Uterine Fibroids, or uterine myomas (short for leiomyoma), affect more than 30% of women. The terms fibroid and myoma are used interchangeably. Most fibroids do not cause symptoms, and do not require treatment. Fibroids may require treatment in the following circumstances:
- Fibroids are growing large enough to cause pressure on other organs, such as the bladder.
- Fibroids are growing rapidly
- Fibroids are causing abnormal bleeding
- Fibroids are causing problems with fertility.
Types of Fibroids
Uterine Fibroids are classified by their location (see figure), which effects the symptoms they may cause and how they can be treated. Fibroids that are inside the cavity of the uterus will often cause bleeding between periods and often cause severe cramping. Fortunately, these fibroids can usually be easily removed by a method called “hysteroscopic resection,” which can be done through the cervix without the need for an incision. Submucous myomas are partially in the cavity and partially in the wall of the uterus. They too can cause heavy menstrual periods (menorrhagia), well as bleeding between periods. Many of these submucous fibroids can also be removed by hysteroscopic resection.
Intramural myomas are in the wall of the uterus, and can range in size from microscopic to larger than a grapefruit. Many intramural fibroids do not cause problems unless they become quite large. There are a number of alternatives for treating these, but often they do not need any treatment at all. Subserous myomas are on the outside wall of the uterus, and may even be connected to the uterus by a stalk (pedunculated fibroid.) These do not need treatment unless they grow large, but those on a stalk can twist and cause pain. This type of fibroid is the easiest to remove by laparoscopy.
