At least 25 percent of childbearing women have clinically recognized fibroids. African-American women are at even higher risk with as many as 50 percent developing fibroids of significant size. Jill Vibhakar, M.D., UI Hospitals and Clinics gynecologist, says the majority of women with fibroids do not have symptoms.

"Perhaps about 25 percent of women with clinically recognized fibroids have symptoms. Fibroids have been associated with heavy, prolonged periods, inter-menstrual bleeding, pelvic pressure, pain--including pain during intercourse--urinary symptoms, and bowel problems," she says.

A pelvic exam often detects fibroids, and ultrasound is used to confirm the presence of fibroids and describe their location and size. Vibhakar says. "It's not necessary to have this test unless a pelvic mass is appreciated on exam or unless a woman is having symptoms associated with fibroids."

All fibroids do not need to be treated. In fact, the majority do not require treatment, as most fibroids are asymptomatic, she says. "Since fibroids are benign, we focus on treatment of symptoms. Treatment depends on the symptoms. Often we can control bleeding abnormalities with hormonal manipulation of periods. If the fibroid is located in the uterine cavity, we can remove it hysteroscopically using a vaginal approach. We can also remove fibroids laparoscopically or through a laparotomy incision. Fibroids also can be treated via uterine artery embolization. Hysterectomy is another option," Vibhakar says.

A uterine fibroid embolization or UFE is a minimally invasive procedure performed by interventional radiologists, Vibhakar says. A catheter is threaded to the uterine arteries. Particles are injected which block the main blood supply to the uterus temporarily. This causes fibroids to die and shrink about 50 percent in volume. It is about 85-95 percent effective in treating symptoms of bleeding and/or pain.

A woman having a UFE instead of a total hysterectomy to treat uterine fibroidsis finds recovery time is faster with UFE. However, she says, not every woman is a candidate for UFE depending upon the fibroid size and locations. Also, neither procedure is appropriate for women who want to maintain their fertility. New fibroids can develop after a UFE procedure but may not become symptomatic.

"We do not think fibroids undergo malignant transformation into cancer," she says, "or if they do it's exceedingly rare. However, fibroids can present similarly to a relatively rare form of uterine cancer called leiomyosarcoma."

To learn more about uterine fibroid treatment, call the gynecology clinic at UI hospitals and Clinics at 319-356-2294.

For more information:

Department of Obstetrics and Gynecology

Jill Vibhakar, M.D.