Topics of Interest

What Size and Number of Fibroids Cause Symptoms that Lead to Treatment?

The Fibroid Growth Study: Determinants of Therapeutic Intervention.

Authors: Davis BJ, Haneke KE, Miner K, Kowalik A, Barrett JC, Peddada S, Baird DD. J
Journal: Women’s Health (Larchmt). 2009 May;18(5):725-32.
Study performed by: National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA.

Problem: A common question in my office is “if these fibroids grow, won’t I just need treatment in the future?” Despite years of studies about fibroids, no one has ever documented if there is a size at which women will always want treatment.
Study: MRIs were done on 116 premenopausal women, ranging in age from 20 to 54 years; 48% were black women, 41% were white women, 10% were women of other racial backgrounds

Conclusions: Neither the number of fibroids a woman had nor the over-all size of her uterus was related to which women chose treatment. The women who asked for treatment had more symptoms, including more bleeding and pain, compared with the women who chose not to have any treatment. The authors suggested that aggressive treatment of pain and bleeding might reduce the need for surgery.

Dr. Parker’s Comment: The size of a woman’s fibroid does not always correspond with the degree of her symptoms. For instance, a small fibroid (even 2-3 cm = 1 inch) inside the uterine cavity can cause severe bleeding and anemia. But, a large fibroid, say 7 cm (3 in), outside the uterine wall will cause no extra bleeding. A 7 cm fibroid sitting directly over the bladder can cause urinary frequency and the need to get up in the middle of the night to urinate, very bothersome symptoms to some women. But, a 7 cm fibroid at the top of the uterus may cause a little bloating, but not enough for the woman to seek treatment. So, sizes, number and position of the fibroids are all important factors in determining which women might have bothersome symptoms.



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