Fibroids
What do Doctors call this Condition? - Uterine leiomyomas, myomas
What is this Condition?
The most common benign tumors in women, fibroids are smoothmuscle tumors that arise in the uterus. They usually occur in multiples in the uterine body, although they may appear on the cervix or on the round or broad ligament. (The term fibroids is somewhat misleading because these tumors consist of muscle cells, not fibrous tissue.)
Uterine fibroids occur in 20% to 25% of women of reproductive age and affect three times as many blacks as whites. The tumors become malignant in only 0.1 % of women.
What Causes them?
The cause of fibroids is unknown, but use of steroid hormones, including estrogen and progesterone, and several growth factors, including epidermal growth factor, have been implicated as a possible cause of fibroid growth. Fibroids typically arise after the first menstrual period and regress after menopause, suggesting that estrogen may promote fibroid growth.
What are the Symptoms?
Fibroids may be located within the uterine wall or may protrude into the endometrial cavity of the uterus. Most fibroids produce no symptoms. The most common symptom is abnormal bleeding, which typically occurs as heavy menstrual bleeding. Uterine fibroids probably do not cause pain directly unless they bulge into the peritoneal cavity and become twisted. Pelvic pressure and impingement on nearby organs are common indications for treatment. Various reproductive disorders, including infertility, recurrent spontaneous abortion, and preterm labor, have been attributed to fibroids.
How are they Diagnosed?
Clinical findings and the woman's history suggest uterine fibroids. Blood studies showing anemia from abnormal bleeding support the diagnosis. Bimanual exam may reveal an enlarged, firm, nontender. and irregularly contoured uterus. Ultrasound allows accurate assessment of the dimensions, number, and location of tumors. Other diagnostic procedures include hysterosalpingography, dilation and curettage (D&C), endometrial biopsy, and laparoscopy.
How are they Treated?
Treatment depends on the severity of symptoms, the size and location of the tumors and the woman's age, pregnancy status, desire to have children, and general health.
Treatment options include nonsurgical as well as surgical procedures. Nonsurgical methods include administration of gonadotropin-releasing hormone analogues, which profoundly depress blood estrogen levels and cause a 50% reduction in uterine volume.
Surgical options include abdominal, laparoscopic, or hysteroscopic myomectomy - for women who want to preserve their fertility - and hysterectomy, the definitive treatment for symptomatic women who have completed childbearing.