Are you a woman with fibroids?  What are they?  Why do you have them?  What can you do about them?

Fibroids are a common benign neoplasm.  They are more common in older women and African American women.  In fact, one study shows that 80% of 50 year-old women have a fibroid.  Most are discovered incidentally.  We affectionally call these findings “incidentalomas” meaning they may be insignificant, but now we know you have them.

What are fibroid symptoms?  You may feel abdominal/pelvic pressure, constipation, increased urinary frequency and urgency (because the fibroid presses on the bladder), urinary retention, abnormal uterine bleeding, and pain with intercourse.

What is the best way to diagnose them?  Ultrasound.

What to do about them?

• Watchful waiting may be best.   If the patient is mostly asymptomatic, then waiting it out may be all that is needed.  That is because that most fibroids shrink  in size during menopause.
• If you have symptoms of heavy menstrual bleeding, then hormonal contraceptives, tranexamic acid or NSAIDS like ibuprofen may help decrease menstrual blood flow.  Surgical treatment is done at times which may lead to

1. hysterectomy (taking out the uterus) or
2. myomectomy (cutting into the uterine muscle to cut out the fibroid),
3. uterine artery embolization (an interventional radiologist or vascular surgeon puts a catheter in to your groin and blocks the artery that feeds the fibroid),or
4. MRI-guided focused ultrasound surgery.