the reproductive years. These hormones have an impact on fibroid growth. Complications due to fibroids that can occur during pregnancy include:

• The increased risk of needing a c-section 

• The baby is breech (bottom or feet first in the womb) 

• The placenta breaks from the wall of the uterus and reduces the oxygen getting to the baby (placental abruption) 

• Delivery could occur prior to your due date, or can be preterm. 

What is a fibroid tumor?

A fibroid tumor is an abnormal growth made of muscle cells and fibrous connective tissue. The type of fibroid tumor depends on its location in or on your uterus. The most common type of fibroid tumor is an intramural fibroid tumor. These develop within the muscular wall of the uterus. Intramural fibroids will cause the walls of the uterus to stretch, which can in turn narrow the uterine cavity (where a baby grows). This can then make it more difficult to get pregnant. . Subserosal fibroids are tumors located outside of the uterus, on the serosa. The uterus may appear larger on one side if these tumors grow large enough. Pedunculated fibroids are subserosal tumors that develop a stem. A less common type of tumor is a submucosal fibroid. These develop in the myometrium, the middle muscle layer of the uterus. 

How do you know if a fibroid is cancerous?

Fibroid tumors are typically benign, though it is possible for a benign fibroid to become cancerous. . Studies show that less than 1 in 1,000 women are affected. This rare type of fibroid tumor is known as leiomyosarcoma, also known as a uterine sarcoma. Diagnosing cancerous fibroid tumors can be challenging. If you have fibroids it is important that you work closely with your OBGYN. If there are indications that your fibroids may be cancerous, you may need to see an OBGYN that has special training in cancers, a Gynecologist Oncologist. There are a few different medication and surgical treatments for cancerous fibroids and your provider should work with you to come up with the best treatment decision for you.  

Signs and symptoms of fibroid tumors

There are many different symptoms that people experience if they have fibroids.. As with other conditions, several of the symptoms are not specific to just fibroids and often overlap.  It’s possible to be completely asymptomatic, or you might experience a variety of symptoms. Fibroid tumor symptoms include:

• Severe abdominal pain (can be accompanied by pressure or swelling)

• Heavy menstrual period bleeding (bleeding may occur irregularly during your cycle)

• Menstrual periods that last over a week 

• Intense cramping

• Pelvic or lower back pain

• More frequent urination and difficulty emptying your bladder

So, how do you know when to visit the doctor? It’s worth visiting your primary care provider if you experience any of the above symptoms, your menstrual cycle changes, or if you experience unexplained anemia.

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Treatment and prevention

Although underlying causes remain unknown, a diagnosis can be made more quickly by paying attention to risk factors such as:

• Pregnancy

• Family history (genetics)

• Age (risk levels increase if you’re  capable of reproducing, particularly if you’re between 30 and 40 years old)

• Race (fibroid tumors are more common in African-Americans)

• High body weight (obesity)

• Hormones (estrogen and progesterone levels)

• Getting your first period at a younger age

• Vitamin D deficiency

• Diet high in red meat and low in green vegetables, fruits, and dairy

• Alcohol

Since hormone levels decrease with the onset of menopause, symptoms associated with fibroids often become less, and in a few cases, fibroids may shrink at this time. In some cases, fibroid tumors may continue to grow despite the onset of menopause and decline in estrogen and progesterone. . Possible fibroid tumor complications include anemia which can, in turn, lead to fatigue from heavy blood loss. Generally, healthy lifestyle decisions around diet, exercise, and stress management can reduce your risk of developing fibroid tumors. Diagnosis is the first stage of treatment. Regular pelvic exams may help you find fibroid tumors more quickly. If additional evaluation is needed for fibroids, a common next step is using an ultrasound or pelvic MRI to determine the size and exact location of the fibroids. 

The type of treatment your primary care provider recommends will depend on your age and overall health, as well as the location, number, and size of the fibroids. Possible treatment options include monitoring (by watching symptoms or with ultrasound), lifestyle and dietary changes, medication, and surgery. Types of surgical treatments include noninvasive procedures, minimally invasive procedures, or more traditional surgical procedures. Your primary care provider may be able to help you come up with a safe and effective treatment plan, possibly combining treatment forms. Some things that you can do at home that may have some benefits include acupuncture, yoga, massage, and heat.

Types of medications include GnRH agonists, placement of a specific IUD, Ibuprofen, and birth control. GnRH agonists block the production of estrogen and progesterone, which may help shrink fibroids. Certain IUDs and other forms of birth control may help manage blood flow. Surgical treatments include noninvasive surgeries like MRI-guided focused ultrasound surgery (FUS), which uses targeted soundwaves to destroy fibroid tissue. Minimally invasive procedures include uterine artery embolization, radiofrequency ablation, laparoscopic myomectomy, hysteroscopic myomectomy, and endometrial ablation. These treatments use different methods to address the specific problems fibroid tumors are causing. Abdominal myomectomy and hysterectomy are more traditional surgical treatments. Hysterectomy is the last procedure to try if no other treatment method is working because it is major surgery.