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Tests and diagnosis
By Mayo Clinic staff
Uterine fibroids are frequently found incidentally during a routine pelvic exam. Your doctor may feel irregularities in the shape of your uterus through your abdomen, suggesting the presence of fibroids.
Ultrasound
If confirmation is needed, your doctor may obtain an ultrasound — a painless exam that uses sound waves to obtain a picture of your uterus — to confirm the diagnosis and to map and measure fibroids. A doctor or technician moves the ultrasound device (transducer) over your abdomen (transabdominal) or places it inside your vagina (transvaginal) to obtain images of your uterus.
Transvaginal ultrasound provides more detail because the probe is closer to the uterus. Transabdominal ultrasound visualizes a larger anatomic area. Sometimes, fibroids are discovered during an ultrasound conducted for a different purpose, such as during a prenatal ultrasound.
Other imaging tests
If traditional ultrasound doesn't provide enough information, your doctor may order other imaging studies, such as:
- Hysterosonography. This ultrasound variation uses sterile saline to expand the uterine cavity, making it easier to obtain interior images of the uterus. This test may be useful if you have heavy menstrual bleeding despite normal results from traditional ultrasound.
- Hysterosalpingography. This technique uses a dye to highlight the uterine cavity and fallopian tubes on X-ray images. Your doctor may recommend it if infertility is a concern. In addition to revealing fibroids, it can help your doctor determine if your fallopian tubes are open.
- Hysteroscopy. Your doctor inserts a small, lighted telescope called a hysteroscope through your cervix into your uterus. Your doctor injects (instills) saline into your uterus expanding the uterine cavity and allowing your doctor to examine the walls of your uterus and the openings of your fallopian tubes. A hysteroscopy can be performed in your doctor's office.
Imaging techniques that may occasionally be necessary include computerized tomography (CT) and magnetic resonance imaging (MRI).
Other tests
If you're experiencing abnormal vaginal bleeding, your doctor may want to conduct other tests to investigate potential causes. He or she may order a complete blood count (CBC) to determine if you have iron deficiency anemia because of chronic blood loss. Your doctor may also order blood tests to rule out bleeding disorders and to determine the levels of reproductive hormones produced by your ovaries.
- Haney AF. Leiomyomata. In: Gibb RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:916.
- Baird DD, et al. High cumulative incidence of uterine leiomyoma in black and white women: Ultrasound evidence. American Journal of Obstetrics and Gynecology. 2003;188:100.
- Stewart EA. Epidemiology, clinical manifestations, diagnosis, and natural history of uterine leiomyomas. http://www.uptodate.com/home/index.html. Accessed April 22, 2009.
- The American College of Obstetrics and Gynecologists. Alternatives to hysterectomy in the management of leiomyomas. Obstetrics & Gynecology. 2008;112:387.
- Evans P, et al. Uterine fibroid tumors: Diagnosis and treatment. American Family Physician. 2007;75:1503.
- Uterine fibroids: Frequently asked questions. The National Women's Health Information Center. http://womenshealth.gov/faq/uterine-fibroids.cfm. Accessed April 22, 2009.
- Uterine fibroids. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp074.cfm. Accessed April 22, 2009.
- Stewart EA. Pathogenesis of uterine leiomyomas. http://www.uptodate.com/home/index.html. Accessed April 22, 2009.
- Management of uterine fibroids: An update of the evidence. Rockville, Md.: Agency for Healthcare Research and Quality. http://www.ahrq.gov/downloads/pub/evidence/pdf/uterupdate/uterup.pdf. Accessed April 29, 2009.
- Stewart EA. Overview of treatment of uterine leiomyomas. http://www.uptodate.com/home/index.html. Accessed April 22, 2009.
- Marshall LM, et al. A prospective study of reproductive factors and oral contraceptive use in relation to the risk of uterine leiomyomata. Fertility and Sterility. 1998;70:432.
- Faerstein E, et al. Risk factors for uterine leiomyoma: A practice-based case control study. I. African-American heritage, reproductive history, body size, and smoking. American Journal of Epidemiology. 2001;153:1.
- Chiaffarino F, et al. Use of oral contraceptives and uterine fibroids: Results from a case-control study. British Journal of Obstetrics and Gynaecology. 1999;106:857.
- Stewart EA (expert opinion). Mayo Clinic, Rochester, Minn. May 13, 2009.
