Home > Medical Reference > Patient Education

Ask the Expert

Get answers to your Interventional Radiology questions.

Note: This is for informational purposes only. Doctors cannot provide a diagnosis or individual treatment advice via e-mail. Please consult your physician about your specific health care concerns.

Please install flash player to see this video.

Uterine fibroids and hysterectomy - Highlights

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of uterine fibroids

Alternative Names

Hysterectomy and uterine fibroids; Leiomyoma; Myoma

Highlights:

Uterine Fibroids

Uterine fibroids, also called leimyomas or myomas, are non-cancerous growths that originate in the thick wall of the uterus. Fibroids are the most common type of tumor found in female reproductive organs. Uterine fibroids are very common, especially among African-American women.

Symptoms of Uterine Fibroids

Common symptoms of uterine fibroids may include:

Heavy and prolonged menstrual bleeding
Pressure and pain in the abdomen and lower back
Frequent urination
Constipation
Pain during intercourse
Some women with fibroids do not have any symptoms

Complications of Uterine Fibroids

Fibroids can increase pregnancy complications and delivery risks.
Anemia due to iron deficiency may result from heavy menstrual bleeding.
Large fibroids may reduce fertility, although this is not very common.

Treatment

Many women with fibroids choose not to have treatment, especially if they are approaching the age of menopause. Fibroids grow slowly and usually shrink after menopause. Treatment may include various drug and surgical options.

Medications for Fibroids

Continuous-dosing oral contraceptives can reduce or eliminate menstrual periods.
Progestin-releasing intrauterine devices can help control excessive menstrual bleeding.
Gonadotropin-releasing hormone (GnRH) agonists reduce estrogen and progesterone levels, which diminishes the size of fibroids.

Surgical Options

Invasive and less-invasive surgical methods include:

Myomectomy
Uterine artery embolization
Endometrial ablation
Magnetic resonance-guided focused ultrasound (still not commonly available)
Hysterectomy

Resources

www.asrm.com -- American Society for Reproductive Medicine
www.acog.org -- American College of Obstetricians and Gynecologists
www.sirweb.org -- Society of Interventional Radiology
www.nuff.org -- National Uterine Fibroids Foundation
www.rsna.org -- Radiological Society of North America
www.radiologyinfo.org -- Radiology info from the American College of Radiology and the Radiological Society of North America
www.womenshealth.gov -- National Women's Health Information Center
www.nichd.nih.gov -- National Institute of Child Health and Human Development

References

American College of Obstetricians and Gynecologists. ACOG practice bulletin. Alternatives to hysterectomy in the management of leiomyomas. Obstet Gynecol. 2008 Aug;112(2 Pt 1):387-400.

Edwards RD, Moss JG, Lumsden MA, Wu O, Murray LS, Twaddle S, et al. Uterine-artery embolization versus surgery for symptomatic uterine fibroids. N Engl J Med. 2007 Jan 25;356(4):360-70.

Evans P, Brunsell S. Uterine fibroid tumors: diagnosis and treatment. Am Fam Physician. 2007 May 15;75(10):1503-8.

Gabriel-Cox K, Jacobson GF, Armstrong MA, Hung YY, Learman LA. Predictors of hysterectomy after uterine artery embolization for leiomyoma. Am J Obstet Gynecol. 2007 Jun;196(6):588.e1-6.

Griffiths A, D'Angelo A, Amso N. Surgical treatment of fibroids for subfertility. Cochrane Database Syst Rev. 2006 Jul 19;3:CD003857.

Hehenkamp WJ, Volkers NA, Donderwinkel PF, de Blok S, Birnie E, Ankum WM, et al. Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids (EMMY trial): peri- and postprocedural results from a randomized controlled trial. Am J Obstet Gynecol. 2005 Nov;193(5):1618-29.

Jacoby VL, Grady D, Sawaya GF. Oophorectomy as a risk factor for coronary heart disease. Am J Obstet Gynecol. 2009 Feb;200(2):140.e1-9. Epub 2008 Nov 18.

Kaunitz AM. Progestin-releasing intrauterine systems and leiomyoma. Contraception. 2007 Jun;75(6 Suppl):S130-3. Epub 2007 Mar 9.

Kaunitz AM, Meredith S, Inki P, Kubba A, Sanchez-Ramos L. Levonorgestrel-releasing intrauterine system and endometrial ablation in heavy menstrual bleeding: a systematic review and meta-analysis. Obstet Gynecol. 2009 May;113(5):1104-16.

Lethaby A, Ivanova V, Johnson NP. Total versus subtotal hysterectomy for benign gynaecological conditions. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD004993.

Olive DL, Lindheim SR, Pritts EA. Conservative surgical management of uterine myomas. Obstet Gynecol Clin North Am. 2006 Mar;33(1):115-24.

Parker WH, Broder MS, Chang E, Feskanich D, Farquhar C, Liu Z, et al. Ovarian conservation at the time of hysterectomy and long-term health outcomes in the nurses' health study. Obstet Gynecol. 2009 May;113(5):1027-37.

Rackow BW, Arici A. Options for medical treatment of myomas. Obstet Gynecol Clin North Am. 2006 Mar;33(1):97-113.

Smart OC, Hindley JT, Regan L, Gedroyc WG. Gonadotrophin-releasing hormone and magnetic-resonance-guided ultrasound surgery for uterine leiomyomata. Obstet Gynecol. 2006 Jul;108(1):49-54.

Van Voorhis B. A 41-year-old woman with menorrhagia, anemia, and fibroids: review of treatment of uterine fibroids. JAMA. 2009 Jan 7;301(1):82-93. Epub 2008 Dec 2.

Viswanathan M, Hartmann K, McKoy N, Stuart G, Rankins N, Thieda P, et al. Management of uterine fibroids: an update of the evidence. Evid Rep Technol Assess (Full Rep). 2007 Jul;(154):1-122.

Volkers NA, Hehenkamp WJ, Birnie E, Ankum WM, Reekers JA. Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids: 2 years' outcome from the randomized EMMY trial. Am J Obstet Gynecol. 2007 Jun;196(6):519.e1-11.

Reviewed last on: 8/5/2009
Reviewed by Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.