FAQs

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.

Women who have fibroids are more likely to have problems during pregnancy and delivery. This doesn't mean there will be problems. Most women with fibroids have normal pregnancies. Every case is unique as it relates to fibroids and fertility. You should work with your healthcare provider to determine the right option for you depending on the size, number and location of your fibroid(s). The most common problems seen in women with fibroids are:

Cesarean section. The risk of needing a c-section is six times greater for women with fibroids.

Baby is breech. The baby is not positioned well for vaginal delivery.

Labor fails to progress.

Placental abruption. The placenta breaks away from the wall of the uterus before delivery. When this happens, the fetus does not get enough oxygen.

Preterm delivery.

Talk to your obstetrician if you have fibroids and become pregnant. All obstetricians have experience dealing with fibroids and pregnancy. Most women who have fibroids and become pregnant do not need to see an OB who deals with high-risk pregnancies.

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. The doctor can feel the fibroid with her or his fingers during an ordinary pelvic exam, as a (usually painless) lump or mass on the uterus. Often, a doctor will describe how small or how large the fibroids are by comparing their size to the size your uterus would be if you were pregnant. For example, you may be told that your fibroids have made your uterus the size it would be if you were 16 weeks pregnant. Or the fibroid might be compared to fruits, nuts, or a ball, such as a grape or an orange, an acorn or a walnut, or a golf ball or a volleyball.

Your doctor can do imaging tests to confirm that you have fibroids. These are tests that create a "picture" of the inside of your body without surgery. These tests might include:

Ultrasound – Uses sound waves to produce the picture. The ultrasound probe can be placed on the abdomen or it can be placed inside the vagina to make the picture.

Magnetic resonance imaging (MRI) – Uses magnets and radio waves to produce the picture

X-rays – Uses a form of radiation to see into the body and produce the picture

Cat scan (CT) – Takes many X-ray pictures of the body from different angles for a more complete image

Hysterosalpingogram (HSG) or sonohysterogram – An HSG involves injecting x-ray dye into the uterus and taking x-ray pictures. A sonohysterogram involves injecting water into the uterus and making ultrasound pictures.

You might also need surgery to know for sure if you have fibroids. There are two types of surgery to do this:

Laparoscopy – The doctor inserts a long, thin scope into a tiny incision made in or near the navel. The scope has a bright light and a camera. This allows the doctor to view the uterus and other organs on a monitor during the procedure. Pictures also can be made.

Hysteroscopy – The doctor passes a long, thin scope with a light through the vagina and cervix into the uterus. No incision is needed. The doctor can look inside the uterus for fibroids and other problems, such as polyps. A camera also can be used with the scope.

How many fibroids do I have?

What size is my fibroid(s)?

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

Can I expect the fibroid(s) to grow larger?

How rapidly have they grown (if they were known about already)?

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

What problems can the fibroid(s) cause?

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

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

What are your views on treating fibroids with a hysterectomy versus other types of treatments?

A second opinion is always a good idea if your doctor has not answered your questions completely or does not seem to be meeting your needs.

As Dr. Rochelle Wolfe says, “If there was a best option to treat fibroids, there would be only one.” BUT THERE ISN’T! A listing of various options for fibroid treatment is available in the Fibroid Toolkit here. This toolkit was created by the Society for Women’s Health Research (www.swhr.org) and our own Director of Partnerships, Nkem Osian, was one of the reviewers.

Use this toolkit for discussion of the various options with your healthcare provider, pros and cons for your specific case. If you don’t feel that your healthcare provider can adequately discuss the options or explain clearly why you are NOT a candidate for something other than hysterectomy, seek a second opinion, if possible.

The White Dress Project offers peer-to-peer support through our White Dress Cares program. You will be matched with a peer you can speak with regarding their experience for informational purposes only.

UFE is Uterine Fibroid Embolization is also known as UAE, Uterine Artery Embolization. It is a viable, nonsurgical option to treat uterine fibroids that has been for over 20 years. UFE is performed by a specialized doctor called an interventional radiologist (and rarely performed by gynecologists).

We reposted a great walkthrough of fibroids and the UFE procedure by @thewhizdoc on our Instagram here.

In addition, our Director of Research, Dr. Rochelle Wolfe, has information on UFE as an alternative to surgery, its benefits, how it is perfromed and guidelines for who is a candidate for the procedure on her website.