Women's Health

Uterine fibroids

Benign uterine smooth-muscle tumours that may be asymptomatic or cause heavy menstrual bleeding, pain, pressure symptoms and fertility problems; management depends on symptoms, fibroid anatomy and reproductive wishes.

Definition

Uterine fibroids, or leiomyomas, are benign smooth-muscle tumours arising in or around the uterus. They may be asymptomatic or cause heavy menstrual bleeding, pain, pressure symptoms and difficulty conceiving.

First principles

Anatomical location predicts the symptom pattern

Submucosal fibroids project into or distort the endometrial cavity and are particularly associated with heavy menstrual bleeding and reproductive problems. Intramural fibroids lie within the myometrium and can contribute to bleeding or bulk symptoms. Subserosal fibroids project outward and more often cause pressure or mass-effect symptoms. These relationships are useful clinical patterns, not absolute rules.

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