Phrases like genetic mutation, softball size, and abdominal myomectomy sound downright frightening, but women needn’t be terrified of uterine fibroids. Before imagination can work you into a frenzy, Charleston OB/GYN’s Dr. Stan Ottinger shares a not-so-worrisome explanation of this common condition. “Don’t be scared to death of uterine fibroids,” he reassures. “As long as they’re small and not causing discomfort, there’s no reason to even mess with them.”
Unwelcome Development
Designed to carry babies, the uterus is made up primarily of muscle cells that can stretch and contract; they can also mutate into a fibroid. While the idea of a cell mutation may sound the cancer alarm in your mind, less than one in a thousand become malignant.
“Fibroids appear in various sizes, shapes and locations,” continues Dr. Ottinger. These growths can develop in the middle, on the inner wall or on the outside of the uterus and range in size from a pea to a basketball. Fibroids develop in 40 percent of women and impact every ethnicity and race, “with a slightly higher prevalence in African Americans.” There’s also a genetic predisposition for the condition, so if your mother had fibroids, chances are good you will, too.
Sneaky Symptoms
Fibroids grow over many years, meaning the body doesn’t always scream that there’s a problem. “A lot of women have fibroids and don’t even realize it,” says the doctor. “Symptoms sometimes develop so slowly that a patient just excuses them as normal.”
A heavier menstrual flow and longer cycle with more severe cramping or spotting can indicate the presence of fibroids, especially in the center of the uterus. Fibroids outside the uterus could lead to pelvic pressure on the bladder or rectum that mimics the sensation of needing to use the restroom. And if a fibroid is pushing on a patient’s ureter and affecting kidney function, high blood pressure may result.
Just because fibroids are common and asymptomatic, doesn’t mean they can be ignored though. “If your periods last longer than seven days, you have to replace pads and tampons more than every four hours, or you’re bleeding through to your clothes, that’s too heavy,” says Dr. Ottinger, who encourages women facing such scenarios to seek care. “You don’t have to live in misery.”
Come Out, Come Out
An OB/GYN may perform an abdominal exam to feel for fibroids or use an ultrasound to make a diagnosis. (Doctors also sometimes discover fibroids when conducting an ultrasound for an entirely different reason.) Small, unproblematic fibroids are usually left alone, while larger fibroids may be treated using either medication or surgery.
Hormone management options, such as IUDs, can suppress fibroid growth. “Think of estrogen as a fertilizer stimulating tissue to grow during a woman’s reproductive years,” explains the OB/GYN. “It can also stimulate fibroids.” Of course, once a woman hits menopause and that estrogen declines, fibroids may shrink on their own.
For a fibroid inside the uterus, a minimally invasive, outpatient surgery can be conducted vaginally to remove the growth. Larger fibroids or those outside the uterus may call for a myomectomy, a surgery similar to a Cesarean section that requires a few more days of healing.
Keeping Watch “Fibroids are spontaneous, not the result of lifestyle choices. They just happen,” says Dr. Ottinger. Rather than feel powerless to prevent uterine fibroids, the doctor encourages patients to recognize that fibroids are easily treated. And since they’re most often detected during routine pelvic exams, getting an annual checkup with an OB/GYN may be the best defense against these stealthy spots.