Uterine fibroids, also known as leiomyomas or myomas, are benign smooth muscle tumors that develop within the wall of the uterus. They are the most common pelvic tumors in women, affecting up to 70-80% of women by age 50, though many are asymptomatic and go undiagnosed. Fibroids can vary greatly in size, from microscopic to large masses that can significantly enlarge the uterus. They are classified by their location: subserosal (on the outer surface), intramural (within the muscle wall), submucosal (just under the endometrium), and pedunculated (attached by a stalk).

The exact cause of fibroid development is not fully understood, but they are hormone-dependent tumors that grow in response to estrogen and progesterone. Risk factors include African American ethnicity, family history, early menarche, nulliparity, obesity, and diet high in red meat and low in fruits and vegetables. Protective factors include pregnancy, breastfeeding, and use of hormonal contraceptives. Fibroids typically grow during reproductive years and may shrink after menopause when hormone levels decline.

Symptoms of uterine fibroids vary depending on their size, number, and location. Many women with small fibroids experience no symptoms, while others may have heavy menstrual bleeding, prolonged periods, pelvic pain or pressure, frequent urination, difficulty emptying the bladder, constipation, backache, or leg pains. Large fibroids can cause visible abdominal enlargement. Submucosal fibroids are most likely to cause heavy bleeding and fertility problems, while subserosal fibroids typically cause pressure symptoms.

Treatment options for uterine fibroids depend on symptom severity, fibroid characteristics, patient age, and desire for future fertility. Asymptomatic fibroids often require only observation with periodic monitoring. Medical treatments include hormonal therapies to control bleeding and reduce fibroid size, such as GnRH agonists, selective progesterone receptor modulators, and tranexamic acid for heavy bleeding. Surgical options range from minimally invasive procedures such as uterine artery embolization and focused ultrasound ablation to myomectomy (fibroid removal) or hysterectomy. Our team works with each patient to develop a personalized treatment plan that addresses their specific symptoms and reproductive goals.