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Q: What are uterine fibroids?
A: A uterine fibroid is an abnormal, benign growth of cells in the muscular wall of the uterus(myometrium). Fibroids affect 20% to 40% of all women over 35, and do not develop after menopause. Although they frequently present without any symptoms, symptoms may also be present. In particular, they can lead to a more frequent menstruation, often associated with large clots and pelvic discomfort. Also, they can lead to increased menstrual flow and discomfort, bleeding between periods, pain during or bleeding after sexual intercourse, anemia, i.e., a decrease in the red blood cell count, and to pressure on the urinary bladder or rectum.
Estrogen is required for the stimulation and growth of uterine fibroids, and, thus, uterine fibroids are rare in prepubertal girls or menopausal women. In view of their estrogen dependence for growth, fibroids tend to appear more frequently in women taking the pill. Furthermore, they are much more common in black than white women and. In the absence of,or in presence of minimal symptoms, uterine fibroids do not need to be treated. In other cases, however, surgery might be necessary. When surgery is performed, fibroids can often be removed surgically without removing the entire uterus. If surgery is not necessary prior to menopause, fibroids usually decrease in size after menopause without treatment. The ability to conceive continues as long as the uterus remains. Malignant change in a fibroid is a rather rare ocurrence, and is characterized by very rapid growth of the fibroid whenever it occurs.
When a woman presents with a small fibroid, contraceptive pills with a high estrogen content should be avoided, since estrogen usually cause fibroids to enlarge. In this case, other forms of contraception should then be considered. Examples include: diaphragm, cervical cap, intrauterine device, condom, etc.
Updated: 06/21/99
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