DEAR MAYO CLINIC: I am 27 and have heavy menstrual cycles. In the past year, I have begun to have more pelvic pain, especially during my period. A friend said I should get checked for fibroids. What are fibroids, and how do you treat them?
ANSWER: Uterine fibroids, also called leiomyomas or myomas, are benign masses that come from the muscle portion of the uterus.
Fibroids are common. Approximately 80% of people born with a uterus will develop fibroids, but not everyone has symptoms. Fibroids are most often diagnosed between the ages of 20 and 40 years old.
The cause of fibroids is unknown, although estrogen and progesterone appear to promote the growth of fibroids. Scientists are looking into other possible risk factors, such as family history, early onset of menstruation and lifestyle factors. People of African descent have a greater risk of fibroids, which can occur at an earlier age and produce more severe symptoms.
The main types of symptoms caused by fibroids are:
In some women, reproductive issues, including difficulty getting pregnant or miscarriage, may be a sign of fibroids.
Given that excessive menstrual bleeding and pelvic pain may be signs of any number of issues, I always recommend that any person experiencing pain or heavy periods should visit their gynecologist.
Fibroids often can be felt on physical exam. Usually when the uterus is enlarged or irregular, an ultrasound is ordered as the first test to diagnose fibroids.
Both medical and surgical treatment options are available to treat fibroids. Treatment is individualized to each patient, depending on which symptoms are most bothersome, as well as the size, number and location of the fibroids, and whether pregnancy is desired in the future.
Most medications aim to reduce the heavy bleeding common in people with fibroids. Hormonal medications — both birth control and therapies unrelated to birth control, as well as nonhormonal medications can help suppress period bleeding. While medications can help shrink fibroids, these medications are not meant to be taken long term.
Multiple surgical options are available, including minimally invasive surgical approaches that are safer and have a shorter recovery time. Surgical treatments include:
If you are diagnosed with fibroids, it's important to know that you have many treatment options and you can return to having a good quality of life. — Dr. Michelle Louie, Surgery, Mayo Clinic, Phoenix