Fibroids and PMS are distinct medical conditions, but some may confuse them because some of their symptoms overlap, pain, constipation, and pelvic pressure.

Uterine fibroids are benign tumors in the uterus. They're extremely common, affecting as many as 75 percent of women. Since usually harmless and often symptom-less, many women don't know they have them.

Fibroids form from uterine muscle cells, which divide over again until they grow into a rubbery mass, nourished by a woman's blood supply. Fibroids can be tiny— about the size of a pea or a plant seed— or big enough to distort the uterus. They usually grow in masses, although it is possible for a single fibroid to grow. Generally, fibroids grow in the muscle wall, but as they get larger they can push into the uterine cavity or outside the uterine wall.

Symptoms

Fibroids are most common in women between the ages thirty and fifty, and between 20 and 50 percent of women have fibroid-related symptoms, especially abnormal uterine bleeding and pelvic pain. Common symptoms include heavy periods; prolonged periods or bleeding between periods; pelvic pressure pain; urinary incontinence or frequent urination; constipation; backache; or leg pains. The symptoms also vary depending on the size and location of the fibroids. For example, fibroids that grow into the uterine cavity cause prolonged menstrual bleeding, while those that project outside of the uterus can press on the bladder, causing urinary problems, or on the spinal nerves, causing a backache. In pregnant women, uterine fibroids can increase in size and may cause problems during birth depending on their position the uterus.

It's not uncommon for women to mistake their fibroids for PMS, and to mistake PMS for fibroids, especially since pain and constipation are symptoms for both, while pelvic pressure may be written off as bloating. Doctors aren't sure why fibroids develop, but genetics, hormones, and other chemicals in the body are thought to play role.

Hormones and Fibroids

Estrogen and progesterone regulate fibroid growth. Fibroids contain more estrogen receptors than normal uterine muscle cells; they also grow when women are in their reproductive years, when estrogen levels are higher, and then decrease or shrink when women undergo menopause. Experts believe that progesterone facilitates the growth of fibroids, and other hormones and chemicals, including growth hormone and prolactin, play a role as well, although that role is not clearly defined.

Some women may have a genetic predisposition to uterine fibroids. For example, black women are two to five times as likely to develop fibroids as white women, and researchers have identified two genes that are associated with some fibroids.

Diagnosing Fibroids

Doctors generally diagnose fibroids if they feel them during regular pelvic exam. They may also diagnose them (or confirm diagnosis) using ultrasound, known as an SIS, which uses fluid the uterine cavity). Physicians may also discover fibroids a hysteroscopy but only if the woman is having the procedure for another reason.

Ultrasound uses sound waves to get an image of internal Vaginal ultrasounds are used to look at the pelvic structure find small fibroids, while abdominal ultrasounds are used large fibroids. Your doctor may perform one or both types Sometimes advanced imaging tools such as magnetic imaging (MRI) or computerized tomography (CT) scans used to confirm a diagnosis.

A hysteroscopy involves using a small telescope to look your uterus; sometimes a small sample, or biopsy, is taken tissue. This slightly painful procedure is done using a local usually in the hospital. This method is especially useful examining the type of fibroids commonly associated with abnormal uterine bleeding.

Treating Fibroids

Some alternative medicine practitioners advocate progesterone cream as a treatment for PMS and fibroids, based on the notion that fibroids are caused by “estrogen dominance” and the progesterone creams rebalance a woman's hormones. Progesterone creams, they claim, dramatically shrink fibroids.

Conventional medicine treats fibroids with surgery, drugs, and ultrasound treatment. Surgery can mean hysterectomy (a complete removal of the uterus), myomectomy (removal of individual fibroids), or uterine artery embolization (injection of small particles into the blood vessels to cut blood flow to the fibroid and cause them to shrink). For years, doctors recommended hysterectomies as a first-line treatment; in fact, fibroids are the main reason women receive this surgical procedure, accounting for about two hundred thousand procedures annually, or one-third of all hysterectomies performed each year.

In recent years, however, other fibroid-removal techniques have been developed and approved, including a device that uses magnetic resonance image (MRI)–guided ultrasound to target and destroy fibroids. This noninvasive procedure, approved by the FDA in 2004, offers an alternative to surgery. Although this treatment spares a woman's uterus, it's not intended for women who want become pregnant.

Medical treatment for fibroids uses drugs called GnRH agonists to stop the menstrual cycles. GnRH agonists reduce the tumors and stop bleeding, but they also cause osteoporosis if used over a longer period. In addition, once the drugs are stopped, the fibroids quickly grow again. For this reason, GnRH agonists are usually given for one to three months as preparation for a surgical procedure.