Fibroids are very common, especially in women who have reached childbearing age. Women who have not had children may be at higher risk of developing fibroids.  Your risk of developing fibroids increases as you age. Women between the age of 30 and menopause are the most commonly affected.  Having a family member, such as a sister, mother, or cousin, with uterine fibroids increases your risk of developing them.  Women of African descent appear more likely to develop fibroids, especially as they age. Some studies suggest that African American women are two to three times more likely to develop fibroids than white women. 80% of African American women develop fibroids by age 50, compared to 70% of white women. (Though, again, keep in mind that a large percentage of women who have fibroids do not experience any symptoms or problems related to the presence of the fibroids.) Women with a BMI (Body Mass Index) above the “normal” range” are more likely to develop fibroids.  Women who began menstruating at an early age (i.e., before 14) are at a higher risk of developing fibroids. Many women who have fibroids do not know they have them. In many women, fibroids do not cause significant health problems. However, if you are experiencing any of the following symptoms, see your physician:  Heavy and/or prolonged menstrual bleeding Significant change in menstruation patterns (e.g., sharply increased pain, much heavier bleeding) Pelvic pain, or feelings of “heaviness” or “fullness” in the pelvic area Pain during sexual intercourse Frequent and/or difficult urination Constipation Backache Infertility or recurrent miscarriage If you do have fibroids, discuss treatment options with your doctor. In many cases, treatment is not necessary. However, in some cases, medication or surgical procedures may be necessary. The treatment your doctor recommends will vary depending on several factors, such as whether you wish to become pregnant in the future, your age, and the severity of the fibroids.  Drug therapy, such as hormonal birth control, may reduce heavy bleeding and pain. However, it may not prevent new fibroids or keep fibroids from growing.  Gonadotropin releasing hormone agonists (GnRHa) may be prescribed to shrink fibroids. The fibroids regrow rapidly once these medications are stopped, so they are primarily used pre-operatively to shrink fibroids in preparation for hysterectomy. They may have side effects including depression, decreased sex drive, insomnia, and joint pain, but many women tolerate these medications well.  Myomectomy (surgical removal of fibroids) may allow you to conceive children after the procedure. The risks depend on how severe the fibroids are. You may also be able to conceive after having MRI-guided ultrasound surgery, although this procedure is not widely available.  Other treatments for more severe fibroids may include endometrial ablation (surgical destruction of the uterus lining), uterine fibroid embolization (injection of plastic or gel particles into the blood vessels surrounding the fibroid), or hysterectomy (removal of the uterus). Hysterectomy is considered the last resort when other treatments and procedures have not worked. Women cannot have children after some of these procedures.Women who conceive after undergoing embolization may experience complications with their pregnancies, so this method is not recommended for women who may become pregnant in the future.
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