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Learn the facts about uterine fibroids, including symptoms, risks and treatment options, from a gynecologic oncologist and women鈥檚 health expert.

Fibroids are benign tumors that develop in smooth muscle tissue, specifically the muscular wall of the uterus. Uterine fibroids are, in fact, extremely common.

鈥淯p to 70%-80% of women have fibroids by the time they go through menopause around age 50,鈥� explains Marcia Ciccone, MD, a gynecologic oncology, cancer genetics and women鈥檚 health specialist at 喵咪社区.

Most women with fibroids are unaware they have them, however, as many fibroids don鈥檛 cause noticeable symptoms. Only about one in four patients experiences symptoms that require treatment.

Most uterine fibroids are not cancerous

Many will hear 鈥榯umor鈥� and immediately think of cancer, but Dr. Ciccone reassures that noncancerous fibroids (called leiomyomas) are the most common fibroid type, with cancerous fibroids (sarcomas) occurring in only about one in 1,000 cases. 鈥淭he school of thought is that fibroids don鈥檛 start out as benign and transform into cancer,鈥� she notes. In fact, the risk of that happening is so low that it often doesn鈥檛 factor into treatment decisions.

What causes uterine fibroids?

鈥淯terine fibroids are monoclonal collections of cells that have overgrown,鈥� Dr. Ciccone explains. While the exact cause of uterine fibroids remains unclear, she says that fibroids are stimulated by female hormones, particularly estrogen and progesterone.

Understanding this hormonal connection helps explain why certain factors could increase your risk of developing uterine fibroids:

• Age: Risk increases as women approach menopause.
• Race: Black women are two to three times more likely to develop fibroids than white women.
• Early menstruation: Earlier onset means longer lifetime exposure to estrogen.
• Obesity: Fat cells produce additional estrogen, potentially increasing risk.

What are uterine fibroids symptoms?

Heavy or irregular menstrual bleeding can be one of the most serious complications. 鈥淧eople can bleed either over time or heavily at once and become severely anemic, sometimes to the point that they require a blood transfusion,鈥� Dr. Ciccone explains. In rare cases, this severe blood loss/anemia could even lead to heart attack or stroke if left untreated.

Other common symptoms include:

• Pelvic pain or pressure, often worse with menstruation
• Pain during exercise, physical activity or intercourse
• Urinary frequency due to bladder compression
• Lower back pain

Fibroids can also impact fertility and pregnancy. While having fibroids doesn鈥檛 mean you can鈥檛 get pregnant, Dr. Ciccone cautions that they might make it harder for a pregnancy to implant if fibroids distort the uterine cavity. And during pregnancy, fibroids often grow due to hormonal changes and can also lead to preterm labor or abnormal fetal positioning, thus increasing the risk a cesarean section might be needed.

How do doctors diagnose fibroids?

Doctors typically begin diagnosis with a pelvic exam, although as Dr. Ciccone explains, fibroids frequently are not detectable through that examination alone. 鈥淯ltrasound is probably the easiest way to diagnose these,鈥� she says, adding that an MRI might be needed when planning surgery or requiring a more detailed view.

Research in women鈥檚 health is lacking and poorly funded, Dr. Ciccone notes. This may help explain why we know so little about this condition that affects up to 80% of women by the time they reach menopause.

What is the best treatment for fibroids?

鈥淚f fibroids are not symptomatic, we don鈥檛 necessarily recommend surgery just because they鈥檙e there,鈥� Dr. Ciccone advises. She adds that not all fibroids will grow or cause problems.

For those that do present problems, such as fertility challenges or pain and discomfort, treatments are available, she emphasizes.

When treatment is needed, options may include:

• Medications that regulate hormones
• Surgical removal (myomectomy) via minimally invasive or open surgery
• Hysterectomy
• Uterine artery embolization for select cases
• Radiofrequency ablation

For women experiencing significant symptoms, Dr. Ciccone recommends consulting a gynecologist for personalized treatment recommendations.

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