FIBROID TUMORS OF UTERUS
(Myomas; Leiomyoma)

What is It?

* A benign growth of cells in the muscular wall of the uterus.* Cells are composed of muscle cells, and not fibrous tissue. May be present as solitary or multiple tumors.* Common condition, not cancerous.* Present in 20 to 25% of women of child-bearing age.

Causes

* Unknown.* Need estrogen for maintenance, as they are extremely rare before puberty or after menopause, and they sometimes grow rapidly in pregnancy.

Signs and Symptoms

* Often no symptoms. Discovered on a routine pelvic examination.* About 30% of patients report heavier and more frequent menses.* Increased menstrual discomfort.* Bleeding between periods.* Painful sexual intercourse or bleeding after intercourse.* Anemia (weakness, fatigue, and paleness).* Feelings of pressure on the urinary bladder or rectum.* May cause infertility.

Risk Factors

* Use of estrogen replacement therapy and use of oral contraceptives with high estrogen content.* Genetic factors.Fibroid tumors are 3 to 9 times more common in black women than Caucasian women.

Prevention

Cannot be prevented at present.

Diagnosis and Treatment General Measures

* Diagnostic tests may include laboratory blood studies, ultrasound; MRI, laparoscopy; or hysterosalpingogram.* Treatment will be individualized depending on symptoms, diagnostic tests, age of the patient and desire for future pregnancy.* For minimal symptoms, no treatment may be needed. Follow-up every 3-6 months.* Surgery may be recommended for certain situations and several different surgical procedures are possible. If surgery is recommended, be sure you understand all aspects of it before making a decision.* Record dates of bleeding and number of pads used each day.

Medication

* If you have a small fibroid, don't take contraceptive pills with a high estrogen content. Estrogen may cause fibroids to enlarge. Consider other forms of contraception, such as a diaphragm, cervical cap, IUD, condom, or contraceptive foam, sponge or jelly.* Iron supplements if you are anemic from excessive blood loss.* Estrogen must be used with caution in post-menopausal women with fibroids.

Activity

No restrictions unless surgery performed. Then you may need bed rest for a period of time, some restricted activity, and no sexual intercourse for approximately one month.

Diet

No special diet.

Possible Complications

* Malignant change in the fibroid tumor (occurs in less than 0.5%). This rare complication is usually signaled by very rapid growth.* Complications can occur in pregnancy such as spontaneous abortion and premature labor.* Fibroids may return following surgery to remove them.

Prognosis

* If surgery is not necessary prior to menopause, these tumors usually decrease in size without treatment after menopause.* Hospitalization, if surgery is necessary. Fibroids are generally removed surgically if they cause excessive bleeding, become malignant, or produce symptoms that interfere with conception or pregnancy.* Fibroids can often be removed surgically without removing the entire uterus. The ability to conceive continues as long as the uterus remains.

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The contents of this Web site are for informational purposes only and are not intended to be used for medical advice. You should consult your physician or health care provider on a regular basis. You should consult your physician immediately with any problem about which you are concerned.