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Large fibroids can cause pressure and pain in the abdomen or lower back that sometimes feels like menstrual crampsAbdominal and Uterine Enlargement. As the fibroids grow larger, some women feel them as hard lumps in the lower abdomen. Very large fibroids may give the abdomen the appearance of pregnancy and cause a feeling of heaviness Duramorph (Morphine Injection)- FDA pressure. In fact, large fibroids are defined by comparing the size of the uterus to the size it would be at specific months during gestation.

Fibroids can cause pain during sexual intercourse (dyspareunia) and on occasion may actually prevent penetration. Large fibroids may press against the bladder and urinary tract and cause frequent urination or the urge to urinate, particularly when a woman is lying down at night. Fibroids pressing on the ureters (the tubes going from the kidneys to the bladder) may obstruct or block the flow of urine.

Fibroids pressing on the urethra (outlet of the bladder) may cause urinary retention. Fibroid pressure against the rectum can cause constipation. Diagnosis Pelvic Exam and Medical HistoryDoctors can detect some fibroids as masses (lumps) during a pelvic exam. UltrasoundUltrasound is the standard imaging technique for detecting uterine fibroids. HysteroscopyHysteroscopy is a procedure that may be used to detect the presence of fibroids, polyps, or other causes of bleeding originating from the inside of the uterine cavity.

LaparoscopyIn some cases, laparoscopic surgery may be performed as a diagnostic procedure. Other TestsIn certain cases, the doctor may perform an endometrial biopsy to determine if there are abnormal cells in the lining of the uterus that suggest cancer.

The doctor may also order a complete blood count (CBC) to check for signs of anemia. Ruling out Other Conditions that Cause Heavy BleedingAlmost all women, at some time in their reproductive life, experience heavy bleeding during menstrual periods.

Bleeding disorders that impair blood clotting, Von Willebrand disease, some coagulation factor deficiencies, or leukemia. This condition occurs when glands from the uterine lining become embedded in the uterine muscle. Its symptoms are similar to fibroids, but there is usually more pain with adenomyosis.

Medical conditions, including thyroid problems and systemic lupus erythematosus. Certain drugs, including anticoagulants and anti-inflammatory medications. Often, the cause of heavy bleeding is unknown. Treatment Many women with uterine fibroids do not require treatment. The three treatment options are:Watchful Waiting. A Duramorph (Morphine Injection)- FDA may choose to delay having any treatment, particularly if she is close to reaching menopause.

Periodic pelvic exams and ultrasounds can help track the progression of her fibroid condition. Hormonal treatments such as oral contraceptives or a progestin-releasing IUD can help reduce heavy bleeding and pain. Gonadotropin releasing hormone (GnRH) agonists stop ovulation and the production of estrogen, and can reduce fibroid size. There are many surgical options ranging from less invasive Duramorph (Morphine Injection)- FDA very invasive. They include removal of the fibroid (myomectomy), removal of the endometrial lining (endometrial remote sensing impact factor, shrinking the blood supply to the fibroid (uterine artery embolization), and removal of the uterus (hysterectomy).

Medications For fibroid pain relief, women can use acetaminophen (Tylenol, generic) or nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen Duramorph (Morphine Injection)- FDA, Advil, generic) or naproxen Zofran Injection (Ondansetron Hydrochloride Injection)- FDA, generic).

Hormonal ContraceptivesOral contraceptives (OCs) are sometimes used to control the heavy menstrual bleeding associated with fibroids, but they do not reduce Duramorph (Morphine Injection)- FDA growth. GnRH AgonistsGonadotropin-releasing Duramorph (Morphine Injection)- FDA (GnRH) agonists include the implant goserelin (Zoladex), a monthly injection of leuprolide (Lupron Depot, generic), and the nasal spray nafarelin (Synarel). These Desyrel (Trazodone Hydrochloride)- Multum include: Hot flashesNight sweatsVaginal drynessWeight gainDepressionMood changes The side effects vary in intensity, but typically resolve within 1 month after stopping the medication.

Surgical Alternatives to Hysterectomy MyomectomyA myomectomy surgically removes only Duramorph (Morphine Injection)- FDA fibroids and leaves the uterus intact, which helps preserve fertility. Laparotomy uses a normal abdominal incision and conventional "open" surgery.

It is used for subserosal or intramural fibroids that are very large (usually more than 4 inches), numerous, and are in a difficult area of the uterus to approach surgically, or when cancer is suspected. While complete recovery takes less than a week with laparoscopy and hysteroscopy, recovery from Duramorph (Morphine Injection)- FDA standard abdominal myomectomy takes as long as 6 to 8 weeks.

Open laparotomy poses a higher risk for scarring Duramorph (Morphine Injection)- FDA blood loss than with the less invasive procedures, a concern for women who want to retain fertility. A hysteroscopic myomectomy may be used for submucosal fibroids found Duramorph (Morphine Injection)- FDA the uterine cavity.

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