*Overview
Uterine fibroids are
noncancerous growths of
the uterus that often
appear during
childbearing years. Also
called leiomyomas (lie-o-
my-O-muhs) or myomas,
uterine fibroids aren't
associated with an
increased risk of uterine
cancer and almost never develop into
cancer.
Fibroids range in size from seedlings,
undetectable by the human eye, to bulky
masses that can distort and enlarge the
uterus. You can have a single fibroid or
multiple ones. In extreme cases, multiple
fibroids can expand the uterus so much
that it reaches the rib cage and can add
weight.
Many women have uterine fibroids
sometime during their lives. But you might
not know you have uterine fibroids
because they often cause no symptoms.
Your doctor may discover fibroids
incidentally during a pelvic exam or
prenatal ultrasound.
*Symptoms
Many women who have fibroids don't have
any symptoms. In those that do, symptoms
can be influenced by the location, size and
number of fibroids.
In women who have symptoms, the most
common signs and symptoms of uterine
fibroids include:
Heavy menstrual bleeding
Menstrual periods lasting more than a
week
+Pelvic pressure or pain
+Frequent urination
+Difficulty emptying the bladder
+Constipation
+Backache or leg pains
Rarely, a fibroid can cause acute pain when
it outgrows its blood supply, and begins to
die.
Fibroids are generally classified by their
location.
*Intramural fibroids grow within
the muscular uterine wall.
*Submucosal
fibroids bulge into the uterine cavity.
*Subserosal fibroids project to the outside
of the uterus.
When to see a doctor
See your doctor if you have:
+Pelvic pain that doesn't go away
+Overly heavy, prolonged or painful periods
+Spotting or bleeding between periods
+Difficulty emptying your bladder
+Unexplained low red blood cell count (anemia)
Seek prompt medical care if you have severe vaginal bleeding or sharp pelvic
pain that comes on suddenly.
*Causes
Doctors don't know the cause of uterine
fibroids, but research and clinical
experience point to these factors:
Genetic changes. Many fibroids
contain changes in genes that differ
from those in normal uterine muscle
cells.
*Hormones. Estrogen and
progesterone, two hormones that
stimulate development of the uterine
lining during each menstrual cycle in
preparation for pregnancy, appear to
promote the growth of fibroids.
Fibroids contain more estrogen and
progesterone receptors than normal
uterine muscle cells do. Fibroids tend
to shrink after menopause due to a decrease in hormone production.
Other growth factors. Substances
that help the body maintain tissues,
such as insulin-like growth factor,
may affect fibroid growth.
*Extracellular matrix (ECM). ECM is the material that makes cells stick
together, like mortar between bricks.
ECM is increased in fibroids and
makes them fibrous. ECM also stores
growth factors and causes biologic
changes in the cells themselves.
Doctors believe that uterine fibroids develop from a stem cell in the smooth
muscular tissue of the uterus
(myometrium). A single cell divides
repeatedly, eventually creating a firm,
rubbery mass distinct from nearby tissue.
The growth patterns of uterine fibroids
vary — they may grow slowly or rapidly, or
they may remain the same size. Some
fibroids go through growth spurts, and
some may shrink on their own.
Many fibroids that have been present
during pregnancy shrink or disappear after
pregnancy, as the uterus goes back to a
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. Although any woman of
reproductive age can develop
fibroids, black women are more likely
to have fibroids than are women of
other racial groups. In addition, black women have fibroids at younger
ages, and they're also likely to have
more or larger fibroids, along with
more-severe symptoms.
-Heredity.; If your mother or sister had fibroids, you're at increased risk of
developing them.
Other factors. -Onset of menstruation at an early age; obesity; a vitamin D deficiency; having a diet higher in red
meat and lower in green vegetables,
fruit and dairy; and drinking alcohol,
including beer, appear to increase
your risk of developing fibroids.
*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.