Fibroids After 50 (Why They Don’t Always Disappear!)

 

Fibroids, also known as leiomyomas, are estrogen-dependent. As a result, they typically grow and present symptoms during a woman’s reproductive years, when the ovaries are active. Once the ovaries stop naturally producing estradiol (estrogen)—usually in her mid-50’s— a woman is said to have entered menopause. Logically, the drop in estrogen production that occurs in menopause would cause any uterine fibroids to gradually shrink, and this is typically the case. Fibroids and their accompanying symptoms often diminish after menopause. But what if they don’t?

There are a number of reasons why a woman would continue to have difficulty with a fibroid tumor during this stage of her life: stimulation from exogenous estrogen production (i.e. hormone replacement therapy), cancerous tumors, or malignant uterine/fibroid changes are a few possible causes.

Hormone replacement is commonly prescribed for menopausal women to reduce the uncomfortable symptoms that result from estrogen-deficiency, including hot flushes, vaginal dryness, mood fluctuations, and reduced desire for sex. Estrogen deficiency can also compromise bone health, increasing the risk of fractures; adding supplemental estrogens back into the body can help maintain a woman’s bone strength after menopause.

Replacing estrogen with hormone therapy can drastically increase the quality of life for many women in menopause. However, the risks of hormone replacement can sometimes outweigh the benefits, the recurrence or worsening of fibroid symptoms being one example. Dr. Donald Galen, OB-GYN and former Surgical Director at the Reproductive Science Center of the San Francisco Bay Area explains, “if fibroids are present, the addition of estrogens will generally stimulate fibroid growth, or minimize fibroid regression which otherwise would occur during natural menopause.” A study by Lamminen et al. that compared the activity of fibroids in pre- and post-menopausal women found just that: proliferative activity was low in the post-menopausal subjects who weren’t receiving hormone replacement, whereas those women who were receiving hormones had “fibroid proliferative activity equal to premenopausal women”. Dr. Galen also advises patients of other risks related to hormone therapy, as well. He explains, “estrogen can increase health risks, such as an increased risk of blood clots, increased risk of breast hyperplasia/cancer, and increased risk of endometrial hyperplasia and/or endometrial cancer.”

Hormone replacement therapy isn’t the only reason women see a persistence in fibroid symptoms after menopause. Malignant changes in existing fibroids or the emergence of new, cancerous tumors (“neoplasia”) on the uterus or reproductive organs can produce symptoms like those of benign leiomyomas.  Dr. Galen advises, “as a precaution, any woman with an increase in uterine growth/size and/or post-menopausal uterine bleeding should be evaluated to rule-out malignant uterine/fibroid changes.”

 

 

SOURCES:

Burbank, Fred. Fibroids, Menstruation, Childbirth and Evolution: The Fascinating Story of Uterine Blood Vessels. Tucson, AZ: Wheatmark, 2009. 93. Print.

Lamminen, S. et al.”Proliferative activity of human uterine leiomyomacells as measured by automatic image analysis”,Gynecologic and Obstetetric Investigation. 1992; 34:111-114

 

LI-00-0491

The 5 Biggest Myths Surrounding Uterine Fibroids

 

shutterstock_325530068Fibroids are the most common type of pelvic tumor among women of reproductive age. Despite their prevalence, however, fibroids are widely misunderstood. A number of popular misconceptions, in particular, create confusion for women with fibroids who are trying to understand their condition and treatment options. To clear up some of this confusion, we’re breaking down five of the most common myths surrounding fibroids.

 

MYTH: If you have fibroids, you will experience symptoms like heavy menstrual bleeding and pain.
As common as the condition is, researchers estimate that between 50-80% of women with fibroids will experience no fibroid symptoms at all. Many women with asymptomatic fibroids never even know that they have the condition. And, because fibroid tumors are almost always benign, women who aren’t experiencing symptoms may opt to forgo treating their fibroids.

MYTH: A routine ultrasound will detect any uterine fibroids that are present.
If fibroids are suspected, the first diagnostic tool gynecologists employ to confirm the suspicion is transvaginal ultrasound. However, this imaging method doesn’t always reveal all existing fibroids. The size and location of uterine fibroids varies greatly, and extremely small fibroids, submucosal fibroids, and small fibroids that are hidden behind larger tumors, aren’t always detectable through a routine pelvic ultrasound. For clearer visualization of the tumors, physicians frequently rely on laparoscopic ultrasound, which requires inserting a scope through the vagina and into the abdominal cavity provides. Research has shown that laparoscopic ultrasound can detect up to twice as many fibroids as transvaginal ultrasound.

MYTH: Fibroid tumors will become cancerous.
Uterine fibroids, also known as leiomyomas, are almost always benign: in women of reproductive age, less than 0.01% of (removed) fibroids become cancerous. While fibroids typically shrink after menopause, those that do appear in post-menopausal women may be the cancerous type, called leiosarcomas. It’s important to note, however, that – regardless of age – simply having fibroids does not increase a woman’s chances of developing cancer in her reproductive organs.

MYTH: Endometrial ablation is a method of treating fibroids
Endometrial ablation (EA) is a commonly used to treat abnormal uterine bleeding. The technique entails destroying the layer of tissue that lines the uterus known as the endometrium, preventing new tissue from growing and thereby reducing or eliminating menstrual bleeding. While you may have heard EA discussed in the context of fibroids, it is not, in fact a fibroid treatment. The destruction of fibroids that can occur with EA is incidental, and is not likely complete. In such cases, the ablated fibroids will often regrow, since subserosal fibroids – the type that grow inside the uterus and are therefore subject to destruction during EA – often originate below the endometrium layer.

MYTH: If left untreated, fibroids will continue to grow throughout a woman’s lifetime.
Fibroid growth is fueled by estrogen. Accordingly, fibroids will grow and shrink in response to the body’s hormone fluctuations. Pregnant women often experience rapid growth in existing fibroids and may develop new fibroids during pregnancy, due to the heightened levels of estrogen that their bodies are producing. Conversely, fibroids typically shrink after menopause, because the ovaries have stopped producing estrogen. (Post-menopausal women undergoing hormone replacement therapy can expect the opposite to occur, however, since they are artificially replacing the missing estrogen.) Although fibroids do tend to disappear naturally after menopause, pre-menopausal women who are suffering with symptoms of uterine fibroids may not want to wait.

When fibroids are interfering with the quality of life, it’s advisable to discuss treatment options with a gynecologist. With a plethora of treatments available to women with fibroids, including uterine conserving methods like Acessa Procedure, it’s not necessary to endure long-term suffering!

 

SOURCES:

American Society for Reproductive Medicine, “What Are Fibroids? Fact Sheet”, Resources, ReproductiveFacts.org: rev. 2012. Retrieved Aug 26, 2015, from http://www.reproductivefacts.org/FACTSHEET_What_are_Fibroids/

Levine, D.J. et al. “Sensitivity of Myoma Imaging Using Laparoscopic Ultrasound Compared With Magnetic Resonance Imaging and Transvaginal Ultrasound”, Journal of Minimally Invasive Gynecology. Nov/Dec 2013; Vol 20(6): 770-4

Burbank, Fred. Fibroids, Menstruation, Childbirth and Evolution: The Fascinating Story of Uterine Blood Vessels. Tucson, AZ: Wheatmark, 2009. 135. Print.

 

LI-00-0481-A

The Future of Fibroid Research

Hysterectomy may have been the prevailing standard for treating uterine fibroids in the past, but times have changed. Abundant research on the subject of fibroids has yielded new advances in treatment modalities for the condition, fueled by the widespread demand from fibroid patients for uterine- and fertility-sparing treatment options. Thanks to this research, numerous alternative therapies are now available for women with symptomatic fibroids, and awareness of non- and minimally-invasive fibroid treatment options is growing among both patients and health care providers. As fibroid research continues, we can expect the number and availability of alternative treatments to further expand.

“It is extremely important for women to know the options available to treatment of uterine fibroids,” says Dr. Elizabeth Stewart, M.D., Chair of Reproductive Endocrinology at Mayo Clinic. “Equally important,” she adds, “is the need to continue to study fibroids to assist in developing better treatments.” The Mayo Clinic is endeavoring to do just that, launching a massive research effort to compare existing treatments for uterine fibroids. With funding from the Patient-Centered Outcomes Research Institute (PCORI) and the Agency for Healthcare Research and Quality (AHRQ), researchers from several institutions, including Duke University, University of California – San Francisco, and Mayo Clinic are establishing an observational registry that includes 10,000 women with diagnosed uterine fibroids. The research initiative, called COMPARE-UF, will look at the factors that most heavily influence the treatment choices of its women participants and will evaluating all available treatment options in terms of those priorities. Recognizing the importance of uterine-sparing and fertility-sparing therapies that has been widely expressed by women with fibroids, researchers will look at a variety of hysterectomy alternatives, including minimally invasive procedures like radiofrequency ablation.

Beyond the COMPARE-UF registry, a slew of other studies are focusing on alternatives to hysterectomy in the treatment of fibroids. Researchers at UCSF, Duke University, and Mayo Clinic are currently conducting research to compare two uterine-sparing procedures, uterine artery embolization (UAE) and MR-guided focused ultrasound. Their “FIRSTT” study, funded by the National Institute of Health, is the first in the U.S. to compare UAE and MR-guided focused ultrasound. The researchers will look at the differences between the two treatments in terms of symptom relief, side effects, impact on quality of life, and recurrence/re-intervention.

Another major fibroid treatment study is also underway at UCSF: the ULTRA study is being conducted to help patients and doctors better understand how radiofrequency ablation (Acessa Procedure) changes fibroid symptoms, affects fertility and pregnancy, and impacts the need for additional fibroid treatment in the future. While the procedure has already received FDA clearance and is being performed with increasing frequency, studies of this nature provide the kind of additional data that facilitate acceptance by major health insurers.

The increasing focus by medical researchers on hysterectomy alternatives stands to benefit more than the patients; the medical community and the U.S. healthcare system could see a significant, positive, long-term impact from the shift. According to Dr. Jay Berman of Wayne State University’s School of Medicine, the medical community’s demand for safer, less invasive and less expensive treatment options is growing. He explains, “while hysterectomy will continue to be a option for the appropriate patient, some alternative techniques appear to save the cost of hospitalization, are organ-sparing, have low re-operation rates, and result in high patient satisfaction… It behooves the decision-makers to look at the overall acceptability of less-invasive, outpatient treatments that keep hospital beds for the sickest of our patients and reduce the demand for future healthcare services.”

For patients and physicians alike, the improved understanding of the condition and its treatment that research produces translates to improved quality and availability of treatment options. Having options is essential, because fibroid treatments are not “one-size-fits-all”. While hysterectomy’s consequences and general invasiveness make it an undesirable approach to many women seeking fibroid treatment, hysterectomy is still the most medically appropriate approach in certain cases. Mayo Clinic’s Dr. Stewart believes the decision on how to best treat a woman’s fibroids should be guided by the nature and severity of her symptoms; her age and health history; and the size, number, and location of the fibroids themselves. The key for women with fibroids is awareness of all the available treatment options, and —thanks to continuing research on the subject —those options will continue to improve in the future.

Sources:

  1. Rosen, P. “The Endangered Uterus”, More.com Dec 2008/Jan 2009; 117-121, 157-158
  2. “Exploring Treatment Options for Women with Fibroids.” Medical Xpress. April 23, 2015. Retrieved May 7, 2015. http://medicalxpress.com/news/2015-04-exploring-treatment-options-women-fibroids.html.
  3. Berman, Jay M. “Alternative Procedures For the Treatment of Symptomatic Fibroids”, Wayne State University School of Medicine

 

LI-00-0467-A

Why Fibroids Are Everyone’s Problem

Uterine fibroids, benign pelvic tumors that are also known as leiomyomas, are a nightmare for more than just the millions of women who endure the condition’s symptoms: the U.S. healthcare system also feels the pain. A 2011 study by Cardozo et. al quantified that pain, estimating the annual cost of uterine fibroids to the United States at between $5.9 and $34.4 billion, “more than breast cancer, colon cancer or ovarian cancer, and nearly one fifth the annual cost of diabetes”. The enormous economic burden of the condition led another group of researchers, Eltoukhi et. al, to conclude, “fibroid tumors should be considered a public health issue, given the magnitude of the problem and costs of health care for this disease.”

Estimating the real cost of fibroids to the U.S. healthcare system is no simple task. Multiple research studies have delivered a wide range of figures. To thoroughly understand the fiscal burden, estimates have to account for both direct costs—including hospitalizations, outpatient visits, surgical procedures and medical treatments—and indirect costs, like the lost work productivity that correlates with the condition of symptomatic uterine fibroids.

Examining the full economic impact of the condition, the Cardozo study considered both direct and indirect costs. The researchers estimated that between $4.1 and $9.4 billion is spent annually on medical treatments for fibroid patients. The range is fairly wide, due to the difference in cost between various fibroid treatment modalities; the more invasive surgical methods incur the greatest cost. “As approximately 200,000 hysterectomies and 30,000 myomectomies are performed annually for [fibroids],surgical costs alone contribute significantly to the total annual costs of this disease.”

However, healthcare costs are not the only expense contributing to fibroids’ fiscal impact: the Cardozo study found that lost work productivity accounted for the largest portion of the fibroids’ societal cost, potentially totaling as much as $17.2 billion dollars annually. Hartmann et. al determined that women with diagnosed with Uterine Fibroids were 3 times more likely to file a disability claim than their healthy counterparts. Furthermore, Lerner et. al, looked at work-performance limitations and productivity loss in women with untreated uterine fibroids and found that “symptomatic fibroids interfere substantially with women’s ability to function at work”.

Researchers in the Lerner study evaluated survey data from 58 women with symptomatic fibroids and 56 healthy women in a control group. They found that productivity loss related to absenteeism was 5.4% among women with fibroids versus 1.4% for women in the control group. The researchers also looked at ways in which having symptomatic fibroids impacted various aspects of women’s work performance, including time management, performance of mental and interpersonal job tasks, performance of physical tasks, and overall output. Their findings indicated that symptomatic uterine fibroids negatively impacted all aspects of the women’s job performance. The relative impact is represented in the chart below.

halt

 

The results of the Lerner study revealed that, on average, the work performance of fibroid sufferers was impaired 18% of the time, compared to 8% of the time for the average member of the control group. The study, which was published in the Journal of Occupational and Environmental Medicine in 2008, reported that, “the [group with fibroids] had mean at-work productivity deficits that, while lower than observed for primary care patient samples with major depressive disorder or osteoarthritis, are similar to those documented for clinic patients with diagnosed migraine headache”.

The U.S. Bureau of Labor Statistics reports that, “in 2013, women accounted for 51 percent of all workers employed in management, professional, and related occupations, somewhat more than their share of total employment (47 percent)”. Considering the high prevalence of fibroids among adult women, the societal impact of lost productivity, absenteeism, and disability claims attributable to fibroids is one we simply can’t afford to ignore.

The societal and economic impact of uterine fibroids also has a racial dimension. Multiple studies have observed that the incidence of fibroids is higher in African American women than in women of other races. The reason for the disparity in fibroids’ occurrence isn’t fully understood, but the problem is a big one: while it’s estimated that fibroids occur in as many as 70% of women, the incidence of fibroids in black women is even higher, with estimates reaching 80%.
Treated or untreated, the occurrence of fibroids has a particularly negative impact on women of color. African Americans are the “disproportionate majority” having surgery for fibroids, according to Moore et. al. Furthermore, race-based differences have been observed in health outcomes and responses to treatment: for example, African American women have a higher risk of post-surgical complications. Of those women studied by Lerner et. al whose symptomatic fibroids were untreated, women of color experienced greater productivity loss at work. The Lerner study reported that, “racial/ethnic minority status was associated with more difficulty managing physical and mental-interpersonal job tasks”.

A study by Eltoukhi et. al pointed to unequal access to care as an underlying factor. “Socioeconomic status and race influence access to appropriate health care. This disparity is a significant and controversial problem in the United States health care system, especially because access to some therapies is directly affected by insurance status and cost of the procedure. When hysterectomies are performed, white women and women of other racial groups with private insurance are more likely to undergo laparoscopic procedures, whereas African Americans, Hispanics, and women with Medicare coverage are more likely to undergo abdominal procedures, even for the same indication.”

The research team of Weiss et. al found a different explanation for the phenomenon, at least in terms of African American women’s higher likelihood of undergoing hysterectomy: they concluded that, “racial differences in the frequency of hysterectomy for benign conditions are consistent with differences in presenting symptoms, where African-American women seemingly have larger, more symptomatic fibroids”. While the reason for the disparity in treatment remains elusive, the implications have a direct and significant impact on the overall cost of fibroids to the U.S. health system.

Recovery time for a hysterectomy generally exceeds 4 weeks. That’s a lot of lost work days. The Cardozo study determined that “if the percentage of women undergoing hysterectomy was minimized as was the cost of lost work for these women, it would result in a 25.6% savings in the total annual costs due to uterine fibroids”. With that profound statistic in mind, we have reason to be hopeful: newer fibroid treatments such as the Acessa Procedure can effectively treat fibroids through minimally-invasive means, allowing for a faster recovery time. A study by Garza et. al showed that patients who underwent the Acessa Procedure were able to return to work or normal activities in an average of 3-4 days.

The increasing availability of less invasive treatment options that are associated with shorter recovery times give reason to be optimistic in the face of this public health crisis. While a faster recovery means less productivity loss related to fibroid treatment, it could also potentially minimize the productivity loss from untreated fibroid symptoms by reducing the consequences that commonly lead women to delay seeking treatment. If safe, effective, minimally invasive treatments are widely available and accessible to all women with uterine fibroids, the decision to seek treatment would likely be an easier one. In these ways, as fibroid treatment options improve, perhaps the economic burden that the condition creates will do the same.

Sources:

  1. Cardozo, E. et. al, “The Estimated Annual Cost of Uterine Leiomyomata in the United States”, American Journal of Obstetrics and Gynecology. 2011, doi:10.1016/j.ajog.2011.12.002
  2. Hartmann K.E. et al. “Annual costs associated with diagnosis of uterine leiomyomata”, Obstetrics and Gynecology. 2006;108:930 –937.
  3. Lerner,D. et. al, “Impaired Work Performance Among Women With Symptomatic Uterine Fibroids”JOEM. Oct. 2008; Vol.50(10):1149-1157
  4. U.S. Department of Labor and U.S. Bureau of Labor Statistics, “Women in the Labor Force: A Databook”. 2014 edition, 1052. Retrieved 4/15/15 from: http://www.bls.gov/opub/reports/cps/women-in-the-labor-force-a-databook-2014.pdf
  5. Moore, A.B. et. al, “Association of race, age and body mass index with gross pathology of uterine fibroids”, Journal of Reproductive Medicine. Feb. 2008; Vol.53(2):90-6
  6. Eltoukhi, H.M. et. al, “The health disparities of uterine fibroid tumors for African American women: a public health issue”, American Journal of Obstetrics and Gynecology. Mar 2014; Vol.210(3):194-9
  7. Weiss G. et. al, “Racial differences in women who have a hysterectomy for benign conditions”, Women’s Health Issues. May-Jun 2009;Vol.19(3):202–10
  8. Pitter, M.C. et. al, “The Impact of Different Surgical Modalities for Hysterectomy on Satisfaction and Patient Reported Outcomes” Interactive Journal of Medical Research. Jul-Sep. 2014; Vol. 3(3): e11.
  9. Garza, L. et. al, “Laparoscopic ultrasound-guided radiofrequency volumetric thermal ablation of symptomatic uterine leiomyomas: feasibility study using the Halt 2000 ablation system”, Journal of Minimally Invasive Gynecology. 2011;18(3):364–71.

LI-00-0459-A

Fibroids Are Not Color Blind

Over the years, researchers have examined the epidemiological connection between a wide variety of patient characteristics and the occurrence of uterine fibroids, seeking to identify risk factors. Age, weight, diet, geographic location, lifestyle factors like cigarette smoking, medical conditions, and history of childbirth have all been studied, and many have been correlated with fibroids in one way or another. But time after time, study after study, one characteristic has stood out as a major indicator of fibroid risk: race. And the conclusion that researchers have consistently reached is this: uterine fibroids (also known as leiomyomas) disproportionately affect women of color.

Certain, specific differences have been seen in the cases of black women: research shows that, in comparison to white women, black women tend to develop a larger number of fibroids and experience more fibroid-related symptoms. A study published in 2013 by the American Society for Reproductive Medicine reported that, “African-American women had substantially more fibroids” with an average of 9.9 fibroids compared to the Caucasian subjects’ average of 4.5 fibroids. Additionally, Weiss et al. conducted a multi-ethnic, multisite, longitudinal study of 3,302 women ages 42-52 and concluded that “previously diagnosed leiomyomas were presenting symptoms more frequently in African-American woman than Caucasian women (85% vs. 63%)”.

The racial disparity in fibroid occurrence isn’t fully understood. The research that exists mostly defines the relative risk of the condition in terms of black and white. Obviously, black and white women aren’t the only ones affected by uterine fibroids. While very little data exists on the differences in susceptibility and symptoms between other ethnicities, a 2011 study conducted by the U.S. Armed Forces identified the relative risk of fibroids for multiple ethnic groups. The study looked at the population of active military women who were diagnosed with fibroids between 2001 and 2010: 11,931 cases were recorded. The researchers concluded that, relative to the white, non-Hispanic population, the risk of fibroids was slightly higher (1.1 times) for Hispanics and Asians/Pacific Islanders, and slightly lower (.9 times) for American Indians/Alaskan Natives. By comparison, African American women were 4.4 times more likely to have the same diagnosis, and women in the ethnic category of “Other” had almost double (1.9 times) the incidence of fibroids. These findings are depicted in the graph below.

Fibroids--race_MSMRgraph

As of now, there are no clear answers to explain why symptoms and presentation of uterine fibroids are different in women of color. However, the connection between fibroids and race is certainly a topic of interest to researchers, physicians and fibroid patients alike, and one that continues to be the subject of medical research.

Sources:

  1. Schwartz, S.M. “Epidemiology of uterine leiomyomata”, Clinical Obstetrics & Gynecology. June 2001; Vol.44(2):316-26
  2. Moorman, P.G. et al. “Comparison of characteristics of fibroids in African American and white women undergoing premenopausal hysterectomy”, Fertility & Sterility, March 2013; Vol.99(3)768-776>
  3. Weiss, G. et al. “Racial differences in women who have a hysterectomy for benign conditions”, Women’s Health Issues, May-June 2009; Vol.19(3):202-10
  4. Eltoukhi, H.M. et al. “The health disparities of uterine fibroid tumors for African American women: a public health issue”, American Journal of Obstetrics & Gynecology, March 2014; Vol.210(3)
  5. “Uterine Fibroids, Active Component Females, U.S. Armed Forces, 2001-2010”, Medical Surveillance Monthly Report, December 2011; Vol.18(12):10-13

LI-00-0419-A

Fibroid Tumors – What Are They?

They vary in size from microscopic to the size of a grapefruit. Uterine fibroid tumors are usually diagnosed during a routine pelvic exam. Their exact cause is unknown but there are several contributing factors.

What are fibroid tumors caused by?

Doctors have been able to draw correlations between the following conditions/factors and the development of fibroid tumors.

Estrogen. The more estrogen present, the more rapidly fibroid tumors grow; which is why they are never diagnosed in pre-pubescent girls. While its debatable whether or not estrogen causes them, it definitely plays a role in whether or not a women displays symptoms and/or requires treatment. Uterine fibroids are most common in women between the ages of 30 and 50, and much less prevalent in post-menopausal women.

Obesity. Women who are excessively overweight are two-times more likely to develop fibroid tumors.

Diet. Diets heavier in red meat has been linked to the growth of uterine fibroids, while those who eat plenty of green vegetables seem to be less susceptible.

Genetic predisposition. Women who have mothers or grandmothers with a history of fibroid tumors are more likely to develop them, as well.

Race. African American women are more likely to develop uterine fibroids than any other race and can develop them in their 20s, which is earlier than most other women.

There are several different types of fibroid tumors:

Submucosal – Lie just under the mucous lining of the uterus and they frequently cause bleeding outside of the normal menstrual cycle.

Intramural – Occur in the wall of the uterus and can cause uterine bulking or pain as fibroids get larger.

Subserosal – Located on the outside layer of the uterine wall, and cause problems as they grow and come in contact with other organs.

Pedunculated – These fibroid tumors grow on a stalk, and are generally occur as pedunculated submucosal or subserosal fibroid tumors. They may be symptomatic in the same manner as non-pedunculated tumors.

Symptoms and Treatment of Fibroid Tumors

The most common symptoms of uterine fibroids include:

  • Heavy menstrual periods with prolonged bleeding
  • Abnormal bleeding
  • Pain in the pelvic/lower abdominal region
  • A feeling of fullness, or actual enlargement, of the pelvic/lower abdominal region
  • Bladder pressure and/or increased need to urinate
  • Lower back pain/pressure

Treatments for fibroid tumors may vary. Small tumors will usually go untreated, unless they are symptomatic. Some tumors respond well to medicine, which causes them to shrink. Larger tumors may need to be removed via surgery. Women should notify their doctor(s) if they have a family history of fibroid tumors and make an appointment if they experience any symptoms. Thankfully, the majority of women with fibroid tumors will never experience symptoms requiring invasive treatment.

LI-00-0108-A