Uterine Fibroids (Myomas)
Uterine fibroids — also known as myomas or leiomyomas — are benign (non-cancerous) tumours arising from the smooth muscle of the uterine wall. They are the most common pelvic tumour in women, estimated to affect up to 70% of women by the age of 50, though many remain small and cause no symptoms. They vary enormously in number, size, and location within or around the uterus, and this largely determines their clinical significance.
Causes and risk factors
The exact cause of fibroids is not fully understood. Oestrogen and progesterone appear to promote their growth — they rarely develop before puberty, tend to grow during pregnancy, and typically shrink after the menopause. Risk factors include being of Black African or Caribbean descent (where fibroids are more common and often more severe), a family history of fibroids, early onset of menstruation, obesity, and vitamin D deficiency. Fibroids do not become cancerous.
Symptoms
Many women with fibroids have no symptoms at all and are unaware of their presence until found incidentally on an ultrasound scan. When symptoms do occur, they most commonly include heavy menstrual bleeding — which can be severe enough to cause iron deficiency anaemia — prolonged or painful periods, pelvic pressure or bloating, a sensation of fullness or heaviness in the lower abdomen, urinary frequency (if the fibroid presses on the bladder), and constipation or backache (if it presses on the bowel or spine). Fibroids can also affect fertility and pregnancy outcomes in some cases.
Choosing where to be treated
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