Overview

Uterine fibroids are uterine non-cancerous growths which often occur during childbearing years. Often known as leiomyomas (lie-o-my-O-muhs) or myomas, uterine fibroids aren’t associated with increased uterine cancer risk and rarely turn into cancer.

From seedlings, undetectable by the human eye, fibroids vary in size to dense masses that can deform and expand the uterus. You may have single or multiple fibroids. For extreme situations, the uterus can be stretched so far by several fibroids that it enters the rib cage and may add weight.

Many women in their lives often have uterine fibroids. Yet you may not know whether you have uterine fibroids, as they still do not cause any symptoms. Your doctor can incidentally discover fibroids during a pelvic exam or prenatal ultrasound.

Symptoms Uterine Fibroids

Several people with fibroids have no symptoms at all. In those that do, the location, size and number of fibroids can affect the symptoms.

The most common signs and symptoms of uterine fibroids among women who have symptoms including:

• Heavy menstrual bleeding
• Menstrual periods of more than one week
• Pelvic pressure or pain
• Routine urination
• Bladder emptying difficulties
• Constipation
• Back pain or leg pain

Rarely, when a fibroid outgrows its blood supply and starts to die, it may cause intense pain.

In general, fibroids are graded according to their position. Within the muscular uterine wall develop intramural fibroids. Sub mucosal fibroids pile into the cavity of the uterus.

When to see a doctor

See your doctor if you have:

• Pelvic pain that does not go away
• Excessively serious, prolonged or painful periods
• Constant spotting or bleeding
• Trouble emptying the bladder
• Unexplained low red blood cell counts (anaemia)

If you have excessive vaginal bleeding or intense pelvic pain that unexpectedly comes on, seek prompt medical attention.

Causes

Doctors do not know the origin of uterine fibroids but these causes are pointed to by study and clinical experience:

Genetic changes: Some fibroids contain gene changes which differ from those in normal muscle cells in the uterine.

Hormones: Estrogen and progesterone, two hormones which stimulate the development of the uterine lining in preparation for pregnancy during each menstrual cycle, tend to promote the growth of fibroids.

Fibroids have more receptors for estrogen and progesterone than normal uterine muscle cells do. Following the menopause, fibroids tend to shrink due to a reduction in hormone production.

Other growth factors: Substances that help the body sustain tissues, such as the growth factor similar to insulin, can affect fibroid production.

Extracellular matrix (ECM): ECM is the matrix that makes the cells bind together, like brick mortar. ECM develops in fibroids and makes them fibrous. ECM also stores growth factors and it induces biological changes in the cells.

Doctors believe uterine fibroids grow from a stem cell in the smooth uterine muscle tissue (myometrium). A single cell repeatedly divides, gradually forming a solid, rubbery mass that is distinct from surrounding tissue.

Uterine fibroid growth patterns vary — they may grow gradually or rapidly, or they may stay the same size. Many fibroids go through spurts of growth and others can shrink by themselves.

Many of the fibroids that developed during pregnancy shrink or vanish after birth as the uterus returns to normal size.

Risk factors

There are few known risk factors for uterine fibroids, other than being a woman of reproductive age. Factors that can have an impact on fibroid development include:

Race: Even though any woman of reproductive age can develop fibroids, black women are more likely than women of other racial groups to have fibroids. Furthermore, at younger ages, black women have fibroids, and they are more likely to have more or greater fibroids, along with more serious symptoms.

Heredity: If your mother or sister had fibroids, you’re at increased risk of developing them.

Other factors: Early menstruation; obesity; a deficiency in vitamin D; a higher diet in red meat and a lower diet in green vegetables, fruit and dairy; and consuming alcohol, including beer, tend to increase the risk of fibroid growth.

Complications

Although uterine fibroids usually aren’t dangerous, they can cause discomfort and may lead to complications such as a drop in red blood cells (anemia), which causes fatigue, from heavy blood loss. Rarely, a transfusion is needed due to blood loss.

Pregnancy and fibroids

Fibroids usually don’t interfere with getting pregnant. However, it’s possible that fibroids — especially submucosal fibroids — could cause infertility or pregnancy loss.

Fibroids can also increase the risk of certain complications in pregnancy, such as placental abruption, restriction of fetal development, and preterm delivery.

Prevention

Although researchers continue to study the causes of fibroid tumors, there is no scientific evidence about how to prevent them. It may not be possible to avoid uterine fibroids but only a small percentage of such tumors require care.

But, by making healthy lifestyle choices, such as maintaining a normal weight and eating fruits and vegetables, you may be able to decrease your fibroid risk.

Some work also indicates the use of hormonal contraceptives could be associated with a lower fibroid risk.