Fibroid Tumors

Fibroid tumors are solid, noncancerous growths composed of smooth muscle fibers and connective tissue that grow in the walls of the uterus or out from the uterus. Only rarely do they appear on the cervix. Occasionally, they fill the entire uterus, push through the cervix, and appear in the vagina. These tumors usually grow slowly and vary in size and shape.

Fibroid tumors are thought to be the most common type of abdominal tumor, found in about 25 percent of all women over the age of 30 (more frequently in black women). Cancer rarely develops in fibroid tumors; however, they do sometimes cause problems. They tend to enlarge during pregnancy, which can cause complications as the fetus grows.

Causes

The cause of fibroid tumors is not known, but their growth seems to be related to the female hormone estrogen, since these tumors rarely appear before puberty and tend to recede by the menopause years. They most commonly appear in the middle to late reproductive years, when the estrogen level is at its peak.

Fibroid tumors may occur along with other disorders, such as endometriosis (the displacement of tissue from the uterine lining to areas elsewhere in the body) or pelvic inflammatory disease.

Symptoms

Common symptoms of fibroid tumors are dysmenorrhea (pain during menstruation) and gushing or flooding of the menstrual flow. Occasionally, there is abdominal pain; however, pain is not usually a symptom unless a complication develops. If fibroid tumors become very large, they may press on surrounding organs, such as the intestines and bladder, which may result in constipation or frequent urination. If they extend into the uterus, heavy and prolonged menstrual periods may result. If the tumor is advanced, the abdomen may be noticeably enlarged. Sometimes, however, these tumors cause no symptoms.

Diagnosis

Diagnostic evaluation begins with a physical examination and may include curettage (scraping the uterus walls) or endometrial biopsy (removal of some tissue from the lining of the uterus) to test for cancer. X rays and ultrasound may also be used to establish the location, size, and nature of the tumor.

Treatment

Fibroid tumors may require no treatment at all, other than regular checkups with the doctor. Fibroid tumors that are causing complications may require one of two types of surgery. Removal of the tumor (called a myomectomy) is usually recommended for women in their early reproductive years whose symptoms are somewhat mild and who desire a future pregnancy.

Removal of the uterus (called a hysterectomy) is usually recommended for older women who have completed their families and for women who do not want to become pregnant in the future.