When does treatment for fibroids become necessary?

Fibroids are essentially benign or noncancerous growths in the uterus. If they are not causing any problems or if the symptoms (e.g., bleeding, pain) are mild, then treatment might not be necessary—or it may be postponed. Your doctor may recommend more frequent examinations to keep track of the fibroids that are affecting you.

Because fibroids can grow anywhere in the uterus and in a wide range of sizes, they are associated with a variety of uterine problems. The growths are most notable for triggering heavy menstrual bleeding, disabling cramps, and unpredictable bleeding between periods, and they may underlie serious anemia and exhaustion resulting from blood loss. An estimated 30% of women with fibroids experience abnormal uterine bleeding that usually does not begin as extreme blood loss. For most, the build-up to very heavy periods occurs gradually over many months until the flow is persistent. In some cases, the blood loss leads to severe anemia, becoming life-threatening. Some women with fibroids report they never seem to stop menstruating, that one period seems to flow into the next. In some instances, large clots may occur along with the bleeding. As fibroids continue to grow, so do the problems. As previously noted, additional concerns include miscarriages and infertility.

Guidelines from the American College of Obstetricians and Gynecologists strongly emphasize that treatment of uterine fibroids be avoided unless the growths are producing symptoms that interfere with the quality of life.While it is prudent to get a proper diagnosis of your fibroid(s), you should not expect to undergo treatment unless the condition is causing abnormal uterine bleeding, severe pain, miscarriages, interference with conception, or incontinence (fecal or urinary). Medical scientists have developed several alternative treatments to hysterectomy for women with problematic fibroid tumors, which will be discussed in greater detail elsewhere in this section. You may find it interesting to note that despite a growing amount of study devoted to fibroid tumors by medical scientists around the world, the growths still pose numerous research questions and a host of medical mysteries.

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