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Fibroids are tumors that grow from the muscle layers of the uterus (womb), and are non-cancerous. Fibroids are growths of smooth muscle and fibrous tissue. Fibroids can vary in size, from that of a bean to as large as a melon.

Fibroids affect at least 20% of all women at sometime during their life. Women aged between 30 and 50 are the most likely to develop fibroids. Overweight and obese women are at significantly higher risk of developing fibroids, compared to women of normal weight.

Complications associated with fibroids

It is important to stress that in the vast majority of cases fibroids do not result in complications for patients. However, for a tiny minority they do. Complications may include:
• Menorrhagia (heavy periods) - the most common complication being a disruption of the woman's ability to function normally when periods are present, and also the possibility of depression because of this. In some cases, menorrhagia can lead to anemia and fatigue.
• Abdominal pains - if the patient's fibroids are large she may experience swelling and discomfort in the lower abdomen. She may also have a sensation of being constipated. Some women with large fibroids say their bowel movements are painful.
• Premature birth, labor problems, miscarriages - as estrogen levels rise significantly during pregnancy, and as estrogen can speed up fibroid growth, some women may experience early labor, miscarriages or complications during labor.
• Infertility - in some cases fibroids can make it more difficult for the fertilized egg to attach itself to the lining of the uterus. A fibroid that grows outside the uterus (submucosal fibroid) may change the uterus' shape, making it harder for the woman to get pregnant.
• Leiomyosarcoma - this is extremely rare. This is a form of cancer, and it can develop inside the fibroids.

Four types of fibroids
There are four types of fibroids and these are:
1. Intramural
These are located in the wall of the uterus. These are the most common types of fibroids.
2. Subserosal fibroids
These are located outside the wall of the uterus. They can develop into pedunculated fibroids (stalks). Subserosal fibroids can become quite large.
3. Submucosal fibroids
These are located in the muscle beneath the lining of the uterus wall.
4. Cervical fibroids
These are located in the neck of the womb (the cervix).

Causes of fibroids
During a woman's reproductive years her estrogen and progesterone levels are high. When estrogen levels are high, especially during pregnancy, fibroids tend to swell. When estrogen levels are low fibroids may shrink, e.g. during a woman's menopause.
Heredity may also be a factor. Women whose mothers and/or sisters have/had fibroids have a higher risk of developing them too.

Symptoms of uterine fibroids
Most women have no symptoms. That is why most patients with fibroids do not know they have them. When symptoms do develop, they may include:
• Anemia (as a result of heavy periods)
• Backache
• Constipation
• Discomfort in the lower abdomen (especially if fibroids are large)
• Frequent urination
• Heavy painful periods
• Pain in the legs
• Painful sex
• Swelling in the lower abdomen (especially if fibroids are large)
Other possible symptoms of uterine fibroids include:
• Labor problems
• Pregnancy problems
• Fertility problems
• Repeated miscarriages
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