Ask The Doctor

DEAR ASK THE DOCTOR: What are Uterine Fibroids?

DEAR ZAINAB: Uterine fibroid(s) (also called uterine fibroma) are benign tumors which grow from the smooth muscle layer (myometrium) of the uterus, also known as leiomyomas. They are the most common benign neoplasm in females. Often asymptomatic, they cause symptoms in about 25% of white and 50% of black women, often because of mass effect. Uterine fibroids often do not require treatment, but when they are problematic, they may be treated surgically or with medication — possible interventions include a hysterectomy, hormonal therapy, a myomectomy, or uterine artery embolization. Estrogen receptors on fibroids causes them to be larger in reproductive years or during pregnancy and shrink dramatically in size after menopause. Fibroids are more common in overweight women (because of increased estrogen from adipose aromatase activity) and women of colored descent.

Fibroids are named according to where they are found. There are four types: intramural fibroids are located in the wall of the uterus and are the most common type. Subserosal fibroids are located underneath the mucosal (peritoneal) surface of the uterus and can become very large. They can also grow out in a papillary manner to become pedunculated fibroids. These pedunculated growths can actually detach from the uterus to become a parasitic leiomyoma. Submucosal fibroids are located in the muscle beneath the endometrium of the uterus. Cervical fibroids are located in the wall of the cervix (neck of the uterus). In very rare cases, malignant (cancerous) growths, leiomyosarcoma, of the myometrium can develop.