As a woman, pain in the pelvic region is a regular occurrence for some. However, that pain might be a warning that there is more going on than monthly cramping. Uterine fibroids can be painful and become cancerous. Learn about this common but sometimes dangerous health issue from Cool Springs OBGYN in Tennessee. 

What Are Uterine Fibroids?

Fibroids are, almost always, noncancerous growths in the uterus. They appear during the childbearing years and may not need treatment. Around 70 to 80% of women develop fibroids, but the cause is unknown. These tumors are overgrowths of muscle tissue and can get large in some cases. Fibroid sizes range from the size of a pea to a watermelon. 

Uterine fibroids can form in multiple areas of the uterus. 

  • Subserosal: Located under the outer layer of the uterus.
  • Intramural: Found within the uterine wall and can distort the shape of the uterus.
  • Submucous: Located within the uterine cavity and is the most common area. 

For many women, a fibroid feels like nothing, and they won’t even know it is there. For others, a fibroid can cause pain and heavy bleeding. Needing to urinate frequently is another possible sign.

Symptoms of Fibroids

Uterine fibroids, many times, have no symptoms. When symptoms occur, they can vary based on the menstrual cycle, sexual activity, and fibroids’ number and size. The symptoms are similar to other feminine health issues like endometriosis, adenomyosis, and pelvic infection. Getting checked by a doctor is necessary to diagnose uterine fibroids correctly. 

Symptoms to watch for:

  • Lower back and leg pain: This happens when pain radiates from the uterus.
  • Chronic pelvic pressure and pain: This feels like someone is pushing down your pelvis and is a common symptom that gets missed. 
  • Swelling and bloating in the abdomen: While this can happen from overeating or menstruation, it could be a fibroids sign. 
  • Painful periods: Fibroids can make periods last longer than the average 3-4 days. They put pressure on the uterine lining, causing pain.
  • Painful sex: When a fibroid is close to the cervix, a woman may experience pain during intercourse from the pressure. 
  • Frequent urination: If a fibroid is pressing against the bladder, it causes pressure and increases the urge to urinate.
  • Inability to urinate or have bowel movements: Constipation can occasionally be normal, but if it happens often, a uterine fibroid could be to blame. Pressure coming through the uterine wall onto the rectum can result in difficult bowel movements.
  • Fatigue: Fatigue is an easy symptom to miss as so many other factors cause it. The reason fibroids cause fatigue is from loss of blood cells and iron. Over time this could result in anemia.
  • Heavy or inconsistent bleeding: If fibroids are inside the uterine cavity, heavy bleeding is more likely. Even a small fibroid can create extreme bleeding, blood loss, and spotting between menstruation. 

Risks Involving Fibroids

Can uterine fibroids burst?

Although extremely rare, a fibroid can burst. A burst fibroid is a serious medical condition that needs treatment. It can cause abdominal pain, fever, and a high white blood cell count. 

Do fibroids affect pregnancy?

Generally, fibroids do not affect pregnancy. There is a low risk of fibroids creating fertility problems or causing pregnancy loss. They may also raise the risk of complications like placental abruption, preterm delivery, and fetal growth restriction.

Fibroids larger than 4 centimeters can hinder implantation. When located inside the muscle, they may be blocking the fallopian tubes. If you have been unsuccessful in becoming pregnant for over a year, it is time to see your doctor. 

Do they change the quality of life or lifestyle?

If uterine fibroids cause heavy periods, this can affect a woman’s quality of life. Some activities need to be avoided during menstruation due to heavy periods. Excessive blood loss can also lead to anemia.

Will fibroids turn into cancer?

While possible, it is extremely rare for uterine fibroids to become cancerous. Cancer fibroids occur in fewer than 1 in 1,000 cases.

Possible Causes

While common, the exact cause of uterine fibroids is still unknown. Research has given some clues to what some potential causes may be, however. 

Many fibroids have genes that differ from the cellular makeup of the uterine muscle. It seems that genetic changes could be one causing factor.

The feminine hormones estrogen and progesterone appear to promote the growth of fibroids, as well. These hormones stimulate the development of the uterine lining during the menstrual cycle. Fibroids shrink in women with decreased hormones, like after menopause. 

Extracellular matrix, the material that makes cells stick, is increased in fibroids. ECM stores growth factors and has the potential to make biological changes in uterine cells. 

Treating Uterine Fibroids

If fibroids are benign and not causing problems, they do not require treatment. When they are symptomatic, there are treatment options available, ranging from medicines to surgical procedures. 

It is possible to get rid of fibroids without surgery using these medications:

  • GnRH agonists: This is a short term medication that makes the body produce less estrogen and progesterone. 
  • Nonsteroidal anti-inflammatory drugs: Medicines like ibuprofen can help reduce some associated pain. 
  • Hormonal birth control: These regular the menstrual cycle and help to reduce the amount of bleeding each cycle. 

When medicines aren’t enough, there are surgical treatments for severe fibroids:

  • Hysterectomy: With large fibroids or excessive bleeding, removing the uterus may be the best treatment option. Different types of hysterectomies remove various areas of the reproductive organs.
  • Myomectomy: This procedure removes fibroids from the uterus wall. This treatment is done through hysteroscopy or laparoscopy. 
  • Endometrial ablation: This treatment removes the lining of the uterus, taking the tumors with it.
  • Uterine fibroid embolization: By cutting off the blood flow to fibroids they can be reduced or fully removed. It is effective in up to 90% of women but isn’t a good option for all. 

If you have been experiencing the symptoms listed above, it is important to see your OBGYN. Dr. Lodge in Cool Springs Tennessee accurately screens his patients for many reproductive health issues and provides the treatment. The staff at Cool Springs would be happy to answer your questions or schedule your appointment!