Dear Physician,

The diagnosis of uterine fibroids may be suspected based upon a history of symptoms of menorrhagia, dysmenorrhea, dyspareunia, increasing urinary frequency, urinary retention, pelvic/abdominal pressure, or increasing abdominal girth.

Onset of these symptoms usually occurs after age 25, and may increase in frequency and severity over time.

Pelvic examination should be followed by a radiologic study such as ultrasound, CT scan or MRI to confirm the diagnosis of fibroids.

The location, number, and size of all fibroids should be ascertained along with the absence of findings suggestive of adenomyosis.

Other pelvic tumors should also be ruled out.

The various treatment options for uterine fibroids should be discussed. Factors that may influence the ultimate treatment choice include the patient’s age, severity of symptoms, desire to maintain reproductive function, desire to retain the uterus, desire to have an outpatient minimally invasive procedure versus an inpatient procedure, the availability of experience and expertise in the options, cost, recovery time, and the presence of other medical or gynecological conditions.

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