Uterine fibroids are non-cancerous tumors of the uterus. Uterine fibroids are also known as leiomyomata, myomas or uterine polyps. Uterine fibroids grow within the muscles of the uterus, on the outside of the uterus, hang in the uterine cavity or very rarely form within the cervix. They can range in size from microscopic to several inches in diameter. Uterine fibroids form in the childbearing years of a woman’s life. There may be just one fibroid or many, with differing locations. Uterine fibroids are rarely a cause for concern, but when they become too large, or there are many present, they may become a problem.

TYPES OF UTERINE FIBROIDS

SUBMUCOSAL: grow in the innermost layer of the uterus
INTRAMURAL: grow in the middle layer of the uterus
SUBSEROSAL: grow in the outer wall of the uterus
PEDUNCULATED: attached to a stalk either outside of the uterus or within the uterine cavity
CERVICAL: in the cervical tissue
INTERLIGAMENTOUS: between the uterine broad ligaments

CAUSES OF UTERINE FIBROIDS

Though a large percentage of women suffer from uterine fibroids, doctors are actually unsure of what causes them to occur. What they do know however, is that estrogen and progesterone contribute to the growth of the fibroids.

Estrogen and progesterone are at their highest levels during a woman’s childbearing years, this is why uterine fibroids are thought to develop during this time. Normally, after a woman goes through menopause her body produces lower levels of estrogen and progesterone causing the fibroids to begin to shrink and any associated symptoms, such as pain and pressure to subside.

Uterine fibroids are hormone dependent. They develop during the hormonally active years and decline in menopause. Fibroid tissue has a higher amount of estrogen and progesterone receptors. Fibroid tissue is hypersensitive to estrogen, but does not have the capacity to regulate estrogen response, this is why they can grow to become quite large. Other hormones play a role in the growth of uterine fibroids as well, including prolactin, parathyroid hormone, insulin growth factor, and pituitary growth hormone.

FACTORS THAT MAY INCREASE FIBROID DEVELOPMENT

An increase in lifetime exposure to estrogen.
There are many factors that increase a woman’s lifetime exposure to estrogen. More than at any other time in history, women are exposed to more estrogen. This increased exposure can contribute to a wide variety of reproductive health problems including the development of uterine fibroids. The following factors increase a woman’s lifetime exposure to estrogen:

• Early menarche – the longer a woman has her menstrual cycle, the longer estrogen levels are elevated
• Fewer pregnancies – many women today are restricting how many children they are having or are not having children at all, which increases their total exposure to estrogen
• High body fat content – body fat produces and stores estrogen; the more body fat a woman has the more estrogen
• Exposure to xenoestrogens – plastics, pesticides, herbicides, synthetic hormones in both meat and dairy products, and hormone replacement therapy (HRT) including oral contraceptives (birth control) containing synthetic estrogen
• Poor estrogen metabolism – some women’s bodies have a harder time removing and metabolizing excess estrogen

In addition to exposure to estrogen the following factors may also play a role in the development of uterine fibroids:

• Hypertension
• Infection complications from IUD use
• Perineal talc use
• Anovulatory cycles
• Endometrial hyperplasia (common in women with PCOS)

SYMPTOMS OF UTERINE FIBROIDS

While many women will never even know that they have uterine fibroids, because the condition often exhibits no symptoms, there are some women that will experience certain effects from the fibroid’s presence. Symptoms of uterine fibroids include:

A sensation of fullness or pressure in the abdominal area

Excessive bleeding during menstruation

Excessive length of menstruation

Extreme cramping during menstruation

Lower back pain

Painful intercourse

A frequent urge to urinate

UTERINE FIBROIDS MAY NEGATIVELY IMPACT CONCEPTION AND PREGNANCY

Fibroids are thought to be the cause of infertility in 2%-10% of infertility cases. Reports have shown uterine fibroids may be responsible for the following fertility, conception and pregnancy problems:

• Interference with implantation of the ovum
• Compressing the fallopian tubes, preventing conception
• Anovulatory cycles
• Abnormal uterine blood flow, hindering movement of sperm to ova
• Miscarriage
• Intrauterine growth retardation (IUGR)
• Premature rupture of the membranes
• Contributing to retained placenta after birth
• A postpartum hemorrhage
• An abnormal labor

 

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