The Multidisciplinary Uterine Fibroid Clinic at The Ohio State University Wexner Medical Center offers women the latest testing and treatment options available with care coordinated by a full team of medical specialists.

This team includes gynecologists, interventional radiologists, diagnostic radiologists, fertility specialists and basic science researchers, all working together to deliver the best possible care to improve each patient’s quality of life.

What is a fibroid?

Uterine fibroids are lumps that can grow in different parts of your uterus. You can have fibroids on the inside, on the outside or in the wall of your uterus. You can also have them in more than one location.

Your doctor may call them fibroid tumors, leiomyomas or myomas — but fibroids are not cancer. And you do not need to do anything about them unless they are causing problems.

Fibroids can vary greatly in size. The types and location include:

• Submucosal – growth within the uterine cavity
• Intramural – growth within the muscular wall of the uterus
• Subserosal – growth on the outermost layer of the uterus
• Pedunculated – fibroids that grow on a stalk extending from the uterus

Fibroids are very common in women in their 30s and 40s, and they affect up to 70-80% of women by the age of 50. They usually do not cause any symptoms or bothersome problems, and many women never even know they have them.

Yet if you do suffer problems because of fibroids, our clinic can help.

What causes fibroids?

It’s not completely clear what causes fibroids, but genetics may play a role, and the female hormones estrogen and progesterone seem to make fibroids grow. Your body makes the highest amount of these hormones during the years you have periods, so once menopause begins, fibroids usually shrink and symptoms stop.

Obesity and age both increase the chance of developing fibroids, and Black women are more likely to have fibroids than white women.

Fibroid symptoms

Although fibroids don’t always cause symptoms, their size and location can lead to problems for certain women, including:

• Heavy menstrual bleeding
• Pelvic pain or pressure
• Frequent urination
• Difficulty emptying bladder
• Constipation or other bowel issues
• Back ache/leg pains
• Infertility
• Recurrent pregnancy loss

How are fibroids diagnosed?

Uterine fibroids are often found during a routine pelvic exam when a doctor finds that the uterus feels enlarged or irregular in shape.

• Pelvic ultrasound can be used to diagnose or confirm uterine fibroids.
• Other imaging, such as MRI, hysterosonography or hysterosalpingography, can also be used to confirm or evaluate fibroids.

Your doctor might also do blood tests to make sure you don’t have anemia, which is low red blood cell counts caused by excessive bleeding.

Fibroid treatment

If your fibroids aren’t bothering you, you do not need to do anything about them. Your doctor will check them during your regular visits to see if they have gotten bigger. However, if your quality of life is impacted or you have concerns about infertility, there are many treatment options available and your Ohio State specialists can explain the benefits of each.

Medication

Medication options can help treat some of the symptoms associated with fibroids, particularly heavy menstrual bleeding and pelvic pain.

There are different medication options, including anti-inflammatories, birth control pills and medicines that help regulate your hormones.

• If your main symptoms are pain and heavy bleeding, an over-the-counter pain medicine like ibuprofen might help and your doctor can also discuss the use of birth control pills to make your periods lighter.
• If you have anemia, your doctor may suggest taking iron pills. Adding foods to your diet that are high in iron, such as meats, beans and green leafy vegetables can also help.
• If you are near menopause, medications may be prescribed to control symptoms until your heavy periods stop.

Medications will not shrink the size of fibroids, so long-term relief of symptoms may require additional treatment. This can help with not only the more common problems of pain and bleeding, but also issues related to infertility, back/leg pain and bladder or bowel symptoms.

Other treatment options

If your life is interrupted by symptoms that are not helped enough by medication, you may want to consider different solutions. At Ohio State’s Multidisciplinary Uterine Fibroid Clinic, you’ll find a range of noninvasive treatment options, as well as surgical options. The best choice for you depends on your age, the size and location of your fibroids, and whether you want to have children.

Because fibroids usually grow slowly, you can take time to consider your choices. In addition, there are multiple minimally invasive options that can be tried before having a myomectomy or hysterectomy.

• Transcervical radiofrequency ablation –
  One of the newest options for women dealing with symptomatic fibroids who don’t want or can’t have major surgery is transcervical radio frequency. For this innovative procedure, done using an advanced technology known as Sonata®, a small probe is placed through the cervix to deliver a radiofrequency energy that destroys the fibroid.
  
  There are no incisions, and it is a short procedure. Patients can go home the same day and resume normal activities in just 1-2 days.
  
  View a quick animation of how Sonata works.
• Uterine fibroid embolization –
  This is not surgery, but a minimally invasive procedure that can shrink fibroids. It’s a good choice for women who do not plan to have children but do want to keep their uterus.
  
  The doctor places a small tube, known as a catheter, into the wrist or groin to inject small particles into the arteries that supply blood to the fibroids, so the fibroid shrinks or dies off completely.
  
  Although fibroids may grow back in the future, most women feel relief soon after this procedure.
• Hysteroscopic resection – A small camera and device that can shave down fibroids is inserted through the vagina and cervix to make fibroids level with the walls of the uterus.
• Myomectomy – this surgical procedure removes fibroids, but not the uterus, so it’s a good choice for women who hope to get pregnant or just want to keep their uterus. It can improve your chances of having a baby, but fibroids may grow back.
  This can be done laparoscopically with robotic assistance or through an incision on the lower abdomen.
• Hysterectomy – in this surgery, your uterus is removed, making it the only way to make sure that fibroids will not come back. Your symptoms will go away, but you will no longer be able to get pregnant.

Fibroids and fertility

The good news is that fibroids typically don’t interfere with pregnancy.

However, depending on the size and location of your fibroids, fallopian tubes may become blocked, which causes infertility. Fibroids can also cause recurrent pregnancy loss if the fertilized egg implants on a fibroid instead of the uterine wall.

Fibroids may also increase the risk of complications in pregnancy, including placental abruption, fetal growth restriction, preterm delivery, dysfunctional labor or hemorrhage after delivery.

If you have fibroids and plan to become pregnant or are currently pregnant, the specialized team at Ohio State’s Multidisciplinary Uterine Fibroid Clinic can partner with your fertility specialist or Ob/Gyn to determine the best treatment plan, monitor symptoms and minimize complications.

Why choose Ohio State Multidisciplinary Uterine Fibroid Clinic?

At Ohio State, you’ll find a full team of specialists who understand the impact fibroids can have on your life.

Because each team member has extensive, focused experience treating fibroids, including even the most complex cases, we know how important it is to coordinate every aspect of your care. This makes treatment more convenient — and more effective.

In addition, because we are part of one of the largest academic medical centers in the nation, you benefit from the most current therapy options and surgical techniques and the latest knowledge gained from our ongoing research on fibroid causes, complications and treatment. It also means we can easily refer you to other specialists or ask other Ohio State physicians for their expert opinion as needed.

In this dedicated clinic, fibroids are our focus, not an occasional issue with just some patients. We promise to partner with you in any way needed, and we are here to help — we’re always determined to solve the complications and symptoms you face.

Schedule an appointment

To make an appointment, call 614-293-3069 and request Dr. Amber Bondurant-Sullivan or Dr. Michael Blumenfeld in the Uterine Fibroid Clinic.