Despite living in an information-packed era where we can learn every fact ever about Rihanna or pizza or the history of commuter railroads with a few minutes of Internet research, many of us still believe a lot of myths about women's health — especially when it comes to women's health problems like uterine fibroids. Uterine fibroids are common — in fact, by some estimates, 70 to 80 percent of all women will have a fibroid at some point in their lives. The vast majority of these fibroids create no symptoms or complications, and will probably never make themselves known.
But about 30 percent of cases of uterine fibroids do create side effects that impact women's lives, and may require medical treatment — which is where the myths start popping up. Is it true that women with fibroids have a hard or impossible time conceiving? Do they make maintaining a healthy pregnancy difficult? If you have large fibroids, does that mean that you'll inevitably have to get a hysterectomy? When it comes to uterine fibroids, dubious "facts" and incorrect theories abound.
But luckily, you do live in an era filled with easy access to information — which means that you don't have to be afraid of or freaked out by your uterine fibroids because you're not quite sure what they do, or how they'll impact your life. So if you've been diagnosed with fibroids, know someone who's been diagnosed with fibroids, or are just curious, read on for our primer on uterine fibroids.
So, What Are Uterine Fibroids, Exactly?
Fibroids are bumps made of fibrous tissue and muscle that grow inside your uterine cavity, on the inner walls of your uterus, on the outside of your uterus, at opening your cervix, or other spots within your uterine area. You may see uterine fibroids described as "tumors," but they're not the kind of tumors you're thinking of — fibroids are almost always benign growths, which means that they generally won't turn into cancer (fibroids become cancerous less than 0.5 percent of the time). Fibroids can be tiny or large — in some cases, growing as large as six inches across — and can grow in large groupings or all alone.
What Side Effects Do Fibroids Cause?
Uterine fibroids most often impact periods — making them longer, heavier, more frequent, and more painful than average. They can also cause problems with urination, from forcing you to pee more often to making you feel like you are not fully emptying your bladder. Sometimes, fibroids can make vaginally penetrative intercourse painful, and cause general pelvic or abdominal pain.
If You Have Fibroids, Does That Mean You Always Had Them?
Nope; some women have had fibroids their entire reproductive lives, while some only grow them later on. A 2003 study found that most women develop fibroids after menopause — 70 to 80 percent, as opposed to the 35 percent who developed them before menopause. No one is completely sure what causes fibroids to grow — for most people, they're hereditary, and 75 percent of African-American women are impacted by them. But they do seem to be influenced by hormones, often growing when you start your period, getting larger during pregnancies, and shrinking after menopause.
But if you grow a fibroid at any point in time, it doesn't mean that you're having larger health issues, or that anything is wrong with you. And you definitely didn't "do" anything that caused you to grow a fibroid — this is simply something your body has created, so you shouldn't blame yourself in any way for developing fibroids.
How Do I Know If I Should Talk To A Doctor?
If you're finding vaginal penetration very painful, are having very long and painful periods, feel consistent pelvic pain, are spotting between periods, or have been having a hard time peeing, it's not a bad idea to swing by your doctor's and discuss. Even if it's not fibroids, those problems might be symptoms of another health issue.
How Do I Actually Find Out If I Have Them?
If you suspect that you have fibroids, your doctor can use an ultrasound to check for them. If they're very large, your doctor may be able to find feel them without an ultrasound — very large ones can change the shape of the uterus, and can sometimes be detected by hand during a routine exam. An MRI exam is also helpful as a follow-up; sometimes problems associated with uterine fibroids, like bad periods and pelvic pain, can actually be caused by something else, and an MRI or other detailed exam can help you know what's causing your discomfort for sure.
Can Fibroids Keep Me From Getting Pregnant?
Fibroids will almost never keep you from getting pregant. Though on rare occasions, fibroids can grow in a way that accidentally blocks the fallopian tubes, few women with fibroids find that they impact their ability to conceive.
Will They Impact My Pregnancy In Any Way?
Many women with fibroids can have perfectly healthy pregnancies that go off without a hitch. However, fibroids can raise the likelihood of a few pregnancy problems, as they often grow in size during the course of the pregnancy. Fibroids can sometimes become painful for pregnant women, can raise a risk of miscarriage early in the pregnancy, and can increase the chances of complications like breech birth, preterm birth, and abnormal separation of the placenta later in the pregnancy.
But having fibroids doesn't necessarily mean that you'll experience any of these problems should you want to become pregnant.
Can You Treat Uterine Fibroids Without Surgery?
The specifics of fibroid treatment usually relate to which side effect that you're experiencing, and depend on factors like where the fibroids are placed in your uterus, their size, your age, and whether you've completed your family. But if you're not having extreme side effects, there are many non-surgical treatments that work for fibroids.
For example, if you are experiencing long, heavy periods, the treatment may involve taking ibuprofen for mild pain, and taking birth control pills or having a hormonal IUD inserted in order to help control heavy bleeding. Other treatments may involve taking medications like Lupron created specifically to shrink the fibroids.
Am I Going To Need A Hysterectomy?
This is the biggest urban myth about fibroids, so let's repeat this again: you do not have to get a hysterectomy just because you have fibroids. Though some women do choose a hysterectomy as their fibroid treatment option (it is one of the top three most common reasons to have a hysterectomy), know that it is in no way required, especially if you haven't had children yet and wish to have them in the future.
There are a few non-hysterectomy surgical treatments that don't remove your uterus, but do impact your ability to conceive in the future: endometrial ablation, which removes the lining of uterus, causing the patient to no longer have any periods, and preventing you from being able to conceive; and uterine fibroid embolization, which uses a small tube to cut off the blood supply to fibroids, causing them to shrink. Neither option is recommended for women who would like to get pregnant in the future.
There are also surgical options for women who want to cope with their fibroids but still have kids, however. There is a surgery called myomectomy which removes the fibroids, but leaves the uterus iteself intact. If you opt for a myomectomy, though, be aware of the tools being used in your procedure. The USDA has recently cautioned against the use of a tool called a "power morcellator" in uterine fibroid surgery — the tool breaks the fibroids down into very small pieces, which recent studies have shown can cause cancer to spread from the uterus to other parts of the body in patients who don't know that they have cancer. It's a rare occurrence, sure, but still not worth the risk. Some other newer treatments, like radio frequency ablation, aim to destroy the fibroid tissue, while leaving the uterus intact and in healthy, working order.
The bottom line? Fibroids may take some effort to manage, but they don't have to keep you from living a normal life, having a normal sex life, or creating another human life (if that's what you want).