Learn About Uterine Fibroids

What is the definition of Uterine Fibroids?

Uterine fibroids are tumors that grow in a woman's womb (uterus). These growths are typically not cancerous (benign).

Fibroid tumors
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What are the alternative names for Uterine Fibroids?

Leiomyoma; Fibromyoma; Myoma; Fibroids; Uterine bleeding - fibroids; Vaginal bleeding - fibroids

What are the causes of Uterine Fibroids?

Uterine fibroids are common. As many as one in five women may have fibroids during their childbearing years. 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 White, Hispanic, or Asian women.

No one knows exactly what causes fibroids. They are thought to be caused by:

  • Hormones in the body
  • Genes (may run in families)

Fibroids can be so tiny that you need a microscope to see them. They can also grow very large. They may fill the entire uterus and may weigh several pounds or kilograms. Although it is possible for just one fibroid to develop, most often there is more than one.

Fibroids can grow:

  • In the muscle wall of the uterus (myometrial)
  • Just under the surface of the uterine lining (submucosal)
  • Just under the outside lining of the uterus (subserosal)
  • On a long stalk on the outside the uterus or inside the uterus (pedunculated)
What are the symptoms of Uterine Fibroids?

Common symptoms of uterine fibroids are:

  • Bleeding between periods
  • Heavy bleeding during your period, sometimes with blood clots
  • Periods that may last longer than normal
  • Needing to urinate more often
  • Pelvic cramping or pain with periods
  • Feeling fullness or pressure in your lower belly
  • Pain during intercourse

Often, you can have fibroids and not have any 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. A recent study also showed that some small fibroids shrink in premenopausal women.

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What are the current treatments for Uterine Fibroids?

What type of treatment you have depends on:

  • Your age
  • Your general health
  • Your symptoms
  • Type of fibroids
  • If you are pregnant
  • If you want children in the future

Treatment for the symptoms of fibroids may include:

  • Intrauterine devices (IUDs) that release hormones to help reduce heavy bleeding and pain.
  • Tranexamic acid to reduce the amount of blood flow.
  • Iron supplements to prevent or treat anemia due to heavy periods.
  • Pain relievers, such as ibuprofen or naproxen, for cramps or pain.
  • Watchful waiting -- You may have follow-up pelvic exams or ultrasounds to check the fibroid's growth.

Medical or hormonal therapies that may help shrink fibroids include:

  • Birth control pills to help control heavy periods.
  • A type of IUD that releases a low dose of the hormone progestin into the uterus each day.
  • Hormone shots to help shrink fibroids by stopping ovulation. Most often, this therapy is used only for a short time to shrink fibroids before surgery. They can also be used longer when small amounts of estrogen hormone are added back to reduce side effects.

Surgery and procedures used to treat fibroids include:

  • Hysteroscopy -- This procedure can remove fibroids growing inside the uterus.
  • Endometrial ablation -- This procedure is sometimes used to treat heavy bleeding associated with fibroids. It works best when the fibroids are small in size. It often stops menstruation completely.
  • Uterine artery embolization -- This procedure stops the blood supply to the fibroid, causing it to shrink and die. This may be a good option if you wish to avoid surgery and are not planning to become pregnant.
  • Myomectomy -- This surgery removes the fibroids from the uterus. This also may be a good choice if you want to have children. It will not prevent new fibroids from growing.
  • Hysterectomy -- This surgery removes the uterus completely. It may be an option if you do not want children, medicines do not work, and you cannot have any other procedures.

Newer treatments, such as the use of focused ultrasound, are being evaluated in clinical studies.

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What is the outlook (prognosis) for Uterine Fibroids?

If you have fibroids without symptoms, you may not need treatment.

If you have fibroids, they may grow if you become pregnant. This is due to the increased blood flow and higher estrogen levels. The fibroids usually return to their original size after your baby is born.

What are the possible complications of Uterine Fibroids?

Complications of fibroids include:

  • Severe pain or very heavy bleeding that needs emergency surgery.
  • Twisting of the fibroid -- This can cause blocked blood vessels that feed the tumor. You may need surgery if this happens.
  • Anemia (not having enough red blood cells) from heavy bleeding.
  • Urinary tract infections -- If the fibroid presses on the bladder, it can be hard to empty your bladder completely.
  • Infertility, in rare cases.

If you are pregnant, there's a small risk that fibroids may cause complications:

  • You may deliver your baby early because there is not enough room in your womb.
  • If the fibroid blocks the birth canal or puts the baby in a dangerous position, you may need to have a cesarean section (C-section).
  • You may have heavy bleeding right after giving birth.
When should I contact a medical professional for Uterine Fibroids?

Contact your provider if you have:

  • Heavy bleeding, increased cramping, or bleeding between periods
  • Fullness or heaviness in your lower belly area
Female reproductive anatomy
Uterus
What are the latest Uterine Fibroids Clinical Trials?
A Phase 3, Single-Arm, Open-Label Study to Evaluate the Safety and Contraceptive Efficacy of Relugolix Combination Therapy in Women With Uterine Fibroids or Endometriosis Who Are 18 to 50 Years of Age and at Risk for Pregnancy

Summary: The purpose of this study is to assess the contraceptive efficacy of relugolix combination therapy.

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Hereditary Leiomyomatosis Renal Cell Cancer (HLRCC): Identification of the Disease Gene, and Characterization of the Predisposition to Renal Cancer

Summary: This study will investigate what causes hereditary leiomyomatosis renal (kidney) cell cancer, or HLRCC, and how the disease is related to the development of kidney tumors. Leiomyomas are benign (non-cancerous) tumors arising from smooth muscle. HLRCC can cause various health problems. Some people develop red bumps on their skin that can be painful at times. Some women with HLRCC can develop leiomy...

What are the Latest Advances for Uterine Fibroids?
The pathogenic role of uterine erythropoietin in a case of myomatous erythrocytosis syndrome.
Advanced primary vaginal squamous cell carcinoma: A case report and literature review.
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Safety analysis of cesarean myomectomy in twin pregnancies with intramural myomas.
Who are the sources who wrote this article ?

Published Date: January 10, 2022
Published By: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Bulun SE. Physiology and pathology of the female reproductive axis. In: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 17.

Dolan MS, Hill CC, Valea FA. Benign gynecologic lesions: vulva, vagina, cervix, uterus, oviduct, ovary, ultrasound imaging of pelvic structures. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 18.

Manyonda I, Belli AM, Lumsden MA, et al. Uterine-artery embolization or myomectomy for uterine fibroids. N Engl J Med. 2020 ;383(5):440-451. PMID: 32726530. pubmed.ncbi.nlm.nih.gov/32726530/.

Moravek MB, Bulun SE. Uterine fibroids. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 131.

Stewart EA. Clinical practice. Uterine fibroids. N Engl J Med. 2015;372(17):1646-1655. PMID: 25901428 pubmed.ncbi.nlm.nih.gov/25901428/.

Verpalen IM, Anneveldt KJ, Nijholt IM, et al. Magnetic resonance-high intensity focused ultrasound (MR-HIFU) therapy of symptomatic uterine fibroids with unrestrictive treatment protocols: a systematic review and meta-analysis. Eur J Radiol. 2019;120:108700. doi: 10.1016/j.ejrad.2019.108700. PMID: 31634683. pubmed.ncbi.nlm.nih.gov/31634683/.