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Leiomyomas Signs and Symptoms
Introduction
- Also called fibroids, these are benign tumors of the uterus that consist of smooth muscle and extracellular matrix collagen and elastin
- Though pathogenesis is not yet well defined, fibroids are thought to develop from the myometrium after a smooth muscle cell’s neoplastic transformation followed by the formation of a connective tissue component and a pseudocapsule
- Malignant transformation is extremely rare
- Most common solid pelvic tumors and one of the most frequent clinical conditions encountered in gynecologic practice
- Tend to grow during reproductive years and usually regress during menopause
- Development is stimulated by estrogen and progesterone
- Fibroids occur more often in women of African descent than in Caucasian or Asian women
Signs and Symptoms
- About 50% of fibroids are asymptomatic
- Symptoms vary depending on size, number, and location of the fibroids
- Abnormal uterine bleeding clinically manifests as menorrhagia leading to iron-deficiency anemia
- Pelvic mass and pelvic pressure symptoms: Increased abdominal girth, urinary frequency and urgency, urinary incontinence or retention, dysuria, hydronephrosis, constipation, tenesmus, rectal pressure, low back pain
- Infertility, non-cyclic pelvic pain, dyspareunia and dysmenorrhea
- Obstetric complications: Rapid growth of the fibroid, red degeneration and pain, spontaneous miscarriage, breech presentation, preterm delivery, primary cesarean section, low birthweight infants
Risk Factors
- Factors that increase the risk of uterine fibroids include:
- Age >40 years old
- Early menarche <10 years old
- Family history of uterine fibroids
- Obesity
- Nulliparity
- Race (African descent)
- Genetic factors
- Alcohol and caffeine intake
