By Monya De, MD MPH

My friend looked four months pregnant. "Congrat--" was all I could utter, before she interrupted me. "Fibroid."

Instead of a baby, a fibroid, or leiomyoma, was stretching out her uterus in noticeable fashion. She had the most common pelvic tumor, one that's seen in 12-25 percent of reproductive-age women.

Hers wasn't symptomatic, but many women who have fibroids notice lower abdominal pain, heavy and long menstrual bleeding, or problems getting pregnant. Most fibroids are too small to cause these problems. Fibroids come from one small cell undergoing a mutation, or DNA change, which leads to abnormal growth of useless tissue.

Doctors can examine fibroids using the traditional pelvic exam, and may recommend an ultrasound to understand the size and characteristics of the fibroid. Additionally, an MRI may help the doctor get a better look at areas not seen too well with the ultrasound. An MRI is the best way to tell what type of mass is in the uterus. While some suspected fibroids turn out to be cancer, uterine cancer is rare.

The following factors give you a higher risk of fibroids:

•          African-American race
•          Polycystic ovary syndrome
•          Early onset menstruation
•          A genetic defect in the gene HMGA2 (causes fibroids and short height)
•          Never having been pregnant
•          Obesity
•          Eating a lot of red meat
•          Alcohol use (especially beer)
•          Heredity
•          High blood pressure
•          Phthalate exposure (is your nail polish 5-free?)
•         Note that estrogen and soy have not been proven to cause fibroids

How can you be proactive?

Living a healthy lifestyle, avoiding high blood pressure with regular checkups and plenty of exercise and meditation, and not waiting longer than needed to get pregnant are a few ways women can reduce their overall fibroid risk.

Women who have adequate vitamin D levels tend to have less severe fibroids. Drinking green tea may help to fight fibroids as well. Getting to your regularly scheduled gynecologist appointments can help identify small ones early on.

Treatment can include doing nothing (for small fibroids not causing any symptoms), taking hormone-mimicking medications to shrink the fibroids and reduce bleeding, or using an IUD to stop heavy period bleeding. Raloxifene, which changes how the body responds to estrogen, shrinks fibroids in women after menopause, but doesn't seem to work before menopause. Mifepristone, or the RU-486 abortion pill, is in trials as a potential fibroid drug.

If surgery is needed to stop bothersome bleeding or pain, or to help with conception, know that many women experience relief after surgery and can even get pregnant.

Enjoy Your Healthy Life!

Monya De, MD, MPH is a specialist in internal medicine and previously was a medical reporter for ABC News. She graduated with her MPH degree from the University of California, Berkeley School of Public Health and her MD degree from the University of California, Irvine; she received her undergraduate degree with honors in human biology from Stanford University. Dr. De is also a member of the Proactive Health Labs Medical Advisory Board, which monitors all programs, products and services.