Fibroid & Menstrual Disorders

Whether you've had multiple prior surgeries, are overweight, or have very large fibroids, there is an answer. A hysterectomy may not be your only option. You may qualify for a less invasive procedure to treat your fibroids.

The George Washington University Medical Faculty Associates Fibroid and Menstrual Disorder Center will review your case with you and discuss your options.

Comprised of a team of gynecologic surgeons, high-risk obstetricians, oncologists, and interventional radiologists, doctors at The GW MFA Fibroid and Menstrual Disorder Center are committed to helping you make an informed decision on a treatment plan that is right for you.

Uterine Fibroids

Uterine fibroids—also known as fibroid tumors, leiomyomas, or myomas—are benign, non-cancerous lumps that grow in a woman’s uterus. Fibroids may grow on the inside, outside, in the wall of the uterus, or in the tissue that holds the uterus in place. They can be common in women in their 30s and 40s. Although it is not known what causes the formation of fibroids, the presence of estrogen and progesterone can cause existing fibroids to grow.

It is not uncommon for fibroids to shrink after a woman has experienced menopause and the natural production of these hormones is lessened. In many cases, fibroids will not cause symptoms, or they may only cause mild symptoms. Severe symptoms of fibroids can include:

  • Lower back pain
  • Frequent urination
  • Painful intercourse
  • Pressure in the abdomen
  • Long periods of painful cramping

The presence of fibroids can lead to further complications such as anemia caused by excessive bleeding, or difficulties with pregnancy: achieving pregnancy, early labor, or miscarriage. Because most fibroids cause no or mild symptoms, many women many choose not to do anything to treat them.

In severe cases, there are two surgical options for a woman who would like to remove her fibroids:

  • Myomectomy – If a woman hopes to someday become pregnant or would like to keep her uterus, a surgery known as myomectomy can remove only the fibroids. This procedure does not guarantee that a woman will be able to achieve pregnancy later, and the fibroids may eventually return.
  • Hysterectomy – The second surgical option for removing fibroids is the hysterectomy, in which a woman’s entire uterus is removed. Pregnancy is not possible after a hysterectomy.


Dysmenorrhea, also known as menstrual cramps, is a condition that includes pain right before and during menstruation that can range from mild to severe. The types of pain that are associated with dysmenorrhea include sharp, burning, throbbing, dull, burning, or shooting in the hips, lower back, or inner thighs. Other symptoms that can accompany dysmenorrhea include vomiting or diarrhea.

The term primary dysmenorrhea is used to describe menstrual cramps that occur without an identifiable cause other than menstruation, while secondary dysmenorrhea is caused by something other than menstruation. Secondary dysmenorrhea can be caused by endometriosis, ovarian cysts, fibroids, cervical or uterine polyps, pelvic infections, or structural problems in a woman’s uterus, cervix, or vagina.

Premenstrual Syndrome (PMS)

PMS is a common condition that most women experience to some degree as their bodies prepare for menstruation. The symptoms of PMS may appear a week or two before menstruation and may include:

  • Cravings for sweet or salty foods
  • Bloating, constipation or diarrhea
  • Loss of appetite
  • Acne
  • Back pain
  • Headaches
  • Sore breasts
  • Clumsiness
  • Nausea
  • Mood swings
  • An inability to concentrate
  • Worsening of symptoms from other conditions such as asthma, depression, or migraines

Some symptoms of PMS can be mitigated through exercise, eating a diet high in B vitamins, and through avoiding foods such as salt, caffeine, sugar, and alcohol. Additionally, many women find relief from the pains associated with menstruation by taking pain relievers such as aspirin, acetaminophen, ibuprofen, or naproxen. For severe PMS symptoms, a doctor may prescribe the usage of birth control pills or other hormones to make periods lighter and reduce symptoms overall.

Premenstrual Dysphoric Disorder (PMDD)

PMDD is a condition very similar to PMS, however in PMDD the symptoms are heightened. An individual suffering from PMDD may experience panic attacks, crying spells, suicidal thoughts, insomnia, disinterest in activities or relationships, fatigue, or feeling out of control. Treatments meant to provide relief from the symptoms of PMS can also be used to minimize the symptoms of PMDD. In addition to exercise and changes in diet, doctors may prescribe hormonal therapies, anti-depressants, or other medications to treat the extreme symptoms of PMDD.

Abnormal Uterine Bleeding (AUB)

Menorrhagia: Menorrhagia is a condition in which a menstrual bleeding is exceptionally heavy or long. In an average menstrual cycle, a woman will lose approximately 70 mL of blood. If a woman bleeds more than approximately 80 mL or for longer than 7 days in a period, she may be experiencing menorrhagia. A woman who has menorrhagia may experience this excessive blood loss during every period to the degree that she is incapacitated and unable to perform usual activities.

Menorrhagia can be caused by:

  • A hormonal imbalance
  • Dysfunction of the ovaries
  • Fibroids
  • Polyps
  • Adenomyosis
  • The use of an IUD
  • Pregnancy complications
  • Medications
  • Cancer

Menorrhagia can cause complications such as anemia and severe pain. Treatment for menorrhagia can include medications such as ibuprofen to minimize pain and bleeding, or hormonal therapies (such as oral contraceptives) to regulate menstrual cycles. In severe cases, surgical options such as the destruction of the lining of the uterus or the removal of the uterus itself can reduce menstrual flow or cease menstruation entirely.


Amenorrhea is the absence of menstruation, usually for three or more menstrual cycles (secondary amenorrhea), or the lack of beginning menstruations by age 16 (primary amenorrhea). Amenorrhea can be caused by pregnancy, breast feeding, menopause, certain types of contraceptives, or certain medications. Additional factors that can influence the lack of a menstrual cycle include stress, body weight, excessive exercise, a hormonal imbalance, or a structural abnormality of a woman’s reproductive system. A woman experiencing amenorrhea may have difficulty conceiving. Treatment for amenorrhea varies, depending upon the underlying cause, but may include medication, contraceptives, or surgery.