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Uterine fibroids are noncancerous (benign) tumors that develop in the womb (uterus), a female reproductive organ.
Leiomyoma; Fibromyoma; Myoma; Fibroids
Uterine fibroids are common. As many as 1 in 5 women may have fibroids during their childbearing years (the time after starting menstruation for the first time and before menopause). Half of all women have fibroids by age 50.
Fibroids are rare in women under age 20. They are more common in African-Americans than Caucasians.
The cause of uterine fibroids is unknown. However, their growth has been linked to the hormone estrogen. As long as a woman with fibroids is menstruating, a fibroid will probably continue to grow, usually slowly.
Fibroids can be so tiny that you need a microscope to see them. However, they can grow very large. They may fill the entire uterus, and may weigh several pounds. Although it is possible for just one fibroid to develop, usually there are more than one.
Fibroids are often described by their location in the uterus:
More common symptoms of uterine fibroids are:
Note: There are often no symptoms. Your health care provider may find them during a physical exam or other test. Fibroids often shrink and cause no symptoms in women who have gone through menopause.
The health care provider will perform a pelvic exam. This may show that you have a change in the shape of your womb (uterus).
It can be difficult to diagnose fibroids, especially if you are extremely overweight.
An ultrasound may be done to confirm the diagnosis of fibroids. Sometimes, a pelvic MRI is done.
An endometrial biopsy (biopsy of the uterine lining) or laparoscopy may be needed to rule out cancer.
Treatment depends on several things, including:
Some women may just need pelvic exams or ultrasounds every once in a while to monitor the fibroid's growth.
Treatment for the symptoms of fibroids may include:
Surgery and procedures used to treat fibroids include:
National Uterine Fibroid Foundation - www.nuff.org
Some women with fibroids have no symptoms and may not need treatment.
During a pregnancy, existing fibroids may grow due to the increased blood flow and estrogen levels. The fibroids usually return to their original size after the baby is delivered.
Complications of fibroids include:
In rare cases, fibroids may cause infertility. Fibroids may also cause complications if you become pregnant, although the risk is thought to be small:
Call your health care provider if you have:
Katz VL. Benign gynecologic lesions: Vulva, vagina, cervix, uterus, oviduct, ovary. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 18.
Rodriguez MI, Warden M, Darney PD. Intrauterine progestins, progesterone antagonists, and receptor modulators: a review of gynecologic applications. Am J Obstet Gynecol. 2010 May;202(5):420-8. Epub 2009 Dec 23. Review.
Moss J, Cooper K, Khaund A, et al. Randomised comparison of uterine artery embolisation (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST trial): 5-year results. BJOG. 2011 Jul;118(8):936-944.
Peddada SD, Laughlin SK, Miner K, et al. Growth of uterine leiomyomata among premenopausal black and white women. Proc Natl Acad Sci USA. 2008 Dec 16;105(50):19887-92. Epub 2008 Dec 1.
Van Voorhis B. A 41-year-old woman with menorrhagia, anemia, and fibroids: review of treatment of uterine fibroids. JAMA. 2009;301:82-93.
American College of Obstetricians and Gynecologists. ACOG practice bulletin. Alternatives to hysterectomy in the management of leiomyomas. Obstet Gynecol. 2008;112:387-400.