Uterine fibroids (leiomyomas, myomas) are among the most common tumors in women. These growths aren't associated with cancer, and they occur more frequently in black women than in white women. As many as half of all women have fibroids, but most are unaware of them. Your doctor may discover them incidentally during a pelvic exam or prenatal ultrasound. One-third to one-half of women with fibroids develop symptoms, most frequently during their late 30s or 40s.

If you're like most women with fibroids, they aren't causing you any problems. Fibroids that cause no symptoms may require only "watchful waiting" — you and your doctor monitoring your condition through regular pelvic examinations.

Watchful waiting might be a good option if you're nearing menopause. The reproductive hormones estrogen and progesterone appear to stimulate fibroid growth. During menopause, your ovaries stop producing these hormones and fibroids shrink.

You may decide to take action if signs and symptoms such as heavy bleeding, pelvic discomfort and pressure on neighboring organs intrude on your life.
Signs and symptoms of troublesome fibroids

* You find yourself planning your work, recreation and travel around your menstrual period.
* You have anemia from chronic blood loss.
* Your enlarged abdomen forces you to discard a substantial part of your wardrobe.
* You take frequent trips to the bathroom to urinate.
* You have backaches or constipation.
* Your sex life suffers because you're exhausted from anemia, feel self-conscious or have pain with intercourse.

Occasionally, fibroids might affect fertility by blocking fallopian tubes or preventing a fertilized egg from implanting in your uterus. If fibroids interfere with conception, you and your doctor might decide to take action.

A generation ago, doctors almost uniformly recommended a hysterectomy — removal of the uterus — for treatment of uterine fibroids. This operation remains the only proven permanent solution for this condition. Nearly 600,000 women have a hysterectomy each year in the United States, and more than one-third of these operations are performed to treat fibroids. But hysterectomy is major surgery. It ends your ability to bear children, and if you have your ovaries removed along with your uterus, you will develop symptoms of menopause and face the question of whether to take hormone therapy.

Today, several other treatments are available to reduce the size of uterine fibroids, relieving the troublesome symptoms for most women. Because fibroids aren't cancerous and usually grow slowly, you have time to gather information before making a decision. Your plans for childbearing, how close you are to menopause and your feelings about surgery may play a role in determining your options.