What The Heck Is A Uterine Fibroid & How Do You Know If You Have One?

Photographed by Alexandra Gavillet.
You may not have heard of uterine fibroids, but chances are, you'll have them at some point in your life — and they have the potential to cause some serious pain. Here's what you need to know about these weird, (mostly) little bundles of muscle cells.
Around half of all people with uteruses are primed to develop uterine fibroids at some point before menopause, says Veronica Lerner, MD, a gynecologist at NYU Langone Medical Center. And for most of us, they don't cause any problems.
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For some people, though, those fibroids can cause weird feelings of fullness in your pelvic area and intense pain. "The fibroids themselves can affect women in two ways," Dr. Lerner explains: Depending on the size and location, they can cause pain and heavy menstrual bleeding, and they can interfere with your ability to become pregnant.
That's because fibroids are non-cancerous tumors that develop thanks to mutations in the muscle cells along the walls of your uterus. "Because the fibroid is pressing on the lining," Dr. Lerner says, "it may cause heavy or prolonged periods, lots of blood clots, and severe period pain." On top of that, fibroids can make it difficult for an embryo to implant on the uterine lining, reducing your chances for pregnancy.
Although the causes of uterine fibroids aren't totally understood, Dr. Lerner says that doctors believe your hormones have a lot to do with them. They may change and cause swelling during your menstrual cycle, she explains, and they tend to stop growing after menopause, when your estrogen levels plummet. And unfortunately, some people are just more likely to get them than others: African American women, for instance, have a much higher chance of developing fibroids (and more severe symptoms) than white women.
So how do you deal with fibroids? Dr. Lerner says your plans for pregnancy have a lot to do with the way your doctor will proceed. If you're done with (or just not interested in) having kids, you might opt for a hysterectomy to remove your uterus and just be done with it.
But if you're not in the mood for major surgery or you do still want to have kids, Dr. Lerner says you have other options. Sadly, there's no medication that will just make your fibroids go away, though. So depending on how severe your symptoms are, your doctor might suggest sticking with over-the-counter painkillers. And if your menstrual cycle seems to affect your symptoms, she may advise you to go on hormonal birth control.
However, if your fibroids are especially big and painful, you can have a myomectomy, which is a surgical procedure to remove them. Depending on the location of your fibroids, the procedure may be done with minimally invasive techniques. But it's not uncommon for the fibroids to return within a few years. Dr. Lerner says about a third of patients end up going back for another procedure.
So if you think you might have uterine fibroids, definitely talk to your doctor. She'll perform an exam and set you up with an ultrasound. And then she can walk you through the best options for your particular issue and life circumstances. Fibroids may be a fact of life, but they don't have to be the worst.
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