What are uterine fibroids?

Uterine fibroids are benign (not cancer) growths that develop from the muscle tissue of the uterus. They also are called leiomyomas or myomas. The size, shape, and location of fibroids can vary greatly. They may be inside the uterus, on its outer surface or within its wall, or attached to it by a stem-like structure. A woman may have only one fibroid or many of varying sizes. A fibroid may remain very small for a long time and suddenly grow rapidly, or grow slowly over a number of years.

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What are symptoms of fibroids?

Fibroids may have the following symptoms:

• Changes in menstruation

  • Longer, more frequent, or heavy menstrual periods

  • Menstrual pain (cramps)

  • Vaginal bleeding at times other than menstruation

  • Anemia (from blood loss)

• Pain

  • In the abdomen or lower back (often dull, heavy and aching, but may be sharp)

  • During sex

• Pressure

  • Difficulty urinating or frequent urination

  • Constipation, rectal pain, or difficult bowel movements

  • Abdominal cramps

• Enlarged uterus and abdomen

• Miscarriages

• Infertility

Fibroids also may cause no symptoms at all. Fibroids may be found during a routine pelvic exam or during tests for other problems.

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How are fibroids diagnosed?

The first signs of fibroids may be detected during a routine pelvic exam. A number of tests may show more information about fibroids:

• Ultrasonography uses sound waves to create a picture of the uterus and other pelvic organs.

• Hysteroscopy uses a slender device (the hysteroscope) to see the inside of the uterus. It is inserted through the vagina and cervix (opening of the uterus). This lets your health care professional see fibroids inside the uterine cavity.

• Hysterosalpingography is a special X-ray test. It may detect abnormal changes in the size and shape of the uterus and fallopian tubes.

• Sonohysterography is a test in which fluid is put into the uterus through the cervix. Ultrasonography is then used to show the inside of the uterus. The fluid provides a clear picture of the uterine lining.

• Laparoscopy uses a slender device (the laparoscope) to help your health care professional see the inside of the abdomen. It is inserted through a small cut just below or through the navel. Fibroids on the outside of the uterus can be seen with the laparoscope.

Imaging tests, such as magnetic resonance imaging and computed tomography scans, may be used but are rarely needed. Some of these tests may be used to track the growth of fibroids over time.

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