Uterine fibroid

Uterine fibroids
Other names	Uterine leiomyoma, uterine myoma, myoma, fibromyoma, fibroleiomyoma
Uterine fibroids as seen during laparoscopic surgery
Specialty	Gynecology
Symptoms	Painful or heavy periods[1]
Complications	Infertility[1]
Usual onset	Middle and later reproductive years[1]
Causes	Unknown[1]
Risk factors	Family history, obesity, eating red meat[1]
Diagnostic method	Pelvic examination, medical imaging[1]
Differential diagnosis	Leiomyosarcoma, pregnancy, ovarian cyst, ovarian cancer[2]
Treatment	Medications, surgery, uterine artery embolization[1]
Medication	Ibuprofen, paracetamol (acetaminophen), iron supplements, gonadotropin releasing hormone agonist[1]
Prognosis	Improve after menopause[1]
Frequency	~50% of women by age 50[1]

Uterine fibroids, also known as uterine leiomyomas or fibroids, are benign smooth muscle tumors of the uterus, part of the female reproductive system.^[1] Some women with fibroids have no symptoms while others may have painful or heavy periods.^[1] If large enough, they may push on the bladder, causing a frequent need to urinate.^[1] They may also cause pain during penetrative sex or lower back pain.^[1][3] A woman can have one uterine fibroid or many.^[1] It is uncommon but possible that fibroids may make it difficult to become pregnant.^[1]

The exact cause of uterine fibroids is unclear.^[1] However, fibroids run in families and appear to be partly determined by hormone levels.^[1] Risk factors include obesity and eating red meat.^[1] Diagnosis can be performed by pelvic examination or medical imaging.^[1]

Treatment is typically not needed if there are no symptoms.^[1] NSAIDs, such as ibuprofen, may help with pain and bleeding while paracetamol (acetaminophen) may help with pain.^[1][4] Iron supplements may be needed in those with heavy periods.^[1] Medications of the gonadotropin-releasing hormone agonist class may decrease the size of the fibroids but are expensive and associated with side effects.^[1] If greater symptoms are present, surgery to remove the fibroid or uterus may help.^[1] Uterine artery embolization may also help.^[1] Cancerous versions of fibroids are very rare and are known as leiomyosarcomas.^[1] They do not appear to develop from benign fibroids.^[1]

About 20% to 80% of women develop fibroids by the age of 50.^[1] In 2013, it was estimated that 171 million women were affected worldwide.^[5] They are typically found during the middle and later reproductive years.^[1] After menopause, they usually decrease in size.^[1] In the United States, uterine fibroids are a common reason for surgical removal of the uterus.^[6]