MiyomUterine fibroids are benign tumors that originate from the muscle tissue of the uterus. They typically are 1-15cm in diameter. Fibroids are the most common tumors of female genital organs. They are present in 1/3 of all women over 35 years of age. In many women, there are multiple (more than one) fibroids, sometimes innumerable. Estrogen, the female hormon, generally causes fibroids to grow in size. For this reason, fibroids are expected to grow in the reproductive age and during pregnancy, but may become smaller after menapause unless supplemental hormon pills are taken. Fibroids are classified into 3 groups according to their location:

Submucosal Fibroids

They grow towards the inner surface (endometrium) of the uterus. They are the least common type of fibroids but generally cause disturbing symptoms. The most common symptom in submucosal fibroids is increased bleeding during mensturation and anemia.

Subserosal Fibroids

They grow towards the outer surface of the uterus. Typically, they do not cause bleeding problems. Instead, they may squeeze the surrounding organs and cause abdominal pain, bloating, urinary frequency and constipation.

Intramural Fibroids

They are the most common type of fibroids and located within the muscular layer of the uterus. Since they are close to both inner and outer surfaces of the uterus, they may cause the symptoms of both submucosal and subserosal fibroids when they reach a certain size.

What are the symptoms of fibroids?

Most fibroids do not cause any complaints and these patients may not be aware that they have fibroids. In about 10-20% of fibroid cases however, there may be disturbing symptoms. The most common symptom in fibroids is prolonged or increased bleeding, which may be intense and contain clots. Chronic overbleeding frequently results in anemia. Other common symtoms of fibroids include:

  • Abdominal pain and bloating
  • Backpain, legpain
  • Pain during sexual intercourse
  • Urinary frequency or urgency (compression of the urine bladder by fibroids)
  • Constipation (compression of the bowel by fibroids)

How are they diagnosed?

Most fibroids are noticed by coincidence during routine pelvic ultrasound examinations performed by gynecologists or radiologists. Ultrasound however, frequently underestimates the number of fibroids and may not show some other coexisting pathologies. Magnetic resonance imaging (MRI) is currently the gold standart technique in diagnosing uterine fibroids. It may show other fibroids that are not seen with ultrasound and also demonstrate whether the fibroids are alive or dead. For this reason, it is very important that all fibroid patients be examined with MRI and the decision on the most suitable treatment option should always be made based on the MRI findings.

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