What are Uterine Fibroids?

Uterine fibroids are benign (noncancerous) smooth muscle tumors in the uterus that affects about 20% of women of reproductive age. Also called leiomyomas or myomas, they are not associated with an elevated risk of uterine cancer, and the chances of most fibroids developing into cancer are negligible.

Fibroids are:

  • common type of tumor of the reproductive tract.
  • often discovered during routine pelvic exams.
  • have little to no symptoms in many cases. Symptoms include heavy and prolonged periods, pelvic pain, and bleeding between periods.
  • treatable with several different treatment procedures.

Types of Uterine Fibroids

There are three main types of fibroids:

  1. Subserosal: These fibroids occur on the exterior wall of the uterus and account for 55% of cases.
  2. Intramural: These fibroids are found within the muscle layers of the uterine wall and account for about 40% of cases.
  3. Submucosal: These are rare types of fibroids that grow and protrude into the uterus. They constitute only 5% of cases.

What are the causes of Uterine Fibroids?

While the exact reason for what causes fibroids is unknown, there are several different factors:

  1. Family history: Uterine fibroids are known to have genetic components. If the mother has fibroids, the daughter has three times higher than average chance of getting it.
  2. Race: Black women are more prone to have uterine fibroids than women from other races. They also have fibroids at a younger age and tend to have more severe symptoms.
  3. Age: Getting older increases the chances of developing fibroids. Women in their 30s and 40s are more likely to have fibroids until menopause. Fibroids are less likely to form after menopause and tend to shrink if they were present earlier.
  4. Obesity :Overweight women have a three times higher risk of having fibroids than the average.
  5. Hormones: Estrogen and progesterone are known to stimulate the growth of fibroids. Insulin-like growth factors have also been found to influence fibroid growth.

Symptoms of Uterine Fibroids

Many women who have fibroids don’t experience any symptoms. Nevertheless, some common symptoms of uterine fibroids like:

  • Heavy menstrual bleeding
  • Menstrual bleeding that lasts for a week or more
  • Frequent urination
  • Pressure or pain in the pelvic region
  • Difficulty emptying the bladder.
  • Back or leg pain
  • Constipation

Diagnosis of Uterine Fibroids

Uterine fibroids are discovered during a routine pelvic exam. The doctor might feel irregularities in the shape of the uterus. Fibroids can then be confirmed using tests such as:

  • Ultrasound scans: The procedure uses an ultrasound transducer placed on the abdomen or inside the vagina to get a real-time picture. The device generates an image of the focus area using sound waves, allowing for the visualization of fibroids.
  • Lab tests: are performed to rule out the possibility of other conditions like bleeding disorders or thyroid problems.
  • Imaging tests: Doctors might perform imaging tests such as magnetic resonance imaging (MRI), Hysterosonography, Hysterosalpingography, or Hysteroscopy. Medical professionals generally perform these tests if ultrasound scans do not yield conclusive results.

How are Uterine Fibroids treated?

The best approach for uterine fibroids treatment can vary from case to case. A wide range of treatment options are available such as:

  • Watchful waiting – is the approach taken when fibroids cause no significant symptoms. Fibroids don’t always interfere with pregnancy and tend to grow slowly.
  • Medications– medical professionals offer medications for uterine fibroids to regulate the menstrual cycle and relieve symptoms such as heavy bleeding and pelvic pressure. While these medications do not eliminate the fibroids, they can shrink them. Here are some frequently prescribed medicines:
  • Gonadotropin-releasing hormone (GnRH) agonists: these medications block the production of estrogen and progesterone inducing a temporary menopause-like state which can shrink the fibroid.
  • Progestin-releasing intrauterine device (IUD): these devices that are placed inside the uterus can give symptomatic relief by relieving heavy bleeding.
  • Other medications: contraceptives and nonsteroidal anti-inflammatory drugs (NSAIDs) are also given to reduce heavy menstrual bleeding and symptomatic relief.
  • Surgery– is pursued if the size of the mass is large enough to cause health complications, infertility, or complications during pregnancy. Here are commonly performed surgical procedures:
    1. Hysterectomy– is the procedure to remove the uterus completely in women who have no desire to conceive.
    2. Myomectomy– In this procedure, the fibroid is surgically removed leaving the uterus in place. Myomectomy is the go-to option for women who are planning to conceive. However, the procedure carries the risk of scarring and decreased fertility. Myomectomy is performed in three ways:
  • Abdominal Myomectomy: The uterus is accessed through an incision in the abdomen to remove fibroids present on the organ.
  • Laparoscopic Myomectomy: In this minimally invasive procedure. Tiny incisions (5-10mm) are made through the navel to access the fibroids.
  • Hysteroscopic Myomectomy: This procedure removes submucosal fibroids. It is performed using a telescope-like instrument placed into the uterus through the cervix.

Uterine fibroids and infertility

Fibroids can cause a drop in fertility by:

  • Changing the shape of the cervix and hindering the entry of sperm into the uterus.
  • Changing the shape of the uterus interferes with the movement of the sperm.
  • Blocking the fallopian tubes
  • Affecting the size of the inner lining of the uterine cavity
  • Decreasing blood flow to the uterine cavity and interfering with embryo implantation


Uterine fibroid is a benign tumor that affects women of reproductive age. It exhibits no symptoms in most women and often goes undetected for long periods. In some cases, fibroids can interfere with the fertility of women preventing pregnancies.