What is Uterine Fibroid Disease?
Uterine fibroids are non-cancerous growths that develop in or on the uterus. Also known as leiomyomas or myomas, these fibroids are made up of muscle and fibrous tissue and can vary in size, from tiny seedlings to large masses. They are the most common benign tumors of the reproductive organs in women.
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Fibroids can affect a woman’s quality of life, but many women with fibroids experience little to no symptoms. However, in some cases, fibroids can cause significant discomfort, heavy bleeding, and complications such as infertility or pregnancy issues.
Key Points:
Non-cancerous growths in the uterus.
Common among women of reproductive age, particularly between 30 and 40 years old.
Can vary in size, location, and number, influencing symptoms and treatment needs.
What Causes Uterine Fibroids?
The exact cause of uterine fibroids remains unclear, but several factors are thought to play a role in their development.
Factors Linked to Uterine Fibroid Growth:
Hormonal Imbalances:
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Estrogen and Progesterone: Fibroids are believed to grow in response to estrogen and progesterone, two hormones that regulate the menstrual cycle. These hormones stimulate the growth of fibroid tissue. Fibroids tend to grow during a woman’s reproductive years and shrink after menopause, when hormone levels decrease.
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Genetics:
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Family History: Women with a family history of fibroids are more likely to develop them. Certain gene mutations may increase susceptibility to fibroid formation.
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Age and Race:
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Age: Fibroids are more common in women over the age of 30, with a peak incidence in women in their 40s.
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Race: African American women are at a higher risk of developing fibroids and may experience more severe symptoms compared to women of other racial groups
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Other Factors:
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Obesity: Being overweight or obese may increase the risk of fibroid development due to higher levels of estrogen in the body.
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Diet: A diet high in red meat and low in fruits and vegetables has been linked to an increased risk of fibroids.
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Vitamin D Deficiency: Some studies suggest that low levels of vitamin D may be associated with an increased risk of fibroids.
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What Are the Symptoms of Uterine Fibroids?
Many women with uterine fibroids may not experience any symptoms, and the fibroids may be discovered during a routine pelvic exam or ultrasound. However, in some cases, fibroids can cause a range of symptoms, which can vary depending on their size, number, and location.
Factors Linked to Uterine Fibroid Growth:
Heavy Menstrual Bleeding:
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Women with fibroids may experience prolonged or heavy menstrual periods, leading to anemia (low iron levels) due to blood loss.
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Clots may also appear during heavy bleeding
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Pelvic Pain or Pressure:
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Fibroids can cause pain or a feeling of pressure in the lower abdomen or pelvis. Large fibroids may press against nearby organs, such as the bladder or rectum, leading to discomfort or pain during sex.
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Frequent Urination:
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Fibroids pressing against the bladder can cause a frequent need to urinate or a feeling of incomplete bladder emptying.
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Back or Leg Pain:
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Large fibroids may cause pain in the lower back or legs due to pressure on surrounding muscles or nerves.
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Reproductive Issues:
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Fibroids can interfere with fertility, making it difficult to conceive. They may also increase the risk of pregnancy complications, such as miscarriage, preterm birth, or placental abruption (when the placenta separates from the uterus).
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Abdominal Distension or Bloating:
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Large fibroids can cause the abdomen to feel bloated or swollen, resembling pregnancy-like symptoms.
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How is Uterine Fibroid Disease Diagnosed?
Uterine fibroids are often diagnosed during a routine pelvic exam, but additional imaging tests are usually required to confirm the presence of fibroids and assess their size and location.
Factors Linked to Uterine Fibroid Growth:
Pelvic Examination:
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During a pelvic exam, a doctor may feel for an enlarged uterus or irregularities that suggest the presence of fibroids.
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Ultrasound:
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The most common and non-invasive method for diagnosing fibroids. An ultrasound uses sound waves to create an image of the uterus and detect fibroids.
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Magnetic Resonance Imaging (MRI):
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An MRI provides a more detailed image of the uterus and can help determine the size, location, and type of fibroids
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Hysterosonography (Saline Infusion Sonogram):
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A specialized ultrasound procedure where sterile fluid is injected into the uterus to expand it, helping to provide a clearer view of the fibroids
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Hysteroscopy:
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A thin, flexible tube with a camera is inserted through the cervix into the uterus, allowing the doctor to directly view the fibroids.
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Endometrial Biopsy:
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In some cases, a biopsy may be performed to rule out other conditions such as cancer.​
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Minimally Invasive Procedures
For women who wish to avoid surgery, there are several minimally invasive options to treat fibroids:
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Uterine Artery Embolization (UAE) – A procedure in which small particles are injected into the blood vessels supplying the fibroids, cutting off their blood supply and causing them to shrink.
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Magnetic Resonance-guided Focused Ultrasound (MRgFUS) – A non-invasive procedure using ultrasound waves to destroy fibroid tissue.
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Surgical Treatments
In some cases, surgical intervention may be necessary to treat larger or more problematic fibroids:
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Myomectomy – A surgical procedure that removes the fibroids while preserving the uterus. This is often recommended for women who want to maintain fertility.
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Hysterectomy – The complete removal of the uterus. This is the definitive treatment for fibroids and may be recommended for women who do not wish to have children or have severe symptoms that do not respond to other treatments.​
Treatment for Uterine Fibroid Disease
Treatment for uterine fibroids depends on the severity of symptoms, the size and location of the fibroids, and the woman’s age and reproductive plans. Treatment options range from medication to surgical interventions.
Medical Treatments:
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Medications
Medications are often used to control symptoms but do not shrink fibroids permanently. They may include:
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Hormonal Therapy– Birth Control Pills or IUDs: Help regulate menstrual cycles and reduce bleeding. GnRH Agonists: Medications such as leuprolide that temporarily shrink fibroids by blocking estrogen production. These are typically used short-term to prepare for surgery or to manage symptoms.
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Nonsteroidal Anti-inflammatory Drugs (NSAIDs): – NSAIDs such as ibuprofen can help alleviate pain associated with fibroids.
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Tranexamic Acid – Helps reduce heavy bleeding caused by fibroids
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Lifestyle Changes
Certain lifestyle changes may help alleviate symptoms and prevent fibroids from worsening:
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Maintain a Healthy Weight – Being overweight can increase the risk of fibroids and worsen symptoms.
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Eat a Balanced Diet – A diet rich in fruits, vegetables, and whole grains can help balance hormones and reduce fibroid growth.​
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Regular Exercise – Staying physically active can help reduce the size of fibroids and alleviate some symptoms.