Clinical Picture and Treatment of Uterine Leiomyoma (Fibroids) video


Fibroids are the commonest benign uterine tumors and it
is estimated that they occur in 20–40% of women during
their reproductive years1,2. They can cause a wide range
of clinical symptoms such as heavy menstrual periods,
pressure symptoms to surrounding organs and fertility
problems3. As a result, surgery for uterine fibroids is
common, and in both the UK and USA fibroids are
the primary indication for hysterectomy4,5. However, in
many women uterine fibroids are found incidentally on
routine gynecological examination or on pelvic imaging
performed for unrelated symptoms. Whether fibroids
are symptomatic or not depends primarily on their size
and on their position in relation to the uterine cavity6.
Although the definitive management of gynecological
symptoms attributable to uterine fibroids is surgical
removal, many women decline surgery or prefer to
pursue medical management. The natural history of
fibroids is poorly understood, which makes it difficult
to advise asymptomatic women with fibroids on the risk
of developing clinical symptoms in the future. It is well
known, however, that fibroids are sensitive to circulating
estrogens7, which will either cause them to grow or to
maintain their size. It is less clear whether the growth
of fibroids is affected by factors other than ovarian
steroid hormones. The aim of this retrospective study
was to describe the natural history of uterine fibroids in
premenopausal women and to identify demographic and
morphological features that may influence their growth