Overview

Uterine fibroids, or leiomyomas, are noncancerous growths that develop in the muscular wall of the uterus. These benign tumors are composed of muscle and fibrous tissue and vary significantly in size, number, and location. While many people with fibroids may not have symptoms, others experience significant discomfort and complications. Understanding the different aspects of fibroids can help guide diagnosis and treatment.

Types

Fibroids are classified based on their location within the uterus:

  • Intramural fibroids: Found within the muscular wall of the uterus.

  • Subserosal fibroids: Grow on the outer wall of the uterus.

  • Submucosal fibroids: Develop just underneath the lining of the uterine cavity.

  • Pedunculated fibroids: Attached to the uterus by a stalk-like growth.

These distinctions are crucial for determining symptoms and appropriate treatments.

Symptoms

While some individuals may be asymptomatic, those with noticeable symptoms may experience:

  • Heavy or prolonged menstrual periods

  • Pelvic pressure or pain

  • Frequent urination or difficulty emptying the bladder

  • Constipation or rectal pressure

  • Pain during intercourse

  • Lower back or leg pain

  • Enlarged abdomen or bloating

  • Anemia due to excessive bleeding

Causes

Although the precise cause remains unknown, several factors are believed to influence fibroid development:

  • Hormonal factors: Estrogen and progesterone promote fibroid growth. Fibroids often shrink after menopause due to decreased hormone levels.

  • Genetics: A family history of fibroids increases your likelihood of developing them.

  • Other contributing factors: Obesity, early onset of menstruation, vitamin D deficiency, and poor diet (e.g., high intake of red meat) may contribute.

Risk Factors

Certain risk factors may increase the likelihood of developing fibroids:

  • Age (most common between 30–50 years)

  • Family history

  • Ethnicity (more common in Black women)

  • Obesity

  • High blood pressure

  • Low levels of vitamin D

  • Diet high in red meat and low in green vegetables

Diagnosis

Uterine fibroids are often discovered during routine pelvic exams. For confirmation and assessment, healthcare providers may use:

  • Ultrasound: Transabdominal or transvaginal imaging to visualize the uterus

  • MRI: Provides detailed images of fibroids and helps in treatment planning

  • Hysterosonography: Uses saline and ultrasound to get clearer images

  • Hysteroscopy: Uses a thin, lighted tube to inspect the inside of the uterus

  • Laparoscopy: A minimally invasive surgery using a camera inserted through a small abdominal incision

Treatment

Treatment depends on fibroid size, symptoms, patient age, and fertility plans. Options include:

  • Medications:

    • Over-the-counter pain relievers (e.g., ibuprofen)

    • Hormonal therapies like GnRH agonists to shrink fibroids

    • Birth control pills to regulate bleeding

    • Iron supplements for anemia

  • Minimally invasive procedures:

    • Uterine artery embolization (UAE)

    • MRI-guided focused ultrasound

    • Endometrial ablation (not suitable for those wanting to conceive)

  • Surgical options:

    • Myomectomy: Removes fibroids while preserving the uterus

    • Hysterectomy: Complete removal of the uterus (curative, but ends fertility)

Prevention

Fibroids cannot always be prevented, but you may reduce your risk through:

  • Maintaining a healthy weight

  • Eating a balanced diet rich in fruits and vegetables

  • Avoiding excessive red meat and alcohol

  • Regular exercise

  • Managing stress and blood pressure

These measures also contribute to overall reproductive health.

Complications

Potential complications of fibroids include:

  • Severe anemia due to heavy bleeding

  • Infertility or pregnancy difficulties (in rare cases)

  • Recurrent miscarriage

  • Urinary or bowel dysfunction

  • Risk of fibroids turning cancerous is extremely low (<1 in 1,000)

  • Increased risk of cesarean delivery and placental complications during pregnancy

Living With Fibroids

For many, fibroids are manageable with the right approach:

  • Monitor symptoms and cycles regularly

  • Seek medical advice when experiencing severe bleeding or pain

  • Consider lifestyle changes like diet, exercise, and stress management

  • Use heat pads or pain medications for relief during menstruation

  • Join support groups for emotional and mental well-being

Regular follow-ups help in adjusting treatment plans as needed.

When to Seek Help

Contact your healthcare provider if you experience:

  • Excessive or prolonged menstrual bleeding

  • Pelvic pain that interferes with daily life

  • Difficulty becoming pregnant

  • Urinary problems or severe constipation

Early diagnosis allows for a broader range of treatment options and fewer complications.