Curriculum · Gynecology / Women's Health / Infertility / Perinatal Care / Birth Spacing
Uterine fibroids
What it is
Uterine fibroid tumors, the leiomyomas, are the most common tumors of the female reproductive tract, and the cumulative incidence in women age 25-45 years is put at approximately 30%. They are the L of PALM-COEIN, the list of causes of menorrhagia, and are named there among the most common causes with adenomyosis, cesarean scar defect and bleeding disorder. By site they run intracavitary, submucosal, intramural, which is the most common, subserous and pedunculated subserous. They are the most common neoplasm of the uterus, found in 25% of women over 35 years; another source puts them at around 20% of white and around 50% of black women in the later reproductive years. They are benign smooth muscle tumours arising from the myometrium, almost never develop into cancer, are rare before puberty, develop in response to oestrogen and do not tend to progress following menopause. On a cut section they are spherical, well-circumscribed, white and firm with a whorled appearance.
Causes and risk
The risk factors are African-American origin, family hx, rising age, early menarche, obesity, alcohol and Vit. D deficiency. A diet higher in red meat and lower in green vegetables, fruit and dairy is named as well, and nulliparity in one source. Fibroids contain more estrogen and progesterone receptors than normal uterine muscle cells do, and they tend to shrink after menopause due to a decrease in hormone production.