Epidemiology and management of uterine fibroids

Abstract

Uterine leiomyomas are one of the most common and yet understudied diseases in women. These tumors, commonly known as fibroids, affect women mainly during their reproductive years and are diagnosed in up to 70% of white women and more than 80% of women of African ancestry during their lifetime. This disease has a profound impact on health care delivery and costs worldwide. Though most women with fibroids are asymptomatic, approximately 30% of them will present with severe symptoms which can include abnormal uterine bleeding, anemia, pelvic pain and pressure, back pain, urinary frequency, constipation, or infertility, and will require intervention. Furthermore, fibroids have been associated with poor obstetrical outcomes. The current options for symptomatic fibroid treatment include expectant, medical, and surgical management, and interventional radiology procedures. This article reviews the recent progress and available management strategies for uterine fibroids and highlights areas where further research is needed to find new therapeutic targets and better personalize treatments.

Vitamins and Uterine Fibroids: Current Data on Pathophysiology and Possible Clinical Relevance

“…The size and location of the lesion are the main factors which particularly influence symptom severity and the necessity for suitable treatment. Other important determinants of treatment selection include the patient's age and reproductive plans, the gynecologist's skills, and the availability of appropriate medical devices [9,10]. UFs constitute the main reason for hysterectomies and hospitalization due to gynecological conditions in the United States [11].…”

The Contribution of Uterine Artery Embolization as a Safe Treatment Option for Uterine Fibroids

“…The incidence of asymptomatic but sonographically fibroids detected as remarkably high and the incidence depending on women age and race. Their prevalence is 9% in white women, three to nine times higher prevalence in African American, diagnosed in 3.3% of 25 to 32 year olds, 7.8% of the 33 to 40 year olds and increased 20-fold to 6.20 per 1000 women years by ages 45to 50 [9][10][11][12][13][14]. Familial aggregation studies confirm heritability of fibroids 2.5 times more at risk in first degree relatives, increasing to 5.7 for women with an affected first degree relative of less than 45 years old.…”

“…The fibroids occur in a phenotype in wide of genetic diseases, clinically not as single disease entity and their progression varies and based on the various types of disease in different national groups [9,10]. The incidence of asymptomatic but sonographically fibroids detected as remarkably high and the incidence depending on women age and race.…”

How noninvasive treatment of uterine fibroids affects endometrial receptivity: a prospective cohort study

“…Uterine fibroids are a clinically relevant problem due to their high incidence: about 25% of women older than 35 years have myomas and one-third of those patients have symptoms associated with fibroids [1][2]. A combination of uterine fibroids and infertility occurs in 1.2-2.4% of women, while the mechanisms of the influence of uterine fibroids on fertility today remain a subject of discussion [1][2][3][4][5][6].…”

“…In the presence of indications, myomectomy with careful layer-by-layer closure of the node bed is the first-line treatment method for patients with uterine fibroids planning a pregnancy [1,2,[8][9][10]. In this case, the risk of uterine rupture after laparoscopic myomectomy does not exceed 0.5-1% [11][12].…”