Questions to Ask About Uterine Fibroids

General Questions to Ask Your Physician and Potential Answers

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What causes fibroids?

It is unclear why fibroids develop, but several factors may influence their formation:

Many fibroids contain changes in genes that differ from those in normal uterine muscle cells. There’s also some evidence that fibroids run in families and that identical twins are more likely to both have fibroids than nonidentical twins.

Estrogen and progesterone, two hormones that stimulate development of the uterine lining during each menstrual cycle in preparation for pregnancy, appear to promote the growth of fibroids. Fibroids contain more estrogen and progesterone receptors than normal uterine muscle cells do. Fibroids tend to shrink after menopause due to a decrease in hormone production.

Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth.

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How large can fibroids get?

Fibroid size is one of the symptoms of uterine fibroids that doctors follow to determine whether treatment is needed.

Uterine fibroids vary widely in size from as small as a coin to the size of a large melon. A very large uterine fibroid can cause the uterus to expand to the size of a 6 or 7 month pregnancy. Fibroids can form as one single dominant fibroid or as a cluster of many small fibroids.

A woman’s uterus is approximately 3 inches (7.6 cm) long, and pear-shaped. A small fibroid may not cause any symptoms, so you may not even know you have it. A larger fibroid may cause your uterus to enlarge, and then you will start to notice changes.

*This information does not constitute any medical advice and you should consult with your physician.

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Can fibroids turn into cancer?

Fibroids are almost always benign (not cancerous). Rarely (less than one in 1,000) a cancerous fibroid will occur. This is called leiomyosarcoma. Doctors think that these cancers do not arise from an already-existing fibroid. Having fibroids does not increase the risk of developing a cancerous fibroid. Having fibroids also does not increase a woman’s chances of getting other forms of cancer in the uterus.

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How do I know for sure that I have fibroids?

Your doctor may find that you have fibroids when you see her or him for a regular pelvic exam to check your uterus, ovaries, and vagina and for an annual cervical PAP smear. The doctor may be able to feel the fibroid with his or her hands during an ordinary pelvic exam, as a (usually painless) firm lump on the uterus. For medium and larger fibroids, your doctor will describe the size of your fibroids by comparing them to different stages of pregnancy. For example, you may be told that the size of your fibroids is similar in size to a uterus carrying a 20-week pregnancy (at the level of the belly button). Or the fibroid might be compared to fruit such as lemons, oranges or grapefruit to demonstrate a comparative size. One of several imaging test generally confirms the size, position, and dynamic of Fibroids. The two most common modalities include Ultrasound and Magnetic Resonance Imaging (MRI).

Questions to Ask About My Case

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How many fibroids do I have?

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What is the size of my fibroid(s)?

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Where is my fibroid(s) located (outer surface, inner surface, or in the wall of the uterus)?

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How rapidly has my fibroid grown (if they were known about already)?

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How will I know if my fibroid(s) is growing larger?

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What tests or imaging studies are best for keeping track of the growth of my fibroids?

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What are my treatment options if my fibroid(s) becomes a problem?

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Is a procedure necessary or can I just take medication? Are there side effects to medication?

Questions to ask about procedures

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What is the recovery time for each procedure I am considering?

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How will the treatment options affect my ability to become pregnant and carry a fetus to full term?

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What are the advantages and disadvantages/risks of the treatment options?

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How quickly can I expect symptom relief with the treatment options I am considering?

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Are these options routinely covered by insurance?

Questions to Ask Yourself

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Do I need to be able to return to work or family responsibilities within just a few days?

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Do I want to have more children?

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Do I want to preserve my uterus even if I am “family complete”?

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How do I feel about surgery?

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How far am I from menopause, when many fibroids may naturally shrink?