Here because a doctor told you that you have fibroids? Did you sneak a peek at your ultrasound results online, see the word “fibroid” and panic? Maybe you Googled your symptoms and fibroids popped up as a possibility, along with cancer and all kinds of other scary conditions? Whatever the reason, we’re glad you’re here and have created this handy guide on fibroids to answer all your questions.
What Fibroids Are and What They Aren’t
Fibroids are a common type of benign tumor made of smooth muscle tissue that grows in the uterus. They’re sometimes referred to as uterine fibroids. They’re also called leiomyomas, which comes from the Greek words leios (smooth) + mys (muscle) + -oma (tumor). They are not cancer.
I repeat: Fibroids are not cancerous.
Whew! Glad that’s out of the way!
A little more about these pesky little (but not always) tumors that you should know is that you can have one fibroid or several, and they can range from the size of a seed to the size of a watermelon. Yes, a freaking watermelon.
Types of Fibroids: Yep, There’s More Than One Type
There are different types of fibroids—sort of. Fibroids are still fibroids, but they’re classified by where in the uterus they’re located:
- Intramural fibroids—the most common type—grow into the wall of your uterus.
- Submucosal fibroids grow under the lining of your uterus (endometrium).
- Subserosal fibroids grow on the outside wall of the uterus.
- Pedunculated fibroids—the least common type—grow on stalks on the inside or outside wall of the uterus and look kind of like mushrooms.
Who Gets Fibroids and Why
Anyone with a uterus can get fibroids, and it’s estimated that anywhere from 40 to 80 percentexternal link, opens in a new tab of people with a uterus have fibroids. They’re most common between the ages of 30 and 50external link, opens in a new tab and rarely develop in people before their first period or after their last period.
As for why people get them, that’s not quite clear. Experts believe it has something to do with the hormones estrogen and progesterone, since they develop during the reproductive years and during times when hormone levels are higher, like during pregnancy, and shrink after menopause when hormone levels drop.
Some people are more likely to get fibroids, including Black people with uteruses. Experts don’t know why Black people have a higher risk of fibroidsexternal link, opens in a new tab, but research also shows they tend to develop them sooner.
You might have a higher risk of getting fibroids if:
- You’re fat
- Someone else in your family had fibroids
- You got your period at a young age
- You haven’t had kids
- You started menopause late
What Fibroids Feel Like
Fibroids don’t always cause symptoms, especially when they’re small. Bigger fibroids, however, can cause all kinds of symptoms depending on their size and location.
These include:
- Heavy or painful periods
- Bleeding between periods
- Pain during sex
- A feeling of pressure or fullness in your lower abdomen
- Stabbing pains in the lower abdomen
- Low back pain
- Constipation or a feeling of pressure in your bum
- Needing to pee more often
- Trouble fully emptying your bladder when you pee
- Bloating that can make you look pregnant
How Fibroids are Diagnosed
Fibroids are often found randomly during a pelvic exam or when you have an ultrasound to look for the cause of symptoms like heavy periods. A pelvic ultrasound, often combined with a transvaginal ultrasound, is the most common test used to diagnose fibroids.
Here’s more information about these and other tests that a doctor may use to check for fibroids:
- Pelvic ultrasound. An ultrasound uses soundwaves to create pictures of the inside of your pelvis, including your uterus. Having a full bladder helps the tech get a clearer view, so you’ll be told how much water to drink before you test. During the test, the technician glides a wand called a transducer over your lower abdomen to see your pelvic organs, including your uterus. It’s fairly quick and usually painless.
- Transvaginal ultrasound. A transvaginal ultrasound may be part of a pelvic ultrasoundexternal link, opens in a new tab. Once the outer portion of the pelvic ultrasound is done, you’ll be able to go pee. Once your bladder is empty, the technician will insert a narrow wand into your vagina and move it around to get images of your pelvic organs. Other than some pressure or mild discomfort, the test is usually painless.
- Hysteroscopy. This test is usually done under anesthesia so you’re asleep while it’s happening. The surgeon inserts a thin, lighted tube (hysteroscope) through your vagina to look at the inside of your uterus. If needed, tiny surgical instruments can be passed through the hysteroscope to remove fibroids or other tissue.
- Sonohysterography. This is a more advanced ultrasound that creates clearer images of your uterus than a standard ultrasound. For the test, the technician inserts a thin catheter into your vagina and injects saline (sterile salt water) into your uterus before performing a transvaginal ultrasound. You cannot get a sonohysterogram if you are pregnant, so your doctor will want to do a pregnancy test before the procedure.
- MRI. An MRI, or magnetic resonance imaging if you wanna get fancy, uses magnets and radio waves to produce detailed images of your internal organs. During the test, you lie still on a narrow table that slides into a tube-like machine. The test is painless, but the machine is tight and makes loud noises, which can be unnerving. If you have anxiety or claustrophobiaexternal link, opens in a new tab, your doctor can prescribe medication to help you relax.
- CT scan. A CT scan, AKA computed tomography scan or cat scan (FYI, no cuddly cats involved, sadly), takes a quick series of X-rays to create 3D images of your organs. During the test, you lie on a table that slides through a donut-shaped machine. It’s super quick—often under five minutes—and not an enclosed space, like an MRI.
How Fibroids are Treated
Unless fibroids are causing symptoms, they don’t actually need to be treated. Your doctor might just monitor them to make sure they don’t grow. If it’s determined that fibroids are the cause of your symptoms, there are a few things that can be done.
Which treatments are best for you might depend on things like:
- How big the fibroids are and where in the uterus they’re located
- Whether you might want to get pregnant someday
- How old you are (remember, fibroid symptoms usually get better after menopause)
Depending on what you and your doctor decide is best, treatment might involve managing your symptoms or procedures to get rid of the fibroids.
Here are the options:
- Pain medication. Over-the-counter anti-inflammatory pain relievers, like ibuprofen or naproxen, can help with occasional pelvic pain from your fibroids and may even reduce bleeding a bit.
- Iron supplements. If you have heavy periods or bleeding between periods, you could become iron deficient or anemic. Your doctor might recommend taking iron supplements to help get/keep your iron levels where they should be. Low iron can make you feel tired, short of breath, and cause hair loss, heart palpitations, and other symptoms.
- Hormonal treatments. Hormonal birth control, like birth control pills, implants, or IUDs, can help control bleeding from fibroids. Gonadotropin-releasing hormone agonists are a type of medication that’s used to lower your estrogen levels and put you in temporary medical menopause. They can be used to shrink your fibroids to improve your blood count if your fibroids are causing a lot of bleeding or to prepare you for surgery.
- Surgery. There are a few surgical options for treating fibroids. A myomectomy (which can be open, laparoscopic, or hysteroscopic) removes the fibroids while preserving your fertility but doesn’t prevent fibroids from developing again. If you don’t want to have kids, a hysterectomy, which is a major surgery that removes your uterus, is a permanent solution. No uterus = no chance of uterine fibroids.
- Minimally invasive treatments. Uterine artery embolization, radiofrequency ablation, and magnetic resonance guided focused ultrasound are newer techniques that can shrink fibroids. They’re less invasive than surgery, but experts still don’t know if the fibroids will grow back or if these procedures will impact a person’s ability to get pregnant.
What Happens If Fibroids are Not Treated
Fibroids don’t always need to be treated, but they can sometimes cause the symptoms we talked about above, which can impact your quality of life.
Potential complications of fibroids include:
- Excessive bleeding
- Anemiaexternal link, opens in a new tab
- Severe pain that becomes unmanageable
- Swelling of your lower belly
Even though fibroids rarely cause infertility, they can sometimes cause complications during pregnancy and delivery. Remember, fibroids can grow because of the elevated hormones your body releases during pregnancy. Large fibroids can prevent the fetus from facing head-down for delivery, requiring a C-section. They can also stop labor from progressing and increase the risk of premature labor and placental abruption.
Talking To a Healthcare Provider About Fibroids
If you have symptoms of fibroids, like heavy, painful periods, bleeding between periods, or pelvic pain and pressure, it’s a good idea to get checked out even though talking about this stuff might feel a little—or a lot—awkward.
A lot of the symptoms of fibroids can also be caused by other conditions, including PCOS, endometriosis, STIs, and even several cancers, including uterine, ovarian, and cervical cancer.
Speaking of cervical cancer, staying on top of regular screenings, like PAP/HPV tests and STI testing, is super important.
Don’t Have a Doctor? You Can Still Get Help for Fibroids
If you don’t have a family doctor or aren’t already under the care of a gynecologist, a clinic like your local Planned Parenthood can diagnose and treat gynecological issues, including fibroids.
If you don’t have health insurance, they work with you to provide affordable care, so you don’t need to put off getting checked out.
In Canada, some walk-in clinics offer referral services. You can visit one for a referral without a family doctor as long as you have your provincial health card.
If you’re in the UK, you’ll need to get a referral to a gynecologist from a GP. Fibroid treatment is covered on the NHS. If you’re not registered with a GP surgery, you can register with one on the NHS websiteexternal link, opens in a new tab.
Regardless of where you are in the world, you can visit your local urgent care clinic or emergency department if you don’t have a family doctor. Depending on your symptoms, they may perform an exam and an ultrasound and proceed from there or refer you to a gynecologist.
