In the previous article we talked about how fast fibroids grow and what size they can reach in some cases. Our focus today is large uterine fibroids. We are going to explore what fibroid size is considered large, what symptoms large fibroids can cause, and what treatment options are effective for large and giant fibroids.
What Fibroid Is Considered Large?
Uterine fibroids grow in the uterus and depending on their size and location, might cause a number of symptoms. These benign tumors develop in women of reproductive age and are extremely common. They are particularly common in African-American women (as many as 80%). Fibroids are round and hard as a rock and composed of smooth muscle and fibrous tissue.
Estrogen plays the key role in developing uterine fibroids. With estrogen dominance, fibroids tend to grow faster and sometimes, with spurts. The growth rate varies from female to female. Generally speaking, there are four types of fibroids based on their size:
- small fibroids that are up to 2 cm;
- medium fibroids that are 2-6 cm;
- large fibroids that are more than 6 cm; and
- giant fibroids that reach 20-30 cm or more.
Although theoretically uterine fibroids can reach any size, giant fibroids are rare. The largest fibroid ever documented was the size of a pumpkin and weighed 100 lbs.
How Do I Know if I Have a Large Fibroid?
When a female has a large fibroid, her abdomen is usually enlarged due to the enlarged uterus. She might work out a lot or stay on a diet to address extra “volume” in the low abdomen but reaches no result. In fact, it’s common to compare the size of the uterus with fibroids to the size of the uterus during pregnancy (as far as the size measurement only). This way, a woman with a 10 cm fibroid looks like a woman in her 14th – 16th week of pregnancy.
Usually, women with fibroids are diagnosed during a routine pelvic examination. Large tumors can be more easily identified by an OB-GYN because they are hard as a rock. To confirm the diagnosis, a pelvic ultrasound can be ordered. However, the golden standard in examining uterine fibroids is MRI. Along with determining the exact size and position of a large fibroid, this imaging test won’t miss small tumors often not seen on ultrasound images.
What Symptoms Do Big Fibroids Cause?
When talking about large fibroids, the most common consequence is pressure in the abdomen. This often results in problems with the function of organs neighboring the uterus: the bladder and the bowels. A large uterine mass might physically press on the organs and cause pain and frequent urination or difficulty moving the bowels. Besides, big tumors sometimes cause pressure on the cervix resulting in painful intercourse, or on the fallopian tubes affecting a woman’s fertility. A very large fibroid can also block the ureter which delivers urine from the kidney to the bladder. This obstruction is called hydronephrosis and needs urgent attention to correct before kidney damage can occur.
There are cases when large fibroids remain asymptomatic and the only sign of their presence in the body is a bloated stomach. If this is the case, a female might decide to not undergo any treatment (although not advised) until more significant symptoms occur.
Does UFE Work for Large Fibroids?
Usually, a woman with large fibroids is advised to undergo a myomectomy or a hysterectomy. The hysterectomy will end the woman’s suffering, but it can cause a number of unwanted side effects (exs. sexual dysfunction, urinary leaking, bone loss). Myomectomy in a patient with a large fibroid would be directed at that one fibroid, and there is usually multiple fibroids present. Therefore, the other fibroids would be left behind in the uterus after the myomectomy. They would start to grow and within 5 years the woman would need another procedure. The average rate of fibroid recurrence after myomectomy is 11% per year. In other words, in 5 years, over half of the women treated will need another procedure. Another risk related to the myomectomy procedure is that it can result in a hysterectomy; this risk is present in all women who undergo myomectomy, but particularly significant in women with large fibroids.
Unlike myomectomy, UFE (uterine fibroid embolization) treats all fibroids regardless of their number and size. Sometimes, UFE is the only option for a female with a large tumor. At Atlanta Fibroid Center, the procedure takes only 30-40 minutes, and all patients are discharged the day of the procedure. The recovery is much shorter than after a surgery, and fibroids’ symptoms improve over a few months following the UFE, with some symptoms improving in a matter of days.
If you suspect that you have large fibroids, and would like another option besides surgery, please schedule a consultation with one of the leading fibroid experts Dr. John Lipman by calling (770) 953-2600 or by booking an appointment online at Atlanta Fibroid Center.