Endometriosis is a condition in which cells resembling the ones that normally line the uterus grow outside the uterus. These abnormal endometrial-like cells swell and shed during menstruation just as normal endometrial cells do, but because they are not within the uterus, they cannot be expelled from the body normally. Fibroids are noncancerous growths of the uterus which seem to be associated with endometriosis.
What are fibroids?
Fibroids are noncancerous tumors that can grow around the uterus. They can range in size from too small to be seen by the naked eye to so large that they distort the uterus. Depending on their location, they may also affect fertility.
Many women will have fibroids during their lifetime, but most are unaware of them because they may cause little or no symptoms. The symptoms of fibroids include heavy menstruation, or menstruation lasting longer than a week, pelvic pressure or pain, difficulty urinating, or frequent urination. In rare cases, a fibroid outgrows its blood supply and dies, which can be very painful.
The cause of fibroids is unknown but they seem to run in families, which may indicate a genetic or environmental cause. Symptomatic fibroids may be associated with endometriosis.
Types of fibroids
Several types of fibroids are named based on their location in the body.
Intramural fibroids are the most common type and occur in the muscle wall of the uterus.
Subserosal fibroids develop outside the uterine wall and into the pelvis. This type of fibroid can become very large and may need to be removed with surgery.
Submucosal fibroids develop in the inner lining of the uterus beneath the muscle layer and grow into the cavity of the uterus.
Treatment of fibroids
While most fibroids do not cause any symptoms, those that do can be treated. Medications can be used to reduce heavy bleeding caused by fibroids; these include the levonorgestrel intrauterine system, tranexamic acid, or progesterone.
Gonadotropin-releasing hormone analogs may be prescribed to reduce the size of fibroids.
Most fibroids can be removed surgically through procedures such as laparoscopy. Some fibroids can be treated with a procedure called uterine artery embolization, a technique that involves injecting the blood vessel that supplies the fibroid with a chemical compound that blocks it. With no blood supply to provide nutrients, the fibroid shrinks and dies. This type of procedure can be preferable because it is less invasive than other surgical procedures. However, very large fibroids may still need to be removed surgically. In extreme cases, when the location of the fibroids prevents normal removal methods, a hysterectomy (removal of the uterus) may be recommended.
Last updated: July 25, 2019
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