Many women have uterine fibroids. You might not even know you have them, since they don’t always cause any symptoms.
You might not know you have them until you see your doctor. Since your doctor will press on your uterus during a pelvic exam, they may feel abnormal changes in the shape of your uterus that could be due to fibroids. If so, they’ll probably want you to go get some tests to find out.
Ultrasound
An ultrasound is usually the first kind of imaging test your doctor will order. It uses sound waves to take a picture of your uterus, and can show your doctor if you do have fibroids, where they are, and how big they are. During the test, a doctor or technician will take pictures of your uterus by either moving a device over your abdomen or inserting it into your vagina.
Magnetic Resonance Imaging (MRI)
If the ultrasound didn’t provide enough information, your doctor may want you to get an MRI. It can also help your doctor figure out what kinds of different tumors you may have so they can decide which treatment is best.
For this test, you’ll get an IV in your arm that injects a special dye so your doctor can see the fibroids more clearly. You’ll lie down on a bed and go into an imaging machine for about 45 to 60 minutes while a big magnet moves around you. The machine will make a lot of noise, so you’ll probably need to wear earplugs. You may be able to listen to music.
A technician will take pictures of your pelvic area that can show detailed images of the fibroids, how big they are, where they’re located, and how many you have.
Hysterosonography
This test is sometimes called a saline infusion sonogram because your doctor will fill your uterus with sterile saline (salt water) to make it bigger for the test. It helps your doctor see the lining of your uterus, any fibroids, and areas of your soft tissue that X-ray images don’t show clearly.
Your doctor may want you to get this test the week after your period. You need to avoid having sexual intercourse for a few days before the procedure. And although some women don’t have any pain during or after, most do get cramps. You may be able to go back to your normal activities right after the test or some doctors recommend waiting a few days before having sex or using tampons to decrease any infection risk related to the test.
Hysterosalpingography
If you’re concerned about whether you still can have children, your doctor might recommend this test. It shows if you have fibroids, and it can help them see whether your fallopian tubes are open. (You need your fallopian tubes to be open in order for an egg to travel from your ovaries to your uterus, so you can conceive).
Your doctor will take X-ray images of your uterus and fallopian tubes and use a special dye that makes these areas easier to see.
During the test, you’ll lie on your back with your feet up like you’re getting a pelvic exam. After your doctor inserts a speculum to hold your vagina open, they or a technician will insert the dye, and then you’ll move to an X-ray machine. You might feel some cramping from the fluid, and your doctor may suggest you take an over-the-counter pain medication before the test. You’ll probably be able to drive yourself home afterward.
Hysteroscopy
Your doctor will insert a small telescope with a light attached (called a hysteroscope) into your uterus through your cervix. To widen your uterus, they’ll then inject saline to better see the walls of your uterus and your fallopian tubes. Your doctor may also use special instruments to remove the fibroids.
You may be given medicine (anesthesia) to help you relax, to numb the area, or to help you sleep. You might need to stay at the hospital or clinic for a few hours after the test so the doctors can make sure you’re OK.
Also, it’s possible you’ll feel some cramping or have some slight bleeding for a couple of days after the procedure, and you might feel a little sick.