Uterine fibroid
Uterine fibroids, also known as uterine leiomyomas or fibroids, are benign smooth muscle tumors of the uterus. Most women with fibroids have no symptoms while others may have painful or heavy periods. If large enough, they may push on the bladder, causing a frequent need to urinate. They may also cause pain during penetrative sex or lower back pain. A woman can have one uterine fibroid or many. Occasionally, fibroids may make it difficult to become pregnant, although this is uncommon.
| Uterine fibroids | |
|---|---|
| Other names | Uterine leiomyoma, uterine myoma, myoma, fibromyoma, fibroleiomyoma |
| Uterine fibroids as seen during laparoscopic surgery | |
| Specialty | Gynecology |
| Symptoms | Painful or heavy periods |
| Complications | Infertility |
| Usual onset | Middle and later reproductive years |
| Causes | Unknown |
| Risk factors | Family history, obesity, eating red meat |
| Diagnostic method | Pelvic examination, medical imaging |
| Differential diagnosis | Leiomyosarcoma, pregnancy, ovarian cyst, ovarian cancer |
| Treatment | Medications, surgery, uterine artery embolization |
| Medication | Ibuprofen, paracetamol (acetaminophen), iron supplements, gonadotropin releasing hormone agonist |
| Prognosis | Improve after menopause |
| Frequency | ~50% of women by age 50 |
The exact cause of uterine fibroids is unclear. However, fibroids run in families and appear to be partly determined by hormone levels. Risk factors include obesity and eating red meat. Diagnosis can be performed by pelvic examination or medical imaging.
Treatment is typically not needed if there are no symptoms. NSAIDs, such as ibuprofen, may help with pain and bleeding while paracetamol (acetaminophen) may help with pain. Iron supplements may be needed in those with heavy periods. Medications of the gonadotropin-releasing hormone agonist class may decrease the size of the fibroids but are expensive and associated with side effects. If greater symptoms are present, surgery to remove the fibroid or uterus may help. Uterine artery embolization may also help. Cancerous versions of fibroids are very rare and are known as leiomyosarcomas. They do not appear to develop from benign fibroids.
About 20% to 80% of women develop fibroids by the age of 50. In 2013, it was estimated that 171 million women were affected worldwide. They are typically found during the middle and later reproductive years. After menopause, they usually decrease in size. In the United States, uterine fibroids are a common reason for surgical removal of the uterus.