WHAT ARE FIBROIDS?
Uterine fibroids are noncancerous growths in or on the walls of the uterus. They consist of smooth muscle cells and connective tissue. A person may have one or multiple fibroids. They can be as small as an apple seed or as big as a grapefruit (or sometimes even larger than that). They can also shrink or grow over time.
Fibroids are more common from age 30 to the age at which menopause begins. They usually shrink after menopause. Between 20% to 80% of females develop fibroids by the age of 50, according to the Office on Women’s Health (OWH).
It is unclear exactly why fibroids form, but research and clinical experience point to these factors:
- •Genetic changes. Many fibroids contain changes in genes that differ from those in typical uterine muscle cells.
- •Hormones. Estrogen and progesterone, two hormones that stimulate development of the uterine lining during each menstrual cycle in preparation for pregnancy, appear to promote the growth of fibroids. Fibroids contain more estrogen and progesterone receptors than typical uterine muscle cells do. Fibroids tend to shrink after menopause due to a decrease in hormone production.
- •Other growth factors. Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth.
- •Extracellular matrix (ECM). ECM is the material that makes cells stick together, like mortar between bricks. ECM is increased in fibroids and makes them fibrous. ECM also stores growth factors and causes biologic changes in the cells themselves.
The growth patterns of uterine fibroids vary — they may grow slowly or rapidly, or they may remain the same size. Some fibroids go through growth spurts, and some may shrink on their own. Many fibroids that have been present during pregnancy shrink or disappear after pregnancy, as the uterus goes back to its usual size.
Fibroids can cause heavy or prolonged menstrual bleeding, pain in the lower abdomen and back, painful intercourse, and frequent urination, and impacted pregnancy. Symptoms of fibroids can often be managed with medication; however, surgery may be needed. If your family is complete, a da Vinci® hysterectomy might be the best option. This can be done if the fibroid is submucosal (in the cavity of the uterus), but otherwise, can be treated with Acessa™ laparoscopic fibroid ablation, da Vinci® laparoscopic fibroid removal, or open myomectomy. Some patients may benefit from uterine fibroid embolization. These treatment options depend on fibroid type (location), fibroid size, your age, and your fertility plans.
Schedule an appointment to discuss your symptoms and we will help determine the correct treatment plan for you.
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