Fibroid Tumors: What Every Woman Must Know
Diagnosed with fibroids? Three experts help WebMD explore your treatment options.
There probably isn't a woman alive who doesn't feel a wave of terror when her doctor mentions the word tumor. But when it's a fibroid tumor, experts say there is little to fear.
"There is virtually no threat of malignancy -- and there are a number of excellent treatment options, as well as the option to do nothing at all -- so there really is no reason to worry," says Steve Goldstein, MD, professor of obstetrics and gynecology at NYU Medical Center.
Fibroid tumors are composed of renegade muscle cells that come together to form a fibrous "knot" or "mass" within the uterus. Although all uterine fibroids are the same, they are categorized based on their location:
- Submucosal fibroids are located just under the uterine lining.
- Intramural fibroids lie between the muscles of the uterine wall.
- Subserol fibroids extend from the uterine wall into the pelvic cavity.
Fibroids most commonly occur between ages 30 and 40, with black women at greatest risk. To date, at least one genetic link has been identified, indicating that fibroids may also run in families.
For some women fibroids cause no symptoms, but when they do, doctors say problems often involve heavy menstrual periods and prolonged bleeding.
"They can also cause pelvic or abdominal pain or swelling and increased urination," says Aydin Arici, MD, professor of obstetrics and gynecology and director of reproductive endocrinology and infertility at the Yale University School of Medicine.
Arici says that ultimately, it is a combination of your symptoms, the location of the fibroid, and the numbers and size, as well as your age and your childbearing potential, that help determine what your course of treatment should be.
Treatment Options: What You Should Know
In the not-too-distant past, doctors routinely performed a hysterectomy for fibroid tumors. And while newer, less-invasive treatments are available, studies show this dramatic operation is still being performed today -- far more frequently than necessary.
"A panel convened by our own governing body -- the American College of Obstetricians and Gynecologists -- found that 76% of all hysterectomies performed today do not meet the criteria for this surgery. They are being done unnecessarily," says Ernst Bartsich, MD, associate professor of obstetrics and gynecology at the New York Hospital-Cornell Medical Center in New York.
"I believe many women are conceding to a hysterectomy for fibroid tumors because they are led to believe it's the only solution -- and that is wrong," says Bartsich.
At the same time, Goldstein says it's also important to recognize that not all hysterectomies are alike. In particular, he says the newest form of this operation (called a supra cervical hysterectomy) could still hold the answer for some women. Why?
"In a supra cervical hysterectomy you remove only the uterine cavity holding the fibroids and you do not touch the tubes, ovaries, cervix, or vagina, or any of the support muscles in the bladder or pelvis," says Goldstein. This, he says, means you don't suffer any of the consequences linked to a traditional hysterectomy, including bladder and sexual dysfunction, or instant menopause.