Sometimes lower abdominal pain, heavy menstrual periods, or mid-cycle bleeding signals the presence of fibroid tumors--round, hard balls of smooth muscle that develop inside the uterine walls. Some women also experience frequent urination, constipation, or abdominal swelling. And for some women, fibroids cause no discomfort at all and are discovered during a routine pelvic exam.

Fibroids are benign--that is, they aren't cancerous--but they can interfere with conception and pregnancy. Since fibroids are most common during the childbearing years, they can be a problem even if they don't cause any discomfort.

If your doctor says that you need a hysterectomy for fibroids, get a second opinion, especially if you still want to have children. Depending on the number, size, and location of fibroids, your uterus may or may not have to be removed.

One option is myomectomy, a limited procedure that cuts out the fibroids but leaves the uterus intact. Or your doctor may prescribe progesterone or a tumor-shrinking drug called gonadotropin-releasing hormone (GnRH). Yet another option, if you take birth control pills, is to switch to a progesterone-only pill or other nonhormonal method of birth control, since estrogen seems to stimulate the growth of fibroids. (For similar reasons, fibroids almost always shrink after menopause.)

Even if your condition warrants removing your uterus, you may be able to keep your ovaries, thus avoiding a surgically induced menopause. To find out what's best for you, discuss the pros and cons of all the possible options with your doctor.