Cervical myomas (or cervical fibroids) are smooth, round, benign tumors composed mostly of muscle tissue. These myomas are present in the cervix, the lower part of the uterus, and are rare. When they do, they are usually accompanied by uterine myomas, also known as uterine fibroids, in the larger upper part of the uterus. Submucosal fibroids grow into the uterine cavity, intramural fibroids grow within the uterus wall, and subserosal fibroids grow outside the uterus.
Myomas are benign tumors, meaning they are not cancerous. However, they can cause serious problems in some cases, especially if they are large. They may block part of the urinary tract or prolapse through the cervix and into the vaginal canal. Prolapsed myomas may develop ulcers, which could cause abnormal bleeding or infection.
What causes cervical myomas?
Myomas are thought to be caused by high levels of estrogen and progesterone. These hormones cause the lining of the uterus to thicken during the menstrual cycle and can also cause myomas to grow. Myomas contain more cells that estrogen and progesterone bind to than typical uterine muscle cells.
Other risk factors for cervical fibroids include:
Genetics: Experts believe there is a genetic component to fibroid development. People with a family history of cervical or uterine fibroids are more likely to develop them themselves.
Age: Fibroids are most common in women in their 30s and 40s. After menopause, fibroids typically shrink due to a decrease in hormone production.
Mild cervical myomas may not cause any problems, while moderate to severe myomas may cause one or more symptoms, including:
Heavy menstrual bleeding or bleeding between menstrual periods
Anemia, as a result of heavy periods and vaginal bleeding
Painful intercourse
Vaginal discharge
Pelvic pain
Abdominal pain and cramping
A bulge in the abdomen or a feeling of heaviness
Difficulty urinating or incomplete urination, including a urine stream that hesitates to start or dribbles at the end
Urinary tract infections
Constipation
How do we diagnose cervical myomas?
If you’re experiencing fibroid symptoms, please make an appointment for a pelvic exam. In most cases, cervical myomas can be diagnosed during a regular exam. We can also use a transvaginal ultrasound to help diagnose the problem.
At your appointment, your doctor may also want to run additional diagnostic tests, including MRI (magnetic resonance imaging), to evaluate the condition. Other diagnostic tests include:
Hysteroscopy: During this procedure, Dr. Aliabadi will insert a hysteroscope (a thin, flexible tube with a camera on the end) into your vagina to look at the fibroids on your cervix.
Laparoscopy: Using a small incision near your belly button, our gynecologist inserts a thin, flexible, lighted instrument (laparoscope) to see inside the area surrounding your uterus, including the ovaries and fallopian tubes. This tool is useful for detecting additional fibroids that would otherwise have been missed.
What are cervical fibroid treatment options?
Small myomas that do not cause symptoms may not need to be treated. Dr. Aliabadi will want to monitor your myomas to make sure they don’t start to cause problems.
Anti-inflammatory medications like ibuprofen or naproxen can lessen bleeding during menstruation and alleviate pain caused by fibroids. This conservative approach is advised for women who experience intermittent pelvic pain or discomfort from fibroids.
Drug therapy may be an option for some women with fibroids/myomas. Drug treatment for fibroids includes the following options:
Birth control pills — Low doses of hormonal contraceptives are often used to control heavy bleeding and painful periods.
Gonadotropin-releasing hormone agonists — GnRH agonists stop the menstrual cycle and can shrink fibroids. Because of their side effects, GnRH agonists are generally only used for short periods, often for a short while before surgery to reduce the risk of bleeding.
Progestin intrauterine device (IUD) — An option for women with myomas that don’t distort the inside of the uterus. While progestin won’t treat myomas, it can help treat heavy bleeding.
Surgical treatment options for cervical myomas
Heavy bleeding and painful menstruation caused by fibroids/myomas may be controlled with medications. However, large fibroids that are causing pain, bleeding, infertility, or urinary problems can be removed or treated with surgery.
Myoma surgical treatments could include:
Uterine fibroid embolization
Despite being named after the uterus, UFE could be a suitable treatment for cervical fibroids, depending on their size and location. This non-surgical procedure blocks the blood supply that sustains a fibroid’s growth.
However, although UFE has a high success rate of 90% for fibroids located throughout the uterus, early outcomes for cervical fibroids have shown less success.
Laparoscopic myomectomy
Dr. Aliabadi is an expert in minimally invasive outpatient surgeries. A laparoscopic myomectomy allows for the surgical removal of your fibroids through a few small incisions. A laparoscope allows the surgeon to see the area they’re working on.
Laparotomy
Traditional “open surgery” occurs when the surgeon removes myomas through a larger abdominal incision.
Hysterectomy
Complete surgical removal of the uterus and sometimes the cervix. If the myomas are very large, this may be the surgeon’s only option.
Have questions about your health? Talk to Dr. Aliabadi
Dr. Aliabadi and her compassionate team are experts in women’s health care. When treated by Dr. Aliabadi, you’re guaranteed to feel safe, heard, and well cared for. A highly regarded healthcare provider in the gynecological and obstetric fields, Dr. Aliabadi can handle just about any women’s health issue, from menstruation and menopause to childbirth.
We invite you to establish care with Dr. Aliabadi. Please make an appointment onlineor call us at (844) 863-6700.
The practice of Dr. Thais Aliabadi and the Outpatient Hysterectomy Center is conveniently located for patients throughout Southern California and the Los Angeles area. We are near Beverly Hills, West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.
Cervical fibroids FAQs
Can cervical fibroids be cancerous?
Cervical myomas are almost always benign. In fact, fewer than one in 1,000 fibroids turn out to be cancerous. To prevent any rare complications from a potentially cancerous cervical fibroid, it is crucial to get a proper diagnosis and consult with a fibroid specialist. Although extremely uncommon, fibroids are slightly more likely to be cancerous in women who have undergone menopause.
can cervical fibroids cause infertility?
Cervical fibroids can potentially cause infertility, although it is less common than with fibroids located elsewhere in the uterus. These growths may interfere with the natural functions of the cervix, including sperm entry or the ability to sustain a pregnancy.
What are the types of fibroids?
Fibroids are classified based on their location. Submucosal fibroids grow into the uterine cavity while intramural fibroids grow within the wall of the uterus, and subserosal fibroids grow on the outside of the uterus. Some submucosal or subserosal fibroids may be pedunculated. This means they hang from a stalk inside or outside the uterus.
How do ultrasounds detect fibroids?
Ultrasounds detect cervical fibroids by using sound waves to produce detailed images that highlight abnormal growths within the cervical tissue.
Can pregnancy lower your risk of fibroids?
Yes, Childbearing is associated with a lower risk of developing fibroids.
Sources
Effectiveness of pericervical tourniquet by Foley catheter reducing blood loss at abdominal myomectomy. Clinical and experimental obstetrics & gynecology, Alptekin, H., & Efe, D. (2014).
Kaump GR, Spies JB. The impact of uterine artery embolization on ovarian function. J Vasc Interv Radiol. 2013;24(4):459–67. doi:10.1016/j.jvir.2012.12.002.
Kohn JR, et al. Pregnancy after endometrial ablation: A systematic review. BJOG. 2018; doi:10.1111/1471-0528.14854.
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Frequently Asked Questions
What triggers fibroid formation?
The exact cause of fibroid formation is unclear, but factors like hormonal fluctuations, genetic predisposition, and estrogen and progesterone levels may play a role. In some cases, lifestyle choices, such as diet and exercise, may also contribute to fibroid development.
Do genetics influence fibroid development?
Genetics can play a role in fibroid development. Studies suggest a hereditary component, with women more likely to develop fibroids if their relatives also have them. Hormonal factors also contribute, as estrogen and progesterone can promote fibroid growth. Lifestyle factors like diet and weight may also influence fibroid development.
Can diet affect fibroid growth?
Diet may influence fibroid growth. A diet rich in fruits, vegetables, whole grains, and lean proteins may help manage fibroids. Avoiding processed foods, caffeine, and alcohol could potentially reduce inflammation and promote overall health, affecting fibroid growth.
Are fibroids linked to infertility?
Fibroids can impact fertility due to their location and size, affecting the uterine cavity or fallopian tubes. Treatment options like myomectomy can help restore fertility, but consult with a healthcare provider for personalized guidance.
What symptoms indicate fibroid presence?
Symptoms of cervical fibroids include heavy menstrual bleeding, anemia, painful intercourse, vaginal discharge, pelvic or abdominal pain, a feeling of heaviness in the abdomen, difficulties urinating, urinary tract infections, and constipation. When suspected, diagnostic tests like hysteroscopy and MRI can confirm the presence of fibroids in the cervix.
Can fibroids disrupt menstrual cycles?
Fibroids can disrupt menstrual cycles, leading to heavy bleeding, bleeding between periods, and pelvic pain. Other symptoms may include anemia, painful intercourse, and urinary issues. Diagnosis is typically done through pelvic exams and imaging tests like MRI. Treatment options range from medication to surgical procedures like UFE.
Are fibroids detectable during exams?
Fibroids are detectable during a pelvic exam and may require additional diagnostic tests such as MRI, hysteroscopy, or laparoscopy for further evaluation. Early detection through exams can help in managing and treating fibroids effectively.
Can exercise influence fibroid size?
Exercise may help manage fibroids by reducing overall body fat and estrogen levels, which can potentially affect fibroid growth. However, specific studies on the direct influence of exercise on fibroid size are limited, and it's best to consult with a healthcare provider for personalized advice.
Are fibroids prone to malignancy?
Fibroids, including cervical myomas, are typically benign tumors composed mostly of muscle tissue and are not prone to malignancy. While they may cause symptoms and complications, they are not considered cancerous growths. Regular monitoring and management of symptoms are essential.
Do fibroids cause urinary symptoms?
In some cases, fibroids can cause urinary symptoms such as difficulty urinating, incomplete urination, urinary tract infections, and even urinary urgency. These symptoms can occur when fibroids put pressure on the bladder or urethra, affecting normal urinary function.
Can stress exacerbate fibroid growth?
Stress does not directly cause the growth of fibroids, but it can exacerbate symptoms. Stress can lead to hormonal imbalances, which may worsen fibroid symptoms like heavy bleeding and pain. Managing stress through techniques like mindfulness or therapy may help alleviate symptoms.
Is fibroid growth rate predictable?
The growth rate of fibroids is not entirely predictable, varying for each individual. Factors like hormone levels, genetics, and lifestyle can influence growth. Regular monitoring and consultation with a healthcare provider are crucial for managing fibroids effectively.
Can fibroids impact bowel function?
Fibroids can affect bowel function. Symptoms may include constipation due to pressure on the rectum, leading to difficulty passing stool. Additionally, fibroids pressing on the bladder can cause frequent urination or the sensation of needing to urinate often.
Is fibroid pain management effective?
Fibroid pain management can be effective through various methods such as medication, hormonal therapy, or surgical interventions. It depends on the individual case and the severity of symptoms to determine the most appropriate treatment plan for managing fibroid pain.
Do fibroids affect pregnancy outcomes?
Cervical fibroids can impact fertility and lead to complications during pregnancy, such as a higher risk of miscarriage, preterm birth, and abnormal fetal positioning. It's crucial to discuss potential risks and management options with a healthcare provider before conceiving.
Can non-surgical treatments shrink fibroids?
Non-surgical treatments like GnRH agonists can help shrink fibroids temporarily, reducing symptoms pre-surgery. Progestin may ease heavy bleeding. However, surgery is often needed for large, symptomatic fibroids. UFE might be effective, but outcomes with cervical fibroids are less successful than with others.
Are fibroid treatments typically invasive?
Fibroid treatments can be minimally invasive, depending on the size and location of the fibroids. Uterine fibroid embolization (UFE) and laparoscopy are examples of less invasive procedures, while surgery may be necessary for large or problematic fibroids. The choice of treatment depends on individual circumstances.
Can fibroids recur post-treatment?
Fibroids can recur post-treatment, although the likelihood varies based on the treatment type and individual factors. Monitoring and follow-up care are essential to detect any recurrence early on and address accordingly. Regular check-ups are recommended to track post-treatment progress and manage any potential recurrences effectively.
Do fibroids cause heavy bleeding?
Fibroids can cause heavy menstrual bleeding, affecting the severity depending on the size and location of the fibroid. Additionally, symptoms may include painful intercourse, pelvic pain, and urinary issues. Diagnosis involves pelvic exams and possibly imaging tests like MRI. Treatment options range from medications to surgical procedures such as UFE.
How does obesity impact fibroids?
Obesity can impact fibroids by increasing the risk of developing larger and more symptomatic fibroids. It can also make surgical treatments more challenging due to increased surgical risks associated with obesity. Maintaining a healthy weight can help reduce the severity of fibroid symptoms and improve treatment outcomes.
Are fibroid symptoms age-related?
While fibroid occurrence increases with age, symptoms are not age-related. Younger women may have symptoms due to smaller fibroids, while older women are more likely to experience symptoms from larger fibroids. Symptoms depend on fibroid size, location, and individual health factors, not just age.
Can hormonal therapies reduce fibroids?
Hormonal therapies, like GnRH agonists or progestin, may help manage symptoms of fibroids but do not treat the fibroids themselves. These treatments are typically used for short periods or to prepare for surgery. Large fibroids causing significant issues may require surgical removal.
Do fibroids necessitate hysterectomy?
In cases where fibroids are large and causing severe symptoms like pain, bleeding, infertility, or urinary problems, hysterectomy may be necessary for treatment. However, other less invasive surgical options are available depending on the size and location of the fibroids. Utilizing medical advice to determine the best course of action is prudent in such situations.
Can fibroids lead to anemia?
Cervical fibroids can lead to anemia due to heavy menstrual bleeding. Symptoms of fibroids can vary from mild to severe, with potential complications like anemia if left untreated. It is essential to seek medical attention if experiencing symptoms associated with cervical fibroids.
Are fibroids symptomatic in teens?
Fibroids can be symptomatic in teenagers but are rare at that age. Symptoms can include heavy menstrual bleeding, abdominal pain, and pelvic pain. Consulting a healthcare professional is advised for an accurate diagnosis and appropriate treatment.
Do fibroids affect hormonal balance?
Fibroids can affect hormonal balance by causing excessive bleeding, leading to anemia and resulting in hormonal fluctuations. Large fibroids may disrupt the body's hormonal equilibrium, potentially impacting menstrual cycles and hormone levels. Consulting a doctor for personalized advice is recommended to address concerns related to hormonal balance and fibroids.
Are fibroids common post-menopause?
Fibroids are less common post-menopause, as decreased estrogen levels typically shrink existing fibroids or cause them to disappear. However, some women may still experience fibroids or new growths due to hormone replacement therapy. Regular monitoring is advised.
Can fibroids cause pelvic pressure?
Yes, fibroids can cause pelvic pressure, especially if they are large. Symptoms of fibroids may include a feeling of heaviness or discomfort in the pelvic area due to the size and location of the fibroids. It is essential to consult a healthcare provider if experiencing these symptoms.
Do fibroids correlate with ethnicity?
Fibroids have been found to vary in prevalence among different ethnicities. African American women are at a higher risk of developing fibroids compared to women of other ethnic backgrounds. Research suggests genetics and hormonal factors may contribute to this disparity in fibroid occurrence across ethnic groups.
Can fibroids impede sexual comfort?
In some cases, fibroids can cause painful intercourse due to pressure on surrounding tissues. It's important to discuss any symptoms with a healthcare provider for proper evaluation and management.
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