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How do I know I have fibroids?

About half of all women who have fibroids have no symptoms. If you aren't experiencing any problems, there's usually no reason to treat the fibroids. The two most common symptoms of fibroids are heavy menstrual bleeding and pelvic pressure. Normal menstrual periods usually last four to seven days, but if you have fibroids, your periods are likely to last longer.

If you have fibroids, the bleeding might be so heavy that you may need to change your sanitary pads as often as every hour. Bleeding between periods isn't usually associated with fibroids, but may occur in rare situations.

With pelvic pressure, you may experience pressure in the pelvic region from an increase in the size of your uterus or from the location of one fibroid in particular. If you notice these symptoms, you should definitely seek a diagnosis from your health care professional.

Are fibroids hard to diagnose?

Not usually. A health care professional should be able to feel some kind of irregularity in your pelvic region during a regular office pelvic exam. If fibroids are suspected, more detailed tests may be conducted to confirm the initial diagnosis. These may include ultrasound (or ultrasonography), MRI (magnetic resonance imagery) or CT (computed tomography). Ultrasound is the most common option used to confirm the diagnosis.

Does the location of my fibroids really make a difference in how they're treated?

The symptoms you experience may vary depending on where the fibroids are located. However, the ultimate course of treatment for your fibroids will likely depend more on other factors, such as whether you plan to have children or how close to menopause you are. If preserving your fertility is a priority, several options won't be recommended.

Is a hysterectomy really the only way I can get rid of my fibroids forever, or at least before I reach menopause?

Yes. While other procedures are helpful because the existing fibroids are removed surgically or shrink with drug therapies, there is no guarantee that new fibroids won't develop.

Is there anything I can do to protect myself from developing fibroids?

Unfortunately, there isn't. Fibroids appear to affect women mostly in their 30s and 40s. Genetics and hormones appear to play a role in who develops fibroids. Being overweight may also play a role.

I've heard that estrogen and other hormones can make fibroids grow; should I avoid taking birth control pills that contain estrogen?

No, there is no evidence that oral contraceptives have any effect on fibroid size. In fact, health care professionals prescribe oral contraceptive pills for some women with fibroids to help control the prolonged or excessively heavy blood flow during menstruation.

Do I need to see a specialist other than my gynecologist to diagnose and treat fibroids?

Your gynecologist should have adequate experience in diagnosing fibroids because they are so common. However, some gynecologists may have more experience or better success at treating fibroids. If you're considering any of the more innovative treatments, whether surgical or medical, make sure you see a practitioner with a strong track record in treating fibroids, and ask about their success rates. Also ask them to put you in touch with other women who have undergone similar treatments.

Are hormone therapy treatments for fibroids dangerous?

GnRH agonists are one treatment option for fibroids. This treatment shrinks fibroids by blocking estrogen production. Because estrogen production is suppressed temporarily, you will experience menopausal symptoms such as hot flashes and vaginal dryness. Treatment is usually limited to three to six months.

To offset hot flashes and other uncomfortable menopausal symptoms caused by GnRH agonists, your doctor may add estrogen and/or progesterone therapy.

Ask your health care professional to review the risks associated with menopausal hormone therapy and how they may or may not be relevant to your treatment needs for fibroids.