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Definition
Uterine fibroids are noncancerous tumors that develop within or attach to the wall of the uterus, a female reproductive organ.
Alternative Names
Leiomyoma; Fibromyoma; Myoma; Fibroids
Causes, incidence, and risk factors
Uterine fibroids are the most common pelvic tumor. Fibroids may be seen as many as 1 in every 5 women in their childbearing years (the time after starting menstruation for the first time and before menopause.)
Fibroids usually affect women over age 30. They are rare in women under 20 or in those who have gone through menopause. They are more common in African-Americans than Caucasians.
The cause of uterine fibroid tumors is unknown. However, fibroid growth seems to depend on 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 also 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 is more than one.
Sometimes, a fibroid hangs from a long stalk, which is attached to the outside of the uterus. This is called a pedunculated fibroid.
Symptoms
- Abdominal fullness, gas
- Bleeding between periods or very prolonged bleeding with periods
- Increase in urinary frequency
- Heavy menstrual bleeding (menorrhagia), sometimes with the passage of blood clots
- Pelvic cramping or pain with periods
- Sensation of fullness or pressure in lower abdomen
- Sudden, severe pain due to a pedunculated fibroid
Note: There are often no symptoms.
Signs and tests
A pelvic examination may reveal an irregularly shaped, lumpy, or enlarged uterus. Frequently, this diagnosis is reliable. In some cases, diagnosis of fibroids is difficult, especially in obese women. Fibroid tumors have been mistaken for ovarian tumors, inflammation of the fallopian tubes, and pregnancy.
A transvaginal ultrasound or pelvic ultrasound may be done to confirm the diagnosis of fibroids.
An endometrial biopsy (biopsy of the uterine lining) or a pelvic laparoscopy may be needed to rule out cancer.
Reviewer Info: Susan Storck, MD, FACOG, Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine; Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., 05/26/2008