General Questions to Ask Your Physician and Potential Answers
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 non-identical twins.
Oestrogen 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 oestrogen and progesterone receptors than normal uterine muscle cells do. Fibroids tend to shrink after menopause due to a decrease in hormone production.
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.
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.
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).
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