Stamford Health Fibroid Center

Meet Scott Chudnoff, MD, Chair of the Hugh K. Miller, MD, Department of Obstetrics & Gynecology (OBGYN). Dr. Chudnoff specializes in women’s health, gynecology, minimally invasive surgery, medical technology and medical education, and is certified as a sexuality counselor by the American Association of Sexuality Educators, Counselors and Therapists (AASECT).

The Fibroid Center offers:

• A comprehensive, streamlined approach to manage all tests and treatment as well as handle specific concerns you may have
• Personalized treatment plans tailored toward your specific needs.
• The opportunity to participate in a new clinical trial to decrease tumor size and bleeding, if qualified. 
• The option to undergo minimally invasive treatment whenever possible.

What are uterine fibroids?

Uterine fibroids are firm tumors that are made of smooth muscle cells and fibrous connective tissue that develop in the uterus. In many cases, women can have more than one fibroid in the uterus. Fibroids are not cancerous, nor do they increase a woman's risk for uterine cancer. While research continues to be conducted, we still don't know the exact cause of uterine fibroids.

50% of women in the U.S. alone have fibroids occurring in the uterus. For many young women especially, fibroids can be devastating if the alternative to suffering silently is a hysterectomy or other treatment options that aren't ideal to their lifestyle. The good news is there are less invasive fibroid treatments that would allow women to be able to retain both their uterus and fertility.

What are the different types of uterine fibroids?

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Although there are four main types of fibroids, women can have any combination of the following:

Intramural Fibroids
The most common, these fibroids develop within the wall of the uterus and expand from there. This type causes symptoms such as heavy bleeding during periods, longer cycles, clot passing and pelvic pain, all of which can cause pressure on surrounding organs. Intramural fibroids can also be mistaken for pregnancy when they expand.

Subserosal Fibroids
These fibroids form outside the uterine wall, therefore not typically interfering with menstruation itself. However, as these tumors grow outward, pelvic pain and pressure become common.

Submucosal Fibroids
The least common, these fibroids develop under the lining of the uterine cavity. Larger versions can block the fallopian tubes which can ultimately lead to infertility. Inconvenient and challenging symptoms of submucosal fibroids include passing clots, frequent soiling and anemia and/or fatigue if left untreated.

Pedunculated Fibroids
These fibroid tumors grow on a stalk either in the uterus or outside the uterine wall. As the fibroids twist around on the stalk, pain and pressure are often key symptoms.

What are some major risk factors of uterine fibroids?

• Women who are approaching menopause are at the greatest risk for fibroids due to their imbalance of estrogen over progesterone. Fibroids often shrink after menopause when estrogen levels decline.
• Family history of fibroids
• Diet high in red meat
• High blood pressure
• African American women have higher incidences of fibroids

What are the symptoms of uterine fibroids?

Some women show no symptoms at all, especially if the fibroids are small in size. Others may have one or more of the following:

• Bleeding between periods
• Heavy bleeding and fatigue during periods
• Anemia caused by chronic bleeding
• Passing of blood clots
• Pelvic pain and/or pressure; low back pain
• Frequent urination
• A firm mass, often located near the middle of the pelvis, which can be felt by your doctor
• Pain during sexual intercourse

How are fibroids diagnosed?

Fibroids are most often found during a routine pelvic exam. Your doctor may feel a firm, irregular pelvic mass during an abdominal exam. Other tests may include:

• Transvaginal ultrasound: An ultrasound test using a small instrument, called a transducer, that is placed in the vagina.
• MRI: A noninvasive procedure that produces a two-dimensional view of an internal organ or structure.
• Hysteroscopy: Visual exam of the canal of the cervix and the interior of the uterus using a viewing instrument (hysteroscope) inserted through the vagina.

What are the common treatments for fibroids?

• Hysterectomy: a complete removal of the uterus performed laparoscopically (minimally invasive). 50% of hysterectomies are performed for fibroids alone.
• Myomectomy or fibroid excision, a minimally invasive procedure
• Endometrial ablation: removing a thin layer of tissue that lines the uterus
• Hormonal medications & intrauterine devices
• Non-hormonal medications
• Uterine artery embolization (uterine fibroid embolization): A nonsurgical and minimally invasive therapy to treat fibroid symptoms and preserve the uterus with little to no blood loss.