Uterine fibroids
Key points
- Uterine fibroids are benign tumors of muscle and connective tissue that develop within, or are attached to, the uterine wall.
- The cause of fibroid tumors of the uterus is unknown.
- A pelvic examination reveals an irregularly shaped, lumpy, or enlarged uterus.
- Methods of treatment depend on the severity of symptoms, the patient's age, her pregnancy status, her possible desire for future pregnancies, her general health, and characteristics of the fibroids.
Alternative names
Leiomyoma; Fibromyoma; Myoma; Fibroids
Definition
Uterine fibroids are benign tumors of muscle and connective tissue that develop within, or are attached to, the uterine wall.
Causes, incidence, and risk factors
The cause of fibroid tumors of the uterus is unknown. However, it is suggested that fibroids may enlarge with estrogen therapy (such as oral contraceptives) or with pregnancy.
Fibroid growth seems to depend on regular estrogen stimulation, rarely affecting women younger than 20 or postmenopausal women. As long as a woman with fibroids is menstruating, the fibroids will probably continue to grow, although growth is usually quite slow.
Fibroids can be microscopic, but they can also grow to fill the uterine cavity, and may weigh several pounds. Uterine fibroids are the most common pelvic tumor and they may be present in 15 to 20% of reproductive-age women, and 30 to 40% of women over 30.
Fibroids occur 3 to 9 times more frequently in African-American women than in Caucasian women.
Although it is possible for a single fibroid to develop, usually there are a number of them, which begin as small seedlings spread throughout the muscular walls of the uterus.
They slowly enlarge and become more nodular, frequently intruding into the cavity of the uterus or growing out beyond the normal boundary of the uterus. Rarely, a fibroid will hang from a long stalk attached to the outside of the uterus. This is called a pedunculated fibroid, and it may twist and cause the blood vessels feeding the tumor to kink. Hospitalization and surgery may be needed in this instance
Symptoms
- Sensation of fullness or pressure in lower abdomen
- Pelvic cramping or pain with periods
- Abdominal fullness, gas
- Increase in urinary frequency
- Heavy menstrual bleeding (menorrhagia), sometimes with the passage of blood clots
- Sudden, severe pain due to a pedunculated fibroid
Note: There are often no symptoms.
Signs and tests
A pelvic examination reveals an irregularly shaped, lumpy, or enlarged uterus. Frequently, this diagnosis is reliable. However, on occasion, diagnosis is difficult, especially in obese women. Fibroid tumors have been mistaken for ovarian tumors, inflammatory processes of the tubes, and pregnancy.
A transvaginal ultrasound or pelvic ultrasound may be performed to confirm the findings.
Written and revised by
Andrey Nailor, M.D.
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