Fibroids are one of the most common reasons women seek care from a gynecologist and account for 70-80% of all benign tumors of the female genital tract. But what are they? Fibroids are tumors made of smooth muscle. The other term used to describe this tumor is leiomyoma. They can occur anywhere in the body; however the uterus is the most common site. The can develop unnoticed or cause life-threatening problems however; the tumors are typically not cancerous.
The uterus is the organ that supports the growth of the fetus. It is a pear-shaped structure located within the pelvis. The upper portion has two branching areas that are the fallopian tubes, which terminate at the ovaries. The distal portion of the uterus terminates into the cervix, which is the door to the uterine cavity and the structure that must dilate during birth. The surface of the uterus, called the serosa is lined with peritoneal tissue. The major portion of the uterus is the smooth muscle layer, which contracts to expel menstrual tissue or the fetus. The endometrium is the lining of the uterus, which is a vascular rich area that supports the developing fetus.
Fibroids are found in various sites of the uterus. Fibroids growing in the lining of the uterus are described as submucosal because they are beneath the mucosal layer (the endometrium). If they are located within the muscle of the uterus the term intramural is used. Subserosal fibroids are located on the surface of the uterus. Subserosal fibroids can sometimes grow like a flower on a stalk in which case it is described as being pedunculated. Sometimes these pedunculated fibroids can become parasitic, attaching to the intestine and developing a blood supply from this source. In unusual cases the fibroids can grow in the broad ligament, which are the supportive and connecting structures that attach the reproductive organ to the sidewalls and through which the vasculature travels.
Fibroids can range in size from 1 cm up to 15 centimeters or more. A womanís uterus can contain 1 or multiple tumors. These fibroids can be in a variety of locations creating serious problems for the woman. It isnít unusual for fibroids to increase the size of the uterus to that of a term pregnancy or even larger.
The chance of a woman having fibroids increases with age. The reported prevalence is approximately 13% in women but up to 35% in women over the age of 35 and 60% of women by the age of 45. There appears to be some genetic connection in that the problem is more prevalent in family members of women with fibroids. The condition is even more prevalent in certain ethnic groups and is the highest in those of African origin Black women are 3 times more likely to have uterine fibroids compared to white women. Women who have never had children are also at greater risk of developing fibroids.
This prevalent benign tumor can cause significant problems for reproductive age women. If left un-treated they can cause life-threatening problems or decrease fertility. Many treatment options are available for managing these tumors.
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