Uterine fibroids are noncancerous uterine growths that often arise during reproductive years. Uterine fibroids, also known as leiomyomas or myomas, are not connected with an elevated risk of uterine cancer and usually never develop into a malignancy.

Fibroids differ in size from tiny seedlings invisible to the naked eye to bulky masses that may deform and expand the uterus. You might have a single fibroid or many. Multiple fibroids may cause the uterus to enlarge so much that it approaches the rib cage and adds weight in difficult situations.

 

Symptoms

Many women with fibroids exhibit no symptoms. Symptoms may be altered by the location, size, and quantity of fibroids in persons who have them.

The following are the most prevalent indications and symptoms of uterine fibroids in women who experience symptoms:

·       Menstrual periods lasting more than a week

·       Heavy menstrual bleeding

·       Backache or leg pains

·       Pelvic pressure or pain

·       Difficulty emptying the bladder

·       Frequent urination

·       Constipation

Rarely, a fibroid can cause acute pain when it outgrows its blood supply and begins to die.

 

Causes

Although doctors do not know what causes uterine fibroids, research and clinical experience point to the following factors:

·       Many fibroids have gene alterations that vary from those seen in normal uterine muscle cells.

·       Estrogen and progesterone, two hormones that drive the formation of the uterine lining in preparation for pregnancy throughout each menstrual cycle, seem to encourage the growth of fibroids.

·       Fibroids have more estrogen and progesterone receptors than uterine muscle cells in general. Because of a drop in hormone production, fibroids tend to diminish after menopause.

·       Other elements that influence growth Substances that aid in tissue maintenance, such as insulin-like growth factors, may influence fibroid development.

·       Extracellular matrix (ECM): ECM is the substance that holds cells together, similar to mortar between bricks. Fibroids have an increase in ECM, which causes them to become fibrous. ECM also stores growth factors and induces biological changes in cells.

 

Risk factors

Besides being a woman of reproductive age, there are few established risk factors for uterine fibroids. Factors that might influence fibroid growth include:

Although women of reproductive age may have fibroids, black women are more likely than other ethnic groups to have fibroids. Furthermore, black women experience fibroids at a younger age, and they are more likely to have more or bigger fibroids and more severe symptoms.

If your mother or sister had fibroids, you are more likely to acquire them as well.

Starting your period at a young age, being obese, not getting enough vitamin D, eating a diet heavy in red meat and low in green vegetables, fruit, and dairy, and consuming alcohol, particularly beer, all tend to raise your chance of developing fibroids.

 

Complications

Although uterine fibroids are normally not harmful, they may cause pain and may lead to issues such as a decline in red blood cells (anaemia), which causes exhaustion due to excessive blood loss. A transfusion is only required in rare cases owing to blood loss.

 

Prevention

Although experts continue to investigate the origins of fibroid tumours, there is no scientific data on how to avoid them. Although uterine fibroids cannot be prevented, only a tiny fraction of these tumours need therapy.

However, you may reduce your fibroid risk by adopting good lifestyle choices like keeping a healthy weight and consuming fruits and vegetables.

 

References

1)    Uterine fibroids: MedlinePlus Medical Encyclopedia (no date). Available at: https://medlineplus.gov/ency/article/000914.htm (Accessed: 01 January 2022).

2)    Parker WH: Etiology, symptomatology, and diagnosis of uterine myomas. Fertil Steril. 2007, 87 (4): 725-36. 10.1016/j.fertnstert.2007.01.093. Review

3)    Kempson RL, Hendrickson MR: Smooth muscle, endometrial stromal, and mixed Müllerian tumours of the uterus. Mod Pathol. 2000, 13 (3): 328-342. 10.1038/modpathol.3880055.

4)    Rein MS, Barbieri RL, Friedman AJ: Progesterone: a critical role in the pathogenesis of uterine myomas. Am J Obstet Gynecol. 1995, 172 (1 Pt 1): 14-18.

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