Women's HealthPending review

Uterine fibroids

Benign smooth-muscle tumours of the myometrium grow under the drive of oestrogen and progesterone, which is why they enlarge through the reproductive years and regress after the menopause, distorting the uterus and disrupting normal menstrual haemostasis as they grow.

First principles

Fibroids are oestrogen- and progesterone-dependent tumours

Each fibroid arises from a single myometrial smooth muscle cell that has undergone a monoclonal proliferation, and its growth is sustained by circulating oestrogen and progesterone acting on receptors within the tumour. This single fact explains their entire natural history: they emerge and enlarge during the reproductive years when sex hormone levels are high, often grow further during pregnancy, and characteristically shrink once oestrogen falls after the menopause.

You’ve reached the end of the preview

The rest of the extended textbook — mechanism, differentials, complications and prognosis — is part of full access. Sign in to see your options.

Educational content pending clinical review. Not medical advice.