Heavy menstrual bleeding and pelvic pain are telling symptoms of uterine fibroids.
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Dr. Bennett K. Abe
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Many women live with uterine fibroids, but far fewer live with fibroid symptoms. One commonly-cited population study screened women in the United States for uterine fibroids, and found that 40% of caucasion women and 60% of African-American women had developed uterine fibroids by age 35. These numbers increased to 70% and 80% respectively by age 50. [1] This means that most women have uterine fibroids, but fortunately for most women, the majority of fibroids are not symptomatic. According to a large survey of women with uterine fibroids, around 7% of women in the United States are living with symptomatic fibroids. [2]
Fibroids can develop at various locations throughout the uterus at sizes ranging from undetectable seedlings to massive tumors that distort the shape of the uterus and obstruct nearby organ systems. Fibroids can grow within the myometrium, on the outside of the uterus, just underneath the endometrium, or on small stalks inside or outside the uterus. [3] Fibroids receive the majority of their blood supply directly from the uterine arteries and have a tendency to grow over time if left untreated. [4]
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Fibroids and Heavy Menstrual Bleeding
Fibroids Pain
Fibroid ‘Bulk’ Symptoms
Uterine Fibroid Risk Factors
These factors increase your likelihood of developing fibroids:
Older Age | women in their 40’s and 50’s are much more likely to have fibroids than younger women
Family History | fibroids may run in your family
Hormone Levels | estrogen and progesterone, hormones produced by the ovaries, are thought to contribute to fibroid growth
Obesity, High Blood Pressure, and Diabetes | these lifestyle conditions have been associated with higher fibroid risk
African American | black women are at 2 to 3 times higher risk of developing fibroids than white, hispanic, or asian women
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Under certain conditions, a fibroid progenitor cell can turn into a “preclinical” fibroid. The preclinical fibroid is an early-stage, often microscopic fibroid that does not cause any noticeable symptoms. From here, the preclinical fibroid may go on to grow in an accelerated manner and progress into clinically significant uterine fibroids. Factors that influence the progression from “preclinical” to “clinically significant” disease include environmental factors such as diet, vitamin D, sex hormones, and exposure to toxins, as well as a number of complex biological factors. [8]
In most cases uterine fibroids can be diagnosed using ultrasound, but an MRI scan may be helpful in better characterizing the fibroids and may be preferred by your interventional radiologist to rule out other conditions. [9] In addition to confirming your diagnosis, these imaging techniques will allow your Fibroid Specialist to evaluate your treatment options.
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References
[1] Day Baird, D., Dunson, D. B., Hill, M. C., Cousins, D., & Schectman, J. M. (2003). High cumulative incidence of uterine leiomyoma in black and white women: Ultrasound evidence. American Journal of Obstetrics & Gynecology, 188(1), 100–107.
[2] Zimmermann, A., Bernuit, D., Gerlinger, C., Schaefers, M., & Geppert, K. (2012). Prevalence, symptoms and management of uterine fibroids: An international internet-based survey of 21,746 women. BMC Women’s Health, 12(1), 6.
[3] Pelage, J.-P., Cazejust, J., Pluot, E., Le Dref, O., Laurent, A., Spies, J. B., … Lacombe, P. (2005). Uterine Fibroid Vascularization and Clinical Relevance to Uterine Fibroid Embolization. Radiographics, 25, S99–S117.
[4] Peddada, S. D., Laughlin, S. K., Miner, K., Guyon, J.-P., Haneke, K., Vahdat, H. L., … Baird, D. D. (2008). Growth of uterine leiomyomata among premenopausal black and white women. Proceedings of the National Academy of Sciences, 105(50), 19887–19892.
[5] Khan, A. T., Shehmar, M., Gupta, J. K., & Gupta, J. (2014). Uterine fibroids: current perspectives. International Journal of Women’s Health, 6, 95–114.
[6] Gupta, S., Jose, J., & Manyonda, I. (2008). Clinical presentation of fibroids. Best Practice and Research: Clinical Obstetrics and Gynaecology, 22(4), 615–626.
[7] Duhan, N., & Sirohiwal, D. (2010). Uterine myomas revisited. European Journal of Obstetrics Gynecology and Reproductive Biology, 152(2), 119–125.
[8] Elizabeth A Stewart (2015). Uterine Fibroids. New England Journal of Medicine. 2015;372:1646-55.
[9] Bulman, J.C., Ascher, S.M., Spies, J.B. (2012). Current Concepts in Uterine Fibroid Embolization. RadioGraphics, 32(6), 1735-1750.
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