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    Uterine fibroids, one of the most common noncancerous gynecological conditions occuring in reproductive-age women, are estimated to affect more than one out of five women under 50 and account for three out of every ten hysterectomies performed annually in the United States.

A fibroid, or myoma, is a noncancerous mass of muscle and connective tissue in the uterus (womb). No one knows what causes fibroids, but scientists believe their growth may be stimulated by the female sex hormone estrogen.

"A fibroid can be as small as a pinhead or as large as a watermelon," says Gene Williams, M.D., a medical officer in the obstetrics and gynecological devices branch of FDA's Center for Devices and Radiological Health. "It can cause no symptoms or a lot of symptoms. To the women who has one, a fibroid may feel like a rock-hard bulge in the lower abdomen."

Every year, about 175,00 American women -- most of them 35 to 55 -- undergo hysterectomy, or sugical removal of the uterus, as treatment for fibroids. According to American College of Obstetricans and Gynecologists guideline, a fibroid that makes a woman's uterus bigger than it would be at 12 weeks of pregnacy, even if the women is suffering no other symptoms, is an indication for a hysterectomy.

However, the practice of routinely recommending hysterectomy for fibroids has come under increasing scrtiny form both consumer organizations and doctors concerned about the high rate of hysterectomy in the United States. By age 60, more than a third of American women have had a hysterectomy, a rate higher than in any other Western country.

Blue Cross/Blue Shield of Illinois, in a study of all the hysterectomies performed in the state between 1987 and 1989, concluded that one-third were unnecessary. Most of the unnessary surgeries, the unsurer found, were performed for fibroids and other benign (noncancerouis) conditions.

Option Increase

New medications and less invasive surgeries have made more treament options available to women whose fobroids cause them problems. A number of doctors interviewed for this article say the most important consideration in treating a fibroid should be how the patient feels about her condition and what level of intervention she is comfortable with.