Uterine fibroids, also called leiomyomas, or myomas, are noncancerous growths made of muscle and tissue that form in or on the wall of your uterus. They typically look like rounded growths with smooth bumps and may have a thin stem attached. Fibroids can be single or multiple, and may vary in size. A fibroid can be undetectable to the human eye or even the size of a watermelon. 

Fibroids affect an estimated 20% to 50% of women of reproductive age, and up to 77% of women will have fibroids at some point during their childbearing years. Because only around one-third of these fibroids are large enough to be identified during a physical exam, they frequently go undiagnosed. 

There are different types of uterine fibroids depending on where they’re located and how they attach. 

It is very unlikely that fibroids develop into a cancer. In fact it is the most common noncancerous tumor in women and people assigned female at birth. Fibroids rarely appear before menarche and regress after menopause. They are mostly common in those between the ages of 30 and 50 years old, and are unlikely in those who have not had their first period or have entered menopause.  

While many women have uterine fibroids, some may never know as there may be no symptoms, especially if the fibroids are small. As such, fibroids may be discovered incidentally during a pelvic exam or ultrasound. If there are symptoms, the most common symptoms include:

• Heavy menstrual bleeding or periods that last more than a week 
• Bleeding between your periods
• A feeling of fullness in your lower belly (abdomen)/bloating
• Increased abdominal distention (enlargement).
• Pain during sex
• Low back pain, leg pain, pelvic pain, period pain 
• Bowel symptoms, such as constipation or excessive straining with bowel movements, bladder symptoms, such as frequent urination or difficulty emptying the bladder

Fibroids are diagnosed during a gynecological examination, pelvic ultrasound or during surgery for other conditions. They do not require treatment unless there are troublesome symptoms or complications.

The cause of uterine fibroids is unknown. However, the hormones oestrogen and progesterone have been linked to the growth of fibroids, as they usually develop during reproductive years, are higher during pregnancy and shrink during menopause. 

Risk factors may include: Family history of fibroids, early onset of menstruation or late age for menopause, diet rich in red meat , and high blood pressure While fibroids usually don't interfere with getting pregnant, in rare cases, uterine fibroids can cause complications,  such as abnormal attachment of the placenta, fetal growth restriction, increased risk of miscarriage, preterm labor,    increased likelihood of delivery by cesarean section and postpartum hemorrhage.

Consult a fertility specialist if you have fibroids and are having trouble getting pregnant. They will develop a treatment plan that will increase your chances of conceiving . If you need surgery to treat fibroids before starting fertility treatment, a myomectomy is probably your best option.

When should you see a doctor

• When you have pelvic pain that doesn't go away
• Heavy prolonged or painful periods
• Spotting or bleeding between periods
• Difficulty emptying your bladder
• Low haemoglobin count ( anaemia )  

Treatment

Treatment for fibroids typically depends on your symptoms and the fibroid’s position, size, number and location. Treatment options include, medication, surgery, removal of the womb if you have no plans for pregnancy, iron supplements, birth control, high-intensity focused ultrasound waves to destroy the fibroid, and uterine artery embolisation, which shrinks the fibroid by blocking its blood supply.

Although preventing uterine fibroids may not be possible, by making healthy lifestyle choices, such as maintaining a healthy weight and eating fruits and vegetables, regular pelvic exams, monitoring small fibroids, you may be able to decrease your fibroid risk.

References

Medicines, J. H. (n.d.). Fibroids. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/uterine-fibroids

Zimmermann, A., Bernuit, D., Gerlinger, C., Schaefers, M., & Geppert, K. (2012 2012). Prevalence, Symptoms and Management of Uterine Fibroids. BMC Womens Health. Medscape Family Medicine. Retrieved from https://www.medscape.com/viewarticle/763627_2