Everything You Need to Know About Fibroids

Fibroids. As many as 40% of women age 35 and older suffer from these benign tumors, which are usually found in the wall of the uterus.

Treating them often involves surgery or procedures that shut off the blood supply to the fibroids. Dr. Catherine Tuite, an interventional radiologist with St. Luke's Roosevelt Hospital Center in New York City, visited The Saturday Early Show to discuss the topic.

Fibroids are noncancerous growths of smooth muscles that develop in the walls of the uterus, Tuite says. These growths can be very tiny or as large as a cantaloupe.

We don't know what causes them, she says, but we do know that the hormones estrogen and progesterone feed them. Also, fibroids are more commonly found in African-American women, so there could be a genetic component.

Often fibroids don't cause any problems for women who have them, but for others, they can cause heavy bleeding during their periods, pain, a feeling of pressure or heaviness in the lower pelvic area, or pressure on the bladder that may cause a constant sensation of a need to urinate. Fibroids can also cause infertility, Tuite says.

Physical exams may alert a woman's doctor to the presence of fibroids, as can ultrasound or magnetic resonance imaging (MRI).

It isn't necessary to remove all fibroids, Tuite says. A woman should only have fibroids treated if they cause symptoms. Removal is intended to make a woman more comfortable and to relieve the symptoms. Fibroids vary in size, and the larger ones will likely cause pain and other symptoms.

Several treatments are available for fibroids, says Tuite, including medication and surgery.

Because fibroids respond to estrogen, hormone therapy can be used to block their response and stop their growth.

There are also two common types of surgery. A myomectomy is surgery that takes the fibroid out of the uterus. Only the fibroids are removed; the uterus is left in place. This can keep the woman fertile if she still wants to have children. This approach is often used for premenopausal women.

Hysterectomy, or the removal of the entire uterus, is another option. This means the woman won't be able to have children after the surgery, however, so it is often a choice for women after menopause.

Uterine artery embolization is a noninvasive procedure that cuts off the blood flow to the fibroid, and, over time, shrinks the growth in size. A catheter is passed through an artery to the uterus, guided by an ultrasound. The doctor then injects tiny plastic particles to the arteries that send blood to the fibroid. The particles stop the blood flow.

Fibroids don't completely go away after uterine artery embolization, but they are reduced in size by about 50% and that would be, in most cases, enough to provide significant relief from pain and other symptoms.

A new technique, called laser ablation, may also provide relief for women. It is similar to a myomectomy, Tuite says, although there is no surgery involved

Using an MRI to guide them, doctors use lasers to heat up the fibroid. Scar tissue forms and the fibroid starts to shrink within 6 weeks, and it continues shrinking up until about 6 months after treatment.

It's very new, but Tuite says the procedure is expected to be more commonplace soon.

How does a woman know which treatment is right for her? Tuite says it's a team approach involving the woman's gynecologist and interventional radiologist. Basically, the woman's overall health will determine which procedure is best. A woman also needs to consider factors such as whether she wants to keep her uterus and whether she wants to avoid surgery, Tuite says.

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