Uterine fibroids, or leiomyomas, are non-cancerous tumors of the uterus. They are diagnosed in about 30% of women and can cause heavy menstrual bleeding, pelvic pain, frequent urination, and infertility. Excessive menstrual bleeding may lead to anemia and fatigue. Levels of hormones produced by the body, such as estrogen, are thought to influence the occurrence of fibroids. They are most common during a woman’s reproductive years and tend to shrink after menopause. Black women are three times more likely to be diagnosed with fibroids than white women, develop tumors at earlier ages, and have more severe disease at the time of diagnosis. Fibroids are the leading indication for hysterectomy among U.S. women of all ages, accounting for over 200,000 hysterectomies and more than 1.2 billion dollars in health care costs each year.

DIAGNOSIS

Uterine fibroids may be discovered during pelvic examination. The diagnosis is confirmed by follow-up tests, most often an ultrasound.

THREE TYPES OF UTERINE FIBROIDS

Subserosal — These grow in the outer portion of the uterus
Intramural — The most common type of fibroid, they grow within the uterine wall
Submucosal — Grow under the lining of the uterine cavity

SYMPTOMS OR UTERINE FIBROIDS

Women with fibroids may not even know they have them. Treatment is not necessary unless they are associated with bleeding, pain, or other problems. Depending on the size, location, and number of tumors, fibroids may be associated with the symptoms listed below:

Heavy menstrual bleeding, sometimes with clumps of blood clots and flooding

Bleeding between periods

Anemia, which may cause fatigue

Painful periods

Pain during sexual intercourse

Low back pain

Feeling of fullness in the lower abdomonen

Frequent urination and/or incontinence, caused by the fibroid pressing on the bladder

Pressure on the bowel, this may lead to constipation

Infertility

Miscarriage

Leg pain, usually down the back of the leg
 
TREATMENT

There are several treatment options. Appropriate treatment depends upon age, desire for childbearing, symptoms, and size and location of the fibroids.

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RESEARCH

Important studies are being conducted in the U.S. to identify risk factors for fibroids. They include several large prospective cohort studies, a cross-sectional study of women enrolled in a Health Maintenance Organization, and basic science studies that investigate genetic markers for fibroids.