Uterine fibroids, also known as leiomyomas or myomas, are noncancerous growths that develop in the muscular wall of the uterus. They are the most common type of benign tumor found in women of reproductive age. While many fibroids do not cause symptoms and are discovered incidentally during pelvic exams or imaging studies, others can lead to various symptoms and complications.
Types of Uterine Fibroids
- Intramural Fibroids:
- These fibroids develop within the muscular wall of the uterus and are the most common type. They can cause the uterus to enlarge and may lead to heavy menstrual bleeding and pelvic pain.
- Submucosal Fibroids:
- Submucosal fibroids grow just beneath the lining of the uterus (endometrium) and can protrude into the uterine cavity. They are associated with heavy menstrual bleeding and may cause infertility or pregnancy complications if they distort the uterine cavity.
- Subserosal Fibroids:
- Subserosal fibroids grow on the outer surface of the uterus and may protrude into the abdominal cavity. While they may not cause significant menstrual bleeding, they can lead to pelvic pain or pressure and may compress nearby organs.
- Pedunculated Fibroids:
- Pedunculated fibroids are attached to the uterus by a stalk or stem. They can be intramural, submucosal, or subserosal in nature.
Symptoms of Uterine Fibroids
- Heavy Menstrual Bleeding: Excessive menstrual bleeding, including prolonged periods, passing large blood clots, or bleeding between periods.
- Pelvic Pain: Dull, aching pelvic pain or discomfort, often accompanied by pressure or heaviness in the lower abdomen or pelvis.
- Pelvic Pressure or Fullness: Feeling of fullness or pressure in the lower abdomen or pelvis, similar to the sensation of being pregnant.
- Frequent Urination: Increased frequency of urination, particularly if fibroids compress the bladder.
- Difficulty Emptying the Bladder: Difficulty fully emptying the bladder due to fibroids pressing against it.
- Constipation: Difficulty passing stools or feeling of constipation, especially if fibroids compress the rectum.
- Backache or Leg Pain: Pain in the lower back or legs, particularly if fibroids press on nerves in the pelvis.
- Infertility or Pregnancy Complications: Fibroids can sometimes interfere with fertility or increase the risk of pregnancy complications such as miscarriage, preterm labor, or breech presentation.
Causes of Uterine Fibroids
The exact cause of uterine fibroids is not fully understood, but several factors may contribute to their development, including:
- Hormonal Factors:
- Estrogen and progesterone, hormones that regulate the menstrual cycle, may stimulate the growth of fibroids.
- Genetic Predisposition:
- Women with a family history of fibroids are more likely to develop them themselves, suggesting a genetic component to their development.
- Race and Ethnicity:
- Fibroids are more common in women of African descent than in women of other racial or ethnic backgrounds.
- Other Factors:
- Other factors that may increase the risk of fibroids include obesity, early onset of menstruation, vitamin D deficiency, and certain lifestyle factors such as diet and exercise.
Summary
Uterine fibroids are noncancerous growths that develop in the muscular wall of the uterus and are common among women of reproductive age. They can be categorized into different types based on their location within the uterus. While many fibroids do not cause symptoms, others can lead to heavy menstrual bleeding, pelvic pain, pressure, frequent urination, constipation, and other symptoms. The exact cause of fibroids is not fully understood but is believed to involve hormonal factors, genetic predisposition, race, ethnicity, and other factors. Treatment options for fibroids depend on the severity of symptoms, the size and location of the fibroids, and the woman’s age and desire for future fertility. Treatment may include medications, noninvasive procedures such as uterine artery embolization, or surgical interventions such as myomectomy or hysterectomy.