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  • Dr. Joy

The F-word: Symptoms or Nah?

Let's continue our series on the F-word aka Fibroids...

You have a doctor’s visit where they review with you that they found fibroid tumors in your uterus…what do you do? You do not freak out because if you are a woman of African-descent, you know that you are in the sisterhood, the 80% of black women who have fibroids. What you actually do is consult our site for the key questions you ask so you can assess what to do about these fibroids. The first questions, however, you ask yourself.

  • Do I have heavy bleeding?

  • Do I very painful periods or constant pain regardless of my period?

  • Do I feel a fullness in my belly or have to go to the bathroom too frequently?

If you answered yes to any of these questions, you have symptoms of fibroids and possibly the fibroids may be the cause of your discomfort and bleeding. The next step with or with out answering yes to these questions is to ask questions of your doctor.

How many fibroids does it look like I have?

This question is tricky because there is no imaging that will be 100% accurate. Many times when a radiologist produces a report of an ultrasound or MRI about fibroids they talk about the largest or most prominent ones. These are the ones you do want to hear about because the larger ones are typically more impactful.

How big are my largest fibroids?

When it comes to fibroids, size matters. You can have a tiny 1cm fibroid that likely will not do you harm. But if you have a 10cm fibroid, the size of a baby’s head, then you have a big problem on your hands. I know many doctors describe in terms of fruit how big your fibroids are, but if you can imagine, describing that to another physician it may not translate. Apples and oranges come in different sizes right? Try to take a picture of your ultrasound report or write down the actual size so that if you go to a different health care system or doctor you will be able to share the size it was at this time. Rates of growth tend to be faster in black women and knowing the original size is good information to have. Radiologists like to compare to previous sizes based on previous imaging, but often times it is hard to get your hands on this. Keeping your own records, puts the power in your hands.

If you have no symptoms of fibroids, you still may have work to do. The main time we are concerned about fibroids in a woman without symptoms is when she is considering pregnancy. Studies have found that fibroids over 4cm tend to affect a woman’s ability to get pregnant. That said, any ObGyn can tell you of stories of women that they have cared for with large fibroids throughout their pregnancy. The lesson here is to try to get pregnant first, but do not try too long. If you know you have large fibroids over 4cm and it has nearly been 9 months of trying, it may be time to find a doctor to discuss management of your fibroids. Removal of the fibroids may significantly aid in fertility and may allow you to have an easier pregnancy. However, depending on the way surgery goes, you may need a cesarean section for your delivery plan. There will be a separate post, dedicated just to fibroids in pregnancy, so stay tuned.

Where are the fibroids located? On the outside? In the muscle?

In the cavity?

As we discussed earlier, when it comes to fibroids it is just like real estate, “Location, location, location!” You can have a tiny 2cm fibroid, but if it is in your cavity it can cause you heavy bleeding easily. However, if you had a 2cm fibroid in the serosa (outer layer) or muscle, it is much less likely to cause damage.

Once you have asked these questions, you will be better equipped to have an engaging conversation with your physician about a treatment or even a wait-and-see plan. This is a diagnosis, it is not a disease. There is a difference. Fibroids can affect your quality of life, which is why they are impactful.

Things to Remember About Fibroids

  1. Do not be fooled by the number of fibroids seen on imaging, it can often be more

  2. Size Matters!

  3. Location, location, location when it comes to impact of fibroids

  4. Symptoms and fertility should guide your decision about what to do about fibroids. You only need treatment if they are holding you back from living your best life!

Next Fibroid Post...Treatments!

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