By: Jean Johnson for Fibroids1 “Until I discovered I had fibroids in my uterus, my interest in the subject was nil,” said Stephanie Greene, an editor living in Battleground, Washington.
But after physicians diagnosed Greene with the condition, she quit shuddering, overcame her initial misgivings, and educated herself.
“Knowledge is power. So nothing like understanding your own medical situation,” she said.
| Be Prepared |
Questions to ask your doctor:
What options do I have for treating my fibroids?
Can you explain the risks and benefits of each option?
What is your recommendation?
What is the recovery period for the recommended option?
What about short term versus long term treatment options
Remember, you can always seek a second opinion if you feel your doctor did not answer your questions fully or appropriately.
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So if you’re fuzzy on the basics, read up to learn more. Better yet, if you think you might suffer from fibroids, print this article and use it as a refresher before seeing your physician, gynecologist or interventional radiologist. It might help trigger some of those questions we always mean to ask, but tend to forget in the midst of it all. Then again, the article might simply help you follow your healthcare professional’s explanations more readily, and thus hold up your own end of the conversation with the dignity to which you are entitled. So come along on the journey. It’s all about empowerment.
Types of fibroids
Using the Internet to search for information on the origin of the term fibroid does not return much information. There’s fibromyalgia as well as a disease simply called fibro, with the former causing a major physical pain and the latter a source of depression. Both conditions, though, are related to muscle problems, the type that occur when injuries to muscle fibers cause them to shorten.
So the common thread here seems to be muscles. Indeed, fibroids are benign growths that develop in the muscular wall of the uterus.
That said, the most common medical term for fibroids is uterine leiomyomata—a term not at all difficult to pronounce once the syllables are broken up: lei-o-my-o-ma-ta. Of course, medicine is complex, so clinicians can complicate the issue and refer to all manner of nuanced fibroids: leiomyomas, fibromyomas, or just plain old myomas.
Part of the reason for the disparity in word choice is that fibroids come in three basic varieties.
Subserosal growths develop under the outside covering of the uterus and expand outward. A women’s uterus with subserosal fibroids will take on a knobby appearance instead of the smooth pear shape normal organs have. These tumorous growths can develop stalks called peduncles and push out into the abdominal cavity like a top-heavy plant.
Strange appearance of subserosal fibroids aside, it’s the symptoms that most women are concerned over. These growths, although not as common as intramural fibroids, can cause very heavy menstrual bleeding, clotting, pelvic pain and generalized abdominal pressure.
Heavy bleeding and pelvic pain – along with back pain and a generalized pain some women observe – are also present in the most common type of fibroid: Intramural. These tumors develop within the lining of the uterus itself and push out into the cavity to the degree that the uterus feels enlarged on an internal gynecologic exam.
Finally, submucosal fibroids grow just under the lining of the uterus. The least common type of uterine tumor, these fibroids tend to cause the most problems with menstrual bleeding that can be gushing, very heavy and prolonged.
Symptoms
“I was so embarrassed by my symptoms that I didn’t want anyone to know at first,” said Greene. “Having fibroids clearly isn’t like getting some designer disease that gets discussed over lunch. I mean, for one thing, tumors even if they aren’t cancer are just plain creepy.”
If heavy bleeding that can cause anemia and pelvic pain as well as bulk pressure or heaviness caused by the weight of the fibroids seem to be common denominators, location and size of the growths can give rise to additional symptoms.
When fibroids bulge from the back of the uterus, they can press on the spinal nerves or rectum, causing either pain in the back and legs or constipation and bloating, or all of the above. Similarly, fibroids that project outward like subserosal growths do can put pressure on the bladder can lead to the constant urge to urinate along with urinary retention.
Patients with fibroids – submucosal, intermural, and subserosal alike – can also have abnormally large abdomens that clinicians sometimes describe in terms of how a woman would appear at four months of pregnancy and so forth. Finally, if feeling all puffed up around the belly, having significant bleeding problems, and experiencing a variety of problems isn’t bad enough, females with fibroids can also have pain that limits their ability to exercise, not to mention enjoy sexual intercourse.
Prevalence
Stephanie Greene may have felt humiliated by the physical symptoms she had to endure before getting her fibroids treated. But once she found out that conservative estimates peg the number of women between the age of 35 and 50 that have fibroids at 20 to 40 percent, though, the sting lessened. “It’s true. Once I found out how common fibroids are, I felt like less of a freak,” Greene said, laughing again. “Or maybe I should say pariah so your readers won’t think I’m completely cavalier.”
Indeed, fibroids are considered by pundits to be a major public health issue since of the 600,000 hysterectomies performed annually in the United States, a third of the operations are due to fibroids. Not all women that have fibroids need treatment, of course, since only one in four patients in which the tumors are present will have symptoms that necessitate intervention.
While fibroids may often appear the size of an apple seed in women in their twenties, most females don’t have any symptoms until their late thirties or forties. Added to that, physicians are not able to predict whether a fibroid will grow and create problems. So it’s all the luck of the draw – science tells us at this point – whether a woman will remain in the group of 75 to 90 percent with fibroids that never have symptoms, or whether she will join the thousands of women that have to run the gauntlet of first the symptoms, then diagnosis and finally deciding on a treatment option.
If it all sounds complex, it’s because it is. Hopefully, though, we’ve hit sufficient high points to get you started on the road of understanding this common problem.
Stay tuned for our series on Fibroids 101 where we’ll explore what causes fibroids, how female anatomy works, matters of pain, treatment options and more.
