Uf Patient Guide

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Uterine FibroidsA Patients Guide


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Uterine Fibroids

A Patients Guide

Uterine fibroids are very common and, formany women, cause symptoms that affect thequality of their life. This pamphlet providessome answers to questions that patients andtheir families may have about uterine fibroids

and the treatments that are available.

Table of Contents

What are uterine fibroids? page 2

What causes uterine fibroids? page 4

What are typical symptoms? page 5

How do I know

if I have uterine fibroids? page 6

How are uterine fibroids treated? page 6

How do I decide which treatment

is best for me? page 8

Commonly used terms page 9

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The uterus is

part of the female

reproductive system

located in the pelvis.

The uterus, or womb,

is a muscular organ

that receives thefertilized egg and

provides the

environment needed

for growth of a fetus.

What are uterine fibroids?

Uterine fibroids are benign (non-cancerous)tumors of the uterus. It is estimated that20% to 40% of women 35 years of age andolder have fibroids. Although most do notcause symptoms, uterine fibroids can causesevere problems for some women who havethe condition.

Uterine fibroids can grow in various partsof the uterus.

Those that grow in the muscularwall of the uterus are calledintramural fibroids.

Those that grow on the outersurface of the uterus are calledsubserosal fibroids.

Those that grow on the innersurface of the uterus are called

submucosal fibroids.

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Uterus

OvariesFallopianTube

FallopianTube


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3

Intramural fibroids arethe most common typeof fibroid. Because thesefibroids grow in themuscular wall of the uterus,they make it feel larger than

normal. These fibroids cancause an increase inmenstrual bleeding, pelvicpain, back pain or pressure.

Subserosal fibroids are thesecond most common typeof fibroid. Because they arelocated on the outer wallof the uterus, these fibroidsusually do not affectmenstrual flow. However,they can cause pelvic pain,back pain or pressure.

Submucosal fibroids cancause heavy or prolongedperiods, even if the fibroidsare very small.

Typically, women whohave uterine fibroids have more than onefibroid and they can range widely in size. Someare no bigger than a pea, while others can grow

to the size of a melon or larger. When fibroidsare diagnosed, the extent of the disease isdetermined by comparing the size of the uterusto a typical size during pregnancy. For example,a large fibroid or multiple fibroids may enlarge

the uterus to the same size as a six- or seven-month pregnancy.

Intramural

Fibroid

Subserosal

Fibroids

Submucosal

Fibroids


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4

What causes uterine fibroids?

The exact reason why uterine fibroids developis unknown. However, medical researchers haveassociated the condition with two factorsgenetics and hormones.

GeneticsAfrican-Americanwomen are at higherrisk for uterine

fibroids. Fibroidsoccur in as many as50% of these womena rate that is abouttwice that of other

racial groups.

Hormones

Uterine fibroids can dramatically increase insize during pregnancy. It is thought that this

effect is due to the increase in the amount ofestrogenthe female hormonethat naturallyoccurs during pregnancy. After delivery, thefibroids usually shrink to the size they were

before the pregnancy.During menopause,estrogen levelsdramatically decrease.This causes uterinefibroids to shrink,relieving symptoms.However, if a womantakes hormone

replacement therapy (HRT) during menopause,estrogen levels may not decrease, the fibroidsmay not shrink and the symptoms may remain.


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What are typical symptoms?

A uterine fibroid may begin to grow when awoman is in her 20s. However, most womendo not begin to have symptoms until they arein their late 30s or early 40s. Depending on the

location, size and number of fibroids, a womanwith uterine fibroids may experience thefollowing symptoms:

Heavy, prolonged menstrual periods

and unusual monthly bleedingsometimes with clotswhich cancause anemia

Increased menstrual cramping

Pain, pressure or discomfort inthe pelvis

Pain in the back, sides or legs

Pain during sexual intercourse

Blockage of urine flow from thekidney to the bladder

Urinary frequency due to pressureon the bladder

Constipation and/or bloating dueto pressure on the bowel

Abnormally enlarged abdomen

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6

How do I know

if I have uterine fibroids?

Usually, uterine fibroids are first diagnosedduring a gynecologic internal examination.This pelvic exam allows the physician to checkthe size of your uterus. If it feels enlarged, yourphysician may send you for an ultrasoundexamination. This exam can detect if fibroidsare present, as well as determine their precise

location and size.The presence of fibroids can also be diagnosedusing magnetic resonance imaging (MRI) orcomputed tomography (CT). In cases of

submucosal fibroids, your gynecologist mayuse a small scope placed through your vaginato examine the inside wall of your uterus.

How are uterine fibroids treated?

The treatment for uterine fibroids depends onthe size and location of the fibroids and theseverity of your symptoms. If you do not have

symptoms, your doctor may decide that thereis no need to treat the fibroids. However, yourphysician will likely recommend yearly visits tohave them checked.

If you develop symptoms, there are a numberof treatment options available including:

Medical therapy Surgical therapy Non-surgical therapy

(uterine fibroid embolization)


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Medical TherapyMedical therapy for uterine fibroids mayinclude the use of drugs to provide control ofsymptoms. These drugs include non-steroidalanti-inflammatory drugs (NSAIDs), birthcontrol pills and hormone therapy.

Surgical TherapyThere are two surgical options for uterinefibroidsmyomectomy and hysterectomy.A myomectomy is a surgical technique which

removes the fibroids from the wall of theuterus. A hysterectomy is a surgical procedurewhich removes the entire uterus.

Non-Surgical Therapy

Uterine fibroid embolization (UFE)also knownas uterine artery embolization (UAE)is a lessinvasive approach that is designed to preserveyour uterus. It is performed by a speciallytrained physicianan interventional radiologist

in many hospitals and medical centers.

During UFE, a catheter is inserted into a bloodvessel in your groin. The physicianthen threads the

catheter up toyour uterineartery andinjects small

particles. Theseparticles flowinto thebranches ofthe uterine

artery, blockingthe vessel and preventing blood from reachingthe fibroid. Over time, your fibroids shrink,relieving your symptoms.

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Fibroid Particles

Block

Blood

Flow

Catheter

in Uterine

Artery


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How do I decide which treatmentis best for me?

It is important thatyou understand allof the treatmentsthat are available toyou. Therefore, youshould have a

detailed discussionwith your physicianabout your options,including benefits and potential risks.The procedures and information describedare not intended to substitute for a physiciansjudgement. Only you and your physiciancan decide which choice is best for you.

There is additional information available

at www.Fibroids1.com.

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Commonly used termsCatheter

A small flexible tube.

EstrogenThe female hormone.

FibroidA benign (non-cancerous) tumor in the uterus.

HysterectomyA surgical procedure that removes the entire uterus.

Interventional RadiologistA specially trained physician who uses x-rayimaging to guide procedures.

Intramural FibroidsThe most common type of uterine fibroid. These

fibroids grow in the muscular wall of the uterus.MenopauseThe cessation of menstrual periods.

MyomectomyA surgical procedure that removes fibroids from

the wall of the uterus.NSAIDsNon-steroidal anti-inflammatory drugs.

Submucosal FibroidsFibroids that develop just under the inner surfaceof the uterus.

Subserosal FibroidsThe second most common type of uterine fibroid.These fibroids develop at the outer surface of theuterus and expand outward.

Uterine ArteryThe blood vessel that supplies the fibroid with theoxygen and nutrients required for growth.

Uterine Fibroid EmbolizationInjection of particles to block the flow of blood toa fibroid.

UterusThe womb.

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Provided as anEducational Service

by Boston Scientific Corporation.

2007 Boston Scientific

Corporation or its affiliates.

All rights reserved.

ONCPE180 (Rev 2) / 10M / 03/07

The image shown on the cover is

being used for illustrative purposes

only; the person depicted in theimage is a model

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