Management of Uterine Fibroids: Review of Literature

Abstract

Leiomyomas or fibromyomas, commonly called uterine fibroids, are the most common tumors that originate from the smooth muscle of the uterus (myometrium). Uterine fibroids are generally classified into four main types based on their location, namely: intramural fibroids, subserosal fibroids, pedunculated fibroids and submucosal fibroids. The actual cause of leiomyomas is unknown but the hormone estrogen is found to be the possible stimulus to their proliferation which is proven by the increase in the size of these fibroids during pregnancy and high dose estrogen therapy. The most common signs and symptoms of uterine fibroids include heavy menstrual bleeding, menstrual periods lasting longer than a week, pelvic pressure or pain, frequent urination, difficulty emptying the bladder, constipation and backache or leg pain. Some of the factors that may increase the risk of women having uterine fibroids are old age, women of African- American race, obesity, family history of Leiomyomas, high blood pressure, nulliparity, vitamin D deficiency, excess eating leading to weight gain and consumption of estrogen rich foods. Routine examination, ultrasound, saline hysterosonography, lab tests, MRI, hysteroscopy and hysterosalpingography are some of the tests used to diagnose uterine fibroids. Symptomatic treatment of uterine fibroids may include medical management, surgical treatment or a combination of the two. Hence, the treatment of women with uterine fibroids must be tailored according to their symptoms, number, size and location of the fibroids, the patient’s age, need, and desire to preserve their fertility or their uterus, the availability of the treatment and the physician’s experience.