Fibroids, also known as uterine fibroids or leiomyomas, are noncancerous growths of the uterus that often appear during childbearing years. They are not associated with an increased risk of uterine cancer and almost never develop into cancer.

Characteristics of Fibroids

  • Types: Fibroids vary in size, shape, and location. They can be submucosal (under the lining of the uterus), intramural (within the wall of the uterus), or subserosal (on the outer wall of the uterus).

  • Size: They can range from the size of a seed to large masses that can enlarge and distort the uterus.

  • Number: A woman can have a single fibroid or multiple ones.

Symptoms

Many women with fibroids experience no symptoms. When symptoms do occur, they may include:

  • Heavy menstrual bleeding

  • Menstrual periods lasting more than a week

  • Pelvic pressure or pain

  • Frequent urination

  • Difficulty emptying the bladder

  • Constipation

  • Backache or leg pains

Causes

The exact cause of fibroids is unknown, but several factors may influence their development:

  • Hormones: Estrogen and progesterone, which prepare the uterine lining for pregnancy, may promote the growth of fibroids.

  • Genetic changes: Fibroids often contain genes that differ from those in normal uterine muscle cells.

  • Other Growth Factors: Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth.

  • Extracellular Matrix (ECM): ECM makes cells stick together and is more abundant in fibroids, making them fibrous.

Risk Factors

Factors that can increase a woman's risk of developing fibroids include:

  • Age: Fibroids are more common as women age, especially during the 30s and 40s through menopause.

  • Family History: Having a family member with fibroids increases the risk.

  • Ethnic Origin: African-American women are more likely to develop fibroids.

  • Obesity: Women who are overweight are at higher risk for fibroids.

  • Diet: Eating a lot of red meat and ham may increase the risk.

Diagnosis

Fibroids are typically diagnosed via:

  • Pelvic examination: Detecting irregularities in the shape of the uterus.

  • Ultrasound: The most common and reliable way to confirm fibroids.

  • Magnetic Resonance Imaging (MRI): For a more detailed imaging.

  • Hysterosonography, Hysterosalpingography, and Hysteroscopy: For further evaluation, especially for fertility assessments.

Treatment

Treatment depends on several factors and may include:

  • Medication: To regulate the menstrual cycle, control heavy bleeding, or shrink fibroids.

  • Noninvasive procedure: Such as MRI-guided focused ultrasound surgery.

  • Minimally invasive procedures: Including uterine artery embolization, laparoscopic or robotic myomectomy, and endometrial ablation.

  • Traditional surgery: Such as hysterectomy or myomectomy for larger fibroids or when conservative treatment fails.

Impact on Fertility and Pregnancy

While fibroids can sometimes cause infertility or pregnancy problems, many women with fibroids can conceive naturally and have successful pregnancies. The impact depends on the size, number, and location of the fibroids.

Management

Regular monitoring and a healthy lifestyle can help manage fibroids, especially when they are asymptomatic. Women with fibroids should work closely with their healthcare provider to monitor their condition and determine the best course of action.