Uterine Fibroids are nodules of smooth muscle cells and fibrous connective tissue that are given different names depending upon where they lie in the uterus. They increase overall blood flow to the uterus and if large can distort and expand the internal cavity. They can grow as a single nodule or in clusters and sizes vary greatly from 1mm to more than 10cm in diameter.
The most common fibroid symptoms result from increased pressure. An enlarged womb will place pressure on the bladder leading to increased urinary frequency and can also cause back ache, lower abdominal discomfort and pain on intercourse. Fibroids can typically result in very heavy periods leading to iron-deficiency anaemia.
Periods may be more painful than usual (secondary dysmenorrhoea) and fertility problems are present in about 25% of women with fibroids. Fibroids are often discovered on pelvic examination when the uterus feels larger than expected with hard round lumps around the surface. An ultrasound scan will reveal where the fibroids are located and give an idea of their size. Sometimes they are detected on laparoscopy (viewing the abdomen with a small telescope) or hysteroscopy (looking into the uterus with a fine telescope). Hysteroscopy is particularly able to find submucosal fibroids and assess how much of the uterine cavity is involved.
CausesOestrogen often affects the growth of fibroids. Many fibroids are discovered during pregnancy because they tend to become larger as pregnancy causes an increase in oestrogen. Conversely, as oestrogen levels decrease during menopause fibroids may shrink or even disappear. Fibroids are rare for young women who have not begun menstruation.
There is a suggestion that emotional issues can sometimes contribute to hormonal changes that trigger the development of this condition.