Fibroids Are the Roommates Nobody Invited
They can take up space, create a surprising amount of disruption, and behave very differently from one person to the next. Uterine fibroids are common, noncancerous growths, but the word common does not describe how much they may affect an individual patient's life.
Dr. Joseph Leveno evaluates fibroid symptoms and provides individualized gynecologic treatment in Plano based on the size and location of fibroids, symptom severity, health history, and pregnancy goals.
What Are Uterine Fibroids?
Fibroids develop from the muscle of the uterus. They may grow within the uterine wall, project into the uterine cavity, or extend toward the outside of the uterus. A patient may have one fibroid or several, and their sizes can vary considerably.
They are not the same as uterine cancer, and many fibroids never cause symptoms. Finding one on an ultrasound does not automatically mean treatment is required.
Which Symptoms Can Fibroids Cause?
Location often matters as much as size. A fibroid that changes the uterine cavity may contribute to bleeding, while another may create pressure because of where it sits.
- Heavy, prolonged, painful, or more frequent menstrual bleeding
- Pelvic pressure, fullness, abdominal enlargement, or lower back discomfort
- Frequent urination, constipation, or discomfort during sex
- Fertility or pregnancy concerns in some circumstances
Those symptoms can also have other causes, so the goal is not to identify fibroids from a checklist. It is to give your clinician a clear picture of what has changed.
How Are Fibroids Evaluated?
Evaluation begins with symptoms, menstrual history, prior pregnancies, family history, medications, and reproductive plans. A pelvic examination and ultrasound may help identify the number, size, and position of fibroids.
Additional imaging or hysteroscopy may be useful in selected situations, particularly when bleeding is prominent or a fibroid may involve the uterine cavity. Blood work may also be recommended if heavy bleeding could have caused anemia.
Does Every Fibroid Need Treatment?
No. Fibroids that are small, stable, and not causing meaningful symptoms may only need observation. Treatment becomes a more useful discussion when bleeding causes anemia, pain or pressure affects daily life, fertility is involved, or symptoms are worsening.
The decision is about the patient, not simply the ultrasound measurement. Two people with similarly sized fibroids may reasonably choose very different plans.
What Treatment Options Might Be Discussed?
Medication or hormonal treatment may help manage bleeding or pain for some patients. Procedures can include hysteroscopic treatment for selected fibroids inside the uterine cavity, minimally invasive surgery, myomectomy, or hysterectomy depending on the situation.
Future pregnancy plans are especially important. Some treatments preserve the uterus while others end the ability to carry a pregnancy. Ask what the recommendation is intended to improve, which alternatives exist, and how each option may affect fertility and recovery.
When Should You Stop Calling It Normal?
If periods repeatedly cause missed work, nighttime changes, leaks, severe pain, or symptoms of anemia, the disruption is worth evaluating. The same is true for persistent pelvic pressure, urinary changes, or a noticeably enlarging abdomen.
"A fibroid does not need treatment simply because it exists, but symptoms should not be dismissed simply because fibroids are common," says Dr. Leveno. "We decide what to do by looking at the whole clinical picture."
If you have earlier ultrasound reports, operative notes, or records from fertility treatment, bring them when possible. Comparing current findings with prior measurements can help show whether a fibroid has changed. A list of treatments already tried, how long you used them, and what happened is equally useful when discussing the next step.
Frequently Asked Questions
Can fibroids go away on their own?
Fibroids often shrink after menopause as hormone levels change, but the course is not identical for every patient. Symptoms and growth before menopause should still be evaluated appropriately.
Can fibroids affect fertility?
Some fibroids can affect fertility or pregnancy depending on their location, size, and relationship to the uterine cavity. Many patients with fibroids become pregnant without difficulty.
Is a hysterectomy the only definitive option?
Hysterectomy removes the uterus and prevents fibroids from returning, but it is not the only treatment. Medication, monitoring, and uterus-preserving procedures may be appropriate depending on symptoms and goals.
If bleeding, pressure, or pain may be related to fibroids, contact Dr. Leveno's Plano office to schedule a gynecologic evaluation.