Fibroids (or leiomyomas) are benign tumors of the myometrium (the mucous membrane of the uterine wall). Their diameter starts at 1 cm and can reach up to 15 cm, and their weight varies from a few grams to a few pounds in some extreme cases of multiple fibroids. Uterine fibroids are more common in women who are in their fertile years, while they tend to recede during menopause.
There are no specific causes for the appearance of fibroids. Some may be hormonal (estrogen levels) or hereditary, as well as some may be related to the environment. In the majority of cases, the underlying cause appears to be heredity in combination with elevated levels of estrogen in the blood.
It is not necessary for fibroids to manifest through symptoms, but the most common symptoms when they finally occur are:
- Bleeding and menstrual pain.
- Bleeding and menstrual pain in-between 2 periods.
- Weight feeling in the lower abdomen.
- Repeated constipation.
- Pain during sexual intercourse.
Fertility issues (inability to conceive, miscarriages, etc.).
For the diagnosis of fibroids, the ultrasound is used, which identifies the number of fibroids, their size and their location in the uterus. In case the patient presents multiple fibroids preoperatively, pelvic magnetic resonance imaging (MRI) is recommended for more detailed mapping.
If the fibroids are small and asymptomatic, usually no treatment is recommended, except for frequent follow-ups by the gynecologist. Otherwise, the treatment may be either conservative (mild painkillers or hormones) or surgical, depending on the severity of the condition indicated by a number of factors, such as the size or location of the fibroids.