Uterine Fibroids
Also known as: Fibroids, Leiomyomas, Myomas
Uterine fibroids are noncancerous growths of the uterus that develop from smooth muscle tissue. They are extremely common, affecting up to 80% of women by age 50, with Black women disproportionately affected. While many fibroids cause no symptoms, others can cause heavy bleeding, pelvic pain, and reproductive complications.
Symptoms
Causes
- Genetic mutations in smooth muscle cells of the uterus
- Hormonal influence (estrogen and progesterone promote growth)
- Growth factors (insulin-like growth factor)
- Extracellular matrix changes creating fibrous tissue
Risk Factors
- African American race (3 times higher incidence)
- Age during reproductive years, 30s–40s
- Family history of fibroids
- Early onset of menstruation
- Obesity
- Vitamin D deficiency
Diagnosis
- Pelvic examination revealing enlarged or irregularly shaped uterus
- Transvaginal ultrasound to visualize fibroids
- MRI for detailed mapping before surgical planning
- Saline infusion sonography for submucosal fibroids
- Hysteroscopy for fibroids inside the uterine cavity
Treatment
- Watchful waiting for asymptomatic or small fibroids
- Hormonal medications (GnRH agonists, oral contraceptives, progestin IUD)
- Tranexamic acid for heavy menstrual bleeding
- Uterine artery embolization (UAE) to shrink fibroids
- Myomectomy (surgical removal preserving the uterus)
- Hysterectomy for women who do not desire future pregnancy
Prevention
- There is no proven way to prevent fibroids
- Maintaining a healthy weight may reduce risk
- Adequate vitamin D intake may be protective
- A diet rich in fruits, vegetables, and low-fat dairy may lower risk
When to See a Doctor
- Menstrual bleeding is heavy enough to cause anemia
- Pelvic pain or pressure is persistent or worsening
- You are having difficulty getting pregnant
- You notice rapid growth of abdominal size
Frequently Asked Questions
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