FACT SHEET covering top issues on fibroids
- 1Fibroids are a hormone dependent tumor – both estrogen and progesterone is necessary for the fibroid to grow
- 2Women may begin to develop fibroids as young as the early twenties
- 3Fibroids may cause reproductive problems
- 4Some fibroids grow in multiple numbers they often look like a single fibroid due to their tendency to grow in a cluster
- 5The most common symptom of fibroids is abnormal periods
How Are Fibroids Diagnosed
If you have no symptoms for fibroids, you may only find out you have the uterine tumors when you have your routine bimanual pelvic exam. During this routine office exam, the doctor evaluates the size and shape of the uterus and surrounding pelvic structures by inserting two fingers of one hand into the vagina while palpating the patient's abdomen above the pubic bone with the other hand.
During this exam, a uterus with fibroids often feels enlarged and/or irregular and may be felt abdominally above the pubic bone. In contrast, a non-pregnant uterus without fibroids is not palpable above the pubic bone.
While this is the most routine way of diagnosing fibroids, occasionally fibroids that are causing symptoms may be missed if the examiner relies just on this examination. Similarly, if your doctor does discover a lump in the wall of your uterus he or she may want to confirm a fibroid diagnosis with additional tests.
One of these tests is the endovaginal sonogram which is the main method of confirmed diagnosis in a doctors’ office. This method allows doctors to immediately identify where the fibroids are. It’s a prime investigative tool for fibroid location. For some patients with bleeding problems or pain, their uterus may not be big enough for the doctor to feel for the presence or location of the fibroid, therefore endovaginal sonogram is a very valuable tool. One downside to the endovaginal sonogram is that many fibroids grow in multiple numbers, however on the endovaginal sonogram they often look like a single fibroid due to their tendency to grow in a cluster.
The other tool that is regularly used is the MRI for patients who are likely to require surgery. Doctors need to make sure there is no associated adenomyosis, endometriosis or blockage of the ureter or rectum in these cases.
An additional test that can be done is CAT scan with contrast. This test is particularly useful for patients who may have additional pathologies with their digestive system or pelvis and who are scheduled for a fibroid surgery. Hysteroscopy, sonar hysteroscopy and hysteropingogram are the other tools used to diagnose fibroids particularly in cases of endometrial locations where hysteroscopic surgery is contemplated.
When examining a patient for fibroids, doctors talk about the size of a uterus enlarged by fibroids in the same way they talk about the size of a pregnant uterus. When a fibroid stretches the uterus to a 12-to-14-week size, the uterus is about the same size it would be if the patient was 12 to 14 weeks pregnant.