Measuring the Fibroids

Uterine fibroids are non-cancerous muscle tumors of the womb. They are not symptomatic in most people, and they are extremely common occurring in about 20-40% of all women who can have children. Treatments depend on the size, the location, the goals of the patient, the amount of menstrual bleeding. And if you surf around to the other fibroid posts you'll probably get a few of these type questions answered. One issue is really determining the size of the fibroid, and a second issue is determining the fibroid growth, and a third issue all together is treating any heavy periods due to the uterine fibroids.

In order to know if iyour fibroid has grown or changed, it is important to get accurate ultrasound measurements measurements. At Women's Health Practice we use several ultrasound techniques to get these measurements done. We know that from a publication in the Ultrasound Obstetrics and Gynecology journal in 2010, in a study by researchers from University College Hospital in London, that the largest fibroid generally grows about 35% per year! Which can be a lot! A women who has had 35% growth of a fairly large fibroid can go from having a flat to a poofy tummy.

Fibroid measurements are typically done on ultrasound, although CAT scans can measure fibroid size as well. The ultrasounds to measure the fibroids are usually ordered when you show up at your gynos, and they really haven't been studied on each day of the cycle. A group of gals all sitting around wondering what size their fibroids are, may also want to ponder just how those measurements were taken. Questions you might ask are the measurements as accurate if the fibroids are measured on your cycle, off your cycle, any time of the day, with a full bladder, from an abdominal ultrasound, from a vaginal ultrasound, in 3D or two dimensions, only by CT scan, on birth control pills, off birth control pills?
The fibroids are uterine muscle wall tissue, it does have glands, as well as receptors for hormones in the muscle itself, those glands are most responsive to hormones, we can shrink fibroids by long enough treatment with reduction of the circulating estrogen levels by giving a medication called GNRH (brand name Lupron), but can we create errors in measurements, or mere changes in measurements by these variations in when and how we get tested? The testing methods do affect the clarity of pictures, and 3D ultrasounds with color flow are the gold standard today, performed through the use of a vaginal probe. Some of these other questions are just that, questions. Most fibroids are about as malleable as an English breakfast biscuit, so that menstrual cycle time won’t change it. And even if you are flowing so that the cavity of the uterus has a bit of blood, it’s just that, a bit of blood, not a bucket, so the uterus doesn’t fill like a hot air balloon poised for take off, although that is what it might feel like. So if your sonogram is scheduled to measure those fibroids up, go ahead and keep your appointment, you need those measurements, and the sooner your get them, the sooner you and your gyno can make a rational treatment plan, no matter what your cycle day. 

Comments

  1. Great information on fibroids and measuring fibroids. Great article

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  2. Thanks! Look forward to hearing from you more.

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  3. Please How dangerous is a fibroid which measures up to 8 weeks pregnancy?

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  4. Uterine fibroids are common, and whether they pose a threat of medical problem or "danger" as the reader asks for mom or baby depends upon a number of factors. Size, whether they are causing bleeding and symptoms such as pain or pelvic pressure are usually what requires treatment. "Danger" may be a different concept to a patient vs a patient. It is very unlikely for realtively small fibroids, like ones that are described to be consistant with an 8 week pregnancy, to either cause cancer or cause the amount of bleeding that is immediately life threatening. Both of these conditions would be considered immediately "dangerous" of course. But they can grow, they can produce anemia from bleeding and they can produce discomfort as well as other symptoms. It's of course important to speak to your own gynecologist as there are a number of other important considerations depending upon your individual case. Thanks for your question.

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  5. Doc, please would you consider a 7.7cm by 6.3cm fibroid noted on the lower segment of the uterine wall - adjacent to the cervix a threat to pregnancy. My wife had our first son (a year and seven months now) with the fibroid. At some point during the eraly stages of her pregnancy she went through excruciating pain for about 10 days as the fibroid degenerated. Other than than the fibroid is silent. Do you advice its removal before becoming pregnant for a second baby?

    Thank you in anticipation of your response.

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  6. Management of uterine fibroids between pregnancies will take careful consultation by the gynecologist providing care. Some uterine fibroids are in a low enough position that removing them can risk the uterus and make pregnancy impossible in the future. Others cause infertility, pain or bleeding to the extent that they have to be removed. In some cases successful UAE (uterine artery embolization) or medication can be used to treat without surgery. Many physicians would advise removal of what you describe, but exactly the type of surgery varies between surgeons. Some may be willing to do myomectomies through the laparoscope. We do see new patients for consultation 217-356-3736.

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