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. 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 your fibroid has grown or changed, it is important to get accurate ultrasound measurements. A pelvic examination can give you approximate dimensions of the fibroids.
1. Fibroids can grow, and it’s important to get accurate measurements to find out if your fibroids are growing. 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.
2. 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?
3. Treatment can cause dimensions of fibroids can shrink. 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).
4. It is most accurate to get a transvaginal ultrasound, although it may be necessary to get an abdominal ultrasound as well.
5. Ultrasounds can be done when you are bleeding or on a period, and menstrual cycle stage can’t affect the measurements. 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.