An ultrasound probe is inserted into the vagina or over the pelvis on the abdomen, and high-frequency sound waves reflect off the uterus and pelvic structures. The uterus and any uterine fibroids are displayed on a video screen.
Magnetic resonance imaging (pelvic MRI)
An MRI scanner uses a high-powered magnet and a computer to create highly detailed images of the uterus and other pelvic structures. Pelvic MRI can confirm the presence of uterine fibroids, if the diagnosis is unclear.
Occasionally, a doctor may be concerned that a mass in the uterus is cancer, not a uterine fibroid. A small piece of tissue (biopsy) taken from the uterus can usually tell a fibroid from cancer. A uterine biopsy may be done through the vagina, or may require surgery.
Dye is injected into the uterus through the vagina and cervix, and X-ray films show an outline of the uterus and fallopian tubes. Hysterosalpingogram is usually done in women with uterine fibroids who are trying to become pregnant.
A water solution is injected into the uterus through the vagina and cervix, and an ultrasound is then done. Sonohysterogram may show uterine fibroids or other growths not visible on a traditional ultrasound.
A tube with a lighted viewer on its tip (endoscope) is advanced into the uterus, and a video screen shows the uterus interior. Hysteroscopy can detect uterine fibroids projecting into the uterus, but cannot see any part of a fibroid in the uterus wall or outside the uterus.
Not all women will need extensive testing for uterine fibroids. In most women, a pelvic exam and ultrasound are sufficient to make the diagnosis of uterine fibroids.
Treatment of Uterine Fibroids
Most uterine fibroids don’t need any treatment, because they don’t cause symptoms or problems. Uterine fibroids causing problems may be treated with non-surgical or surgical options.
Non-Surgical Treatment Options
Watchful waiting: A minority of fibroids will naturally shrink over time. Most uterine fibroids will either stay the same size or grow.
Oral contraceptives (birth control pills): These contain hormones (estrogen, progesterone, or a combination) that can help reduce heavy periods caused by uterine fibroids.
Lupron: This hormone treatment stops menstrual periods and shrinks uterine fibroids. Lupron is usually used as a temporary treatment before surgery.
Intrauterine device (IUD) with levonorgestrel: Mirena is an IUD that releases a hormone that reduces heavy periods.
Pain relievers: Motrin or Aleve can reduce the pain caused by uterine fibroids.
Iron: Heavy periods caused by uterine fibroids can lead to iron-deficiency anemia. Iron tablets can help the body replace the blood lost during menstruation.
Surgical Treatment Options
Myomectomy: Surgery to remove uterine fibroids while leaving the uterus in place. Myomectomy is often done for women wishing to have children. New uterine fibroids may grow, requiring a later procedure in up to a third of women after myomectomy.