Uterine Fibroids: Symptoms, Diagnosis, and Treatment Options

Posted on Dec 31, 2025 in Social Anthropology

Uterine Fibroids: Definition, Symptoms, and Management

This document addresses the definition of uterine fibroids and describes their comprehensive management protocols.

What Are Uterine Fibroids (Leiomyomas)?

Uterine fibroids, also known as leiomyomas or myomas, are non-cancerous (benign) tumors that develop in or on the uterus. They arise from the smooth muscle tissue of the uterus and are very common, especially in women of reproductive age.

Key Characteristics of Uterine Fibroids

• Size: Fibroids can range from very small (like a pea) to large masses that significantly distort the uterus.

• Number: A woman may have a single fibroid or multiple fibroids.

• Location:

  • Intramural: Located within the muscular wall of the uterus (most common).

  • Subserosal: Found on the outer surface of the uterus.

  • Submucosal: Situated just under the lining of the uterus; these may protrude into the uterine cavity.

  • Pedunculated: Attached by a stalk to the uterus (either inside or outside).

Common Symptoms of Uterine Fibroids

Many women are asymptomatic, but symptoms (if present) may include:

• Heavy or prolonged menstrual bleeding

• Pelvic pain or pressure

• Frequent urination

• Difficulty emptying the bladder

• Pain during intercourse (dyspareunia)

• Backache or leg pains

• Reproductive issues (e.g., infertility, miscarriage, preterm labor)

Diagnosing Uterine Fibroids

• Pelvic Examination

• Ultrasound (Transabdominal or Transvaginal)

• MRI (Magnetic Resonance Imaging, used for detailed imaging)

• Hysteroscopy (especially for submucosal fibroids)

• Sonohysterography (ultrasound with saline infusion)

Management of Uterine Fibroids

Management depends on several factors:

• Severity of symptoms

• Size and location of fibroids

• Age of the patient

• Desire for fertility

• Rate of fibroid growth

1. Watchful Waiting

• If fibroids are small and asymptomatic, no immediate treatment may be necessary.

• Regular monitoring with ultrasound is typically performed.

2. Medical Management

Hormonal Medications

• GnRH Agonists (e.g., leuprolide): Used to temporarily shrink fibroids, often administered pre-surgery.

• Oral Contraceptives or Progestins: Primarily used to control bleeding, but they generally do not shrink fibroids.

• Selective Progesterone Receptor Modulators (e.g., ulipristal acetate): Can shrink fibroids and reduce bleeding (availability varies).

• Tranexamic Acid: A non-hormonal option used specifically for heavy menstrual bleeding.

• NSAIDs (Nonsteroidal Anti-inflammatory Drugs): Help manage pain, but do not affect fibroid size or bleeding volume.

3. Surgical Management

Myomectomy

• Removal of fibroids while preserving the uterus.

• Indicated for women who wish to retain fertility.

• Routes include abdominal, laparoscopic, or hysteroscopic (depending on fibroid location).

Hysterectomy

• Removal of the uterus.

• Considered the definitive treatment for fibroids.

• Suitable for women who have completed childbearing.

Endometrial Ablation

• Destroys the uterine lining.

• Used primarily for submucosal fibroids causing heavy bleeding (not effective for large fibroids).

4. Minimally Invasive Procedures

Uterine Artery Embolization (UAE)

• Cuts off the blood supply to the fibroids, causing them to shrink.

• Effective for women who wish to avoid major surgery, but generally not ideal for those actively trying to conceive.

MRI-guided Focused Ultrasound (MRgFUS)

• A non-invasive thermal ablation technique for fibroids.

• Uses focused ultrasound waves guided by MRI technology.

Treatment Options Summary

This comprehensive information details the definition and management strategies for uterine fibroids. Further resources are often available in formats such as detailed reports or clinical notes.