Fibroidlike Conditions

Certain uterine conditions can mimic the symptoms of fibroids. One such condition is adenomyosis, in which glandular tissue from the uterine lining migrates into its wall. About 20 percent of women are estimated to have this condition, and the vast majority of those have previously given birth. Although the exact cause is unknown, it seems to occur when the barrier between uterine layers breaks down.

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About 60 percent of women with adenomyosis experience abnormal uterine bleeding, such as heavy periods or bleeding between periods, and 25 percent have severe pelvic pain with menstruation. There are no good diagnostic tests to detect the condition. Most of the time, adenomyosis is discovered during a hysterectomy to treat other conditions like fibroids. The only treatment is a surgical removal of the uterus since medications haven't shown to be useful for controlling symptoms long term.

Endometrial polyps can also masquerade as fibroids. These are localized overgrowths of endometrial tissue that project into the uterus. They rarely occur in women under 20 and increase in prevalence with age until menopause when they usually resolve. About 10 to 24 percent of women undergoing hysterectomies have these polyps, which can cause heavy periods and bleeding between periods. Diagnosis can be made through an endometrial biopsy or dilation and curettage (D&C) procedure that dilates the cervix to obtain a sample of uterine lining. Ultrasound can also be useful in making a diagnosis. A newer technique called a hysteroscopy introduces a small tube with a camera attached through the vagina and into the uterus. The instrument can also obtain a biopsy sample. Treatment usually involves a D&C in which the polyps are removed by cutting away part of the uterine lining.