Uterine fibroids, also known as leiomyomas or myomas, are noncancerous growths of the uterus that often appear during childbearing years. They are quite common, with many women having fibroids at some point during their lives. However, they may not always cause symptoms or require treatment.

Characteristics

  • Size: Fibroids can range from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus.

  • Number: A woman can have one fibroid or many.

  • Location: They can develop within the uterine wall, on the outer surface of the uterus, or be attached to the uterus by a stem-like structure.

Symptoms

While many fibroids are asymptomatic, symptoms can vary based on the size, number, and location of the fibroids:

  • Heavy Menstrual Bleeding: One of the most common symptoms.

  • Prolonged Menstrual Periods: Typically lasting more than a week.

  • Pelvic Pressure or Pain: Due to the size and pressure of the fibroids.

  • Frequent Urination: Caused by pressure on the bladder.

  • Difficulty Emptying the Bladder: Due to pressure on the urethra.

  • Constipation: Resulting from pressure on the rectum.

  • Backache or Leg Pains: From the pressure of large fibroids.

Causes

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

  • Hormones: Estrogen and progesterone, hormones that stimulate the development of the uterine lining during each menstrual cycle, appear to promote the growth of fibroids.

  • Genetic Changes: Many fibroids contain changes in genes that differ from those in normal uterine muscle cells.

  • Other Factors: Pregnancy and a family history of fibroids may increase the risk.

Diagnosis

Fibroids are often found incidentally during a pelvic exam or prenatal ultrasound. Imaging tests can confirm the diagnosis:

  • Ultrasound: The most common initial test.

  • Magnetic Resonance Imaging (MRI): For more precise information about size and location.

  • Hysterosonography, Hysterosalpingography, or Hysteroscopy: Additional methods for imaging or examining the uterus.

Treatment

Treatment depends on the symptoms, size and location of the fibroids, age, and overall health. Options include:

  • Medications: Aimed at regulating menstrual cycle, treating symptoms, or shrinking fibroids.

  • Noninvasive Procedure: MRI-guided focused ultrasound surgery (FUS).

  • Minimally Invasive Procedures: Including uterine artery embolization, radiofrequency ablation, and laparoscopic or robotic myomectomy.

  • Traditional Surgical Procedures: Such as hysterectomy and abdominal myomectomy.

Effect on Fertility

While most women with fibroids can conceive naturally, fibroids can sometimes affect fertility and pregnancy. The impact on fertility depends on the size, number, and location of the fibroids.

Regular Monitoring

Asymptomatic fibroids typically require no treatment but should be monitored for growth or onset of symptoms. It's important for women with fibroids to have regular pelvic exams and follow their doctor's recommendations.