CONDITIONS

What Is Uterine Fibroids & Ovarian Cysts

Fibroids (uterine myomas, leiomyomas, fibromas) are uterine tumors that vary in size and are made up of compact connective tissue and smooth muscle. Fibroids are extremely common. An estimated 20% to 50% of women of reproductive age have uterine fibroids, and an estimated 30% to 77% of women develop these fibroids during their childbearing years. 99% of uterine fibroids are benign (non-cancerous), and uterine fibroids do not increase the risk of uterine cancer.

Ovarian cysts are fluid-filled sacs that develop in the ovary, typically during ovulation, when the egg is being released from the follicle. Like uterine fibroids, the majority of ovarian cysts are benign (noncancerous). However, post-menopausal women with ovarian cysts have a higher risk of developing ovarian cancer. According to womenshealth.gov, most women make at least one ovarian cyst every month. Most cysts do not cause symptoms and therefore do not require treatment. Womenshealth.gov also reports that only about 8% of premenopausal women develop large cysts that require treatment.

What Causes Uterine Fibroids & Ovarian Cysts

Doctors and researchers are not sure what causes uterine fibroids to develop, though there is some evidence that a predisposition to uterine fibroids runs in families, suggesting that fibroids are in part genetic. The female hormone estrogen is also thought to influence the growth of uterine fibroids, as the presence of estrogen promotes tumor growth in many different forms of cancer.

Ovarian cysts can be caused by a variety of factors, including:

  • Hormone irregularities within the body (especially those brought about by fertility treatments) are known to cause ovarian cysts.
  • Pregnancy. Ovarian cysts are actually a normal part of pregnancy. The cyst forms during the early stages of pregnancy to protect the uterine environment. The cyst typically goes away later on in the pregnancy. Women whose cysts remain may need to seek treatment.
  • Endometriosis, a condition in which endometrium tissue (the type of tissue that makes up the uterine lining, appears outside the uterus (ovaries, fallopian tubes, uterine ligaments, etc.) The excess tissue often causes the formation of an ovarian cyst known as an endometrioma.

Infection. Pelvic infections that spread to the ovaries may result in ovarian cysts.

Risk Factors For Uterine Fibroids & Ovarian Cysts

The following factors can influence your development of uterine fibroids:

  • Uterine fibroids are most common in women who are approaching menopause, due to their long-term exposure to estrogen.
  • Obese women are more likely to develop uterine fibroids than women of a healthy weight.
  • For unknown reasons, women of African-American descent are more likely to develop fibroids than women of other descents.

The following factors can influence your development of ovarian cysts:

  • Age. Most women with cysts are of reproductive age (puberty-premenopause). Post-menopausal women with ovarian cysts are more likely to develop ovarian cancer.
  • Hormone therapy. Hormone therapy, such as certain birth control methods or hormone-based fertility treatments, can increase the risk of developing ovarian cysts.
  • Previous ovarian cysts. Women who have had ovarian cysts in the past are more likely to develop another.
  • Endometriosis. Women with endometriosis are more likely to develop a specific type of ovarian cyst known as an endometrioma.

Diagnosing Uterine Fibroids & Ovarian Cysts

The following tests may be used to diagnose uterine fibroids and ovarian cysts:

Imaging techniques, which help to better visualize the possible site of the fibroid or cyst. According to the Obstetrics and Gynecology department at UCLA Health, Imaging techniques are commonly used in a fibroid/cyst diagnosis include:

  • X-ray, in which x-ray radiation is used to produced images of the pelvic region
  • Transvaginal ultrasound therapy (ultrasonography), in which ultrasound waves capture imaging of the pelvic region through the insertion of a small probe (transducer) into the vagina
  • Magnetic resonance imagining (MRI), in which magnetic energy is used to produce detailed images of the uterus and surrounding structures.
  • Hysterosalpingography, in which a specialized dye is used in combination with x-ray technology to visualize the uterus and fallopian tube

Pelvic exam, in which the doctor physically examines the pelvic region and reproductive organs.

Blood tests, in order to monitor hormone levels and check for possible signs of pregnancy and/or cancer.

Tissue biopsy, in order to rule out the possibility of cancer

Symptoms of Uterine Fibroids & Ovarian Cysts

Both uterine fibroids and ovarian cysts often occur without symptoms.

According to the National Institute of Health, the following may be signs of a uterine fibroid:

  • Bleeding between periods
  • Heavy bleeding during your period, sometimes with blood clots
  • Periods that may last longer than normal
  • Needing to urinate more often
  • Pelvic cramping or pain with periods
  • Feeling fullness or pressure in your lower belly
  • Pain during intercourse

Ovarian cysts typically only cause symptoms if the cyst grows to be large, ruptures, or is twisted or bumped during physical activity. According to the National Institute of Health, the following may be signs of an ovarian cyst:

  • Bloating or swelling in the abdomen
  • Pain during bowel movements
  • Pain in the pelvis shortly before or after beginning a menstrual period
  • Pain with intercourse or pelvic pain during movement
  • Constant pelvic pain
  • Sudden and severe pelvic pain
  • Nausea
  • Vomiting

Prognosis

The majority of uterine fibroids and ovarian cysts are benign (meaning they are non-cancerous). Fewer than 10% of fibroids and cysts require intervention.

Living With Uterine Fibroids & Ovarian Cysts

If you have been diagnosed with uterine fibroids or ovarian cysts, consider the following tips:

  • Get plenty of rest. The pain caused by uterine fibroids and ovarian cysts can use up a lot of your body’s energy. Be sure to get plenty of rest to give your body the strength that it needs.
  • Seek treatment. If your symptoms are disrupting your daily life, see a doctor about treatment options. Consider all treatment options available, including alternative and complimentary therapies.
  • Exercise regularly. Regular exercise helps to balance the body, improve blood flow, and can even lessen the pain caused by cramps. If you find that exercise triggers your symptoms, be sensitive to your body’s needs and don’t push yourself beyond a healthy limit.
  • Use a heating pad or hot water bottle on your lower abdomen. The warmth helps to relax muscle and ease the pain of cramps.

Screening

Since most uterine fibroids and ovarian cysts do not cause disruptive symptoms, there is not a regular screening process in effect for fibroids or cysts. However, your doctor may discover a cyst or a fibroid during a regular pelvic exam.

Prevention

There are no known methods of prevention against uterine fibroids or ovarian cysts. In order to catch any pelvic irregularities as early as possible, visit your gynecologist for an annual checkup.

Common Treatment

Many cases of uterine fibroids and ovarian cysts do not produce symptoms and therefore do not require treatment. In cases where treatment is needed, the following methods are available:

Uterine Fibroids

  • Hysterectomy, in which the entire uterus is removed. According to UCLA Health, fibroids are the number one cause of hysterectomies in the United States.
  • Myomectomy, in which the fibroids are removed but the uterus remains intact (and able to bear children)
  • Hormone therapy, which manipulates bodily hormone levels in order to influence the growth of fibroids. Types of hormone therapy used to treat uterine fibroids include:
    • Gonadotropin-releasing hormone agonists (GnRH agonists), which induces “medical menopause” through the lowering of estrogen levels. GnRH agonists are often successful in reducing the size of fibroids and may be
    • Anti-estrogen drugs, which impede estrogen function
    • Anti-progestin drugs, which impede progesterone function
  • Uterine artery embolization (UAE), in which blood flow to the fibroids is cut off, shrinking the fibroids and lessening fibroid-related symptoms. This procedure is significantly less invasive than the other surgical procedures available.
  • Prescription pain-killers, such as opioids and non-steroidal anti-inflammatory drugs (NSAIDs).

Ovarian Cysts

  • Hormonal birth control pills, in cases of recurring cysts that cause disruptive symptoms.
  • Surgical removal. Surgical removal of ovarian cysts is rare but can be necessary if:
    • The patient does not respond to other treatments
    • The patient is of menopausal or perimenopausal age
    • The cysts have grown larger than 10 centimeters

Complementary and Alternative Treatment

The following alternative treatments may be available for patients with uterine fibroids or ovarian cysts:

  • Acupuncture, a form of traditional Chinese medicine in which small needles are inserted throughout the body to restore the flow of bodily energy. Acupuncture can help balance the reproductive organs, lessen overall inflammation in the body, and decrease the severity of pain.
  • Mind/body techniques such as yoga, tai chi, and meditation, which can help to lessen stress, anxiety, and pain.
  • Homeopathy is a form of alternative medicine in which plant extracts are diluted to very low concentrations and given to patients as a means of helping their body towards recovery. Visit a homeopathic doctor for remedy recommendations specific to your needs.
  • Herbal therapy. The following herbs can help to promote female reproductive health:
    • Ashwagandha
    • Red raspberry
    • Avena sativa (an extract of oats)

Check with a qualified herbalist about contraindications and possible interactions before taking any herbs.

Care Guide

If you are caring for a loved one with uterine fibroids or ovarian cysts, consider the following:

  • Listen to your loved one. Respect any new limitations or concerns they may have.
  • Educate yourself. Read up on uterine fibroids or ovarian cysts so that you can be an educated companion for your loved one at doctor’s visits and throughout the treatment process.
  • Encourage regular exercise and a healthy diet. Regular exercise helps to balance the body, improve blood flow, and can even lessen the pain caused by cramps. A balanced diet will help to prevent straining and pain during bowel movements as well as promote overall health.
  • Use a heating pad or hot water bottle on their lower abdomen. The warmth helps to relax muscle and ease the pain of cramps.

When To Contact A Doctor

If you experience any of the following symptoms, contact your doctor:

  • Abdomen bloating or swelling
  • Menstrual blood clots larger than a quarter
  • Prolonged menstrual bleeding (more than 7 days)
  • Severe menstrual cramping
  • Sudden, severe pelvic pain**
  • Prolonged, dull pelvic pain
  • Nausea
  • Vomiting**
  • Fever**
  • Rapid Breathing**
  • Painful intercourse

**Contact emergency services, these symptoms may require immediate medical attention.

Questions For Your Doctor

To find a women’s health care physician registered with the American Congress of Obstetricians and Gynecologists, visit The American Congress of Obstetricians and Gynecologists.

Questions For A Doctor

You may want to ask your doctor the following questions:

  • Are my symptoms the result of uterine fibroids or ovarian cysts?
  • Are there other possible causes of my symptoms?
  • What treatments are available?
  • What are the side effects?
  • What alternative or complementary therapies would you recommend?
  • Is it likely that I will need treatment?
  • Do my fibroids/cysts put me at a higher risk of ovarian or uterine cancer?
  • What can I do to lessen the severity of my symptoms?
  • Should I make lifestyle changes to better accommodate my condition?