WHAT IS IT?
â–ª Uterine leiomyomas, also known as a uterine fibroids
â–ª Common benign tumors of smooth muscle cells or myometrium.
â–ª Composed of smooth muscle that is replaced by fibrous (collagen and fibronectin) connective
tissue
â–ª Growth is promoted by estrogen
â–ª Estrogen is the most important stimulus for leiomyoma growth
â–ª Recent findings suggest that volume and growth of myomas are also heavily progesterone
dependent
â–ª Distinct, firm and round
â–ª Often occur in groups
â–ª Classified according to location
â–ª Intramural - within the muscular wall of uterus
▪ Subserous –on the outside surface of uterus
▪ Submucosal – on the inside of the uterus lining
â–ª May be attached by stem, increased risk to torsion or infection)
â–ª Can be located in cervix, or within ligaments
â–ª Can detach from uterus, feeds of blood supply from abdominal organs
RISK FACTORS
â–ª 30 to 50 % of women over 30 years old have leiomyomas
â–ª African Americans have 3 to 4 times higher chances of development when compared to
Caucasian women, in AA women, fibroids develop at earlier ages
â–ª Family history has a three fold risk
â–ª Obesity, which is possibly due to the association between obesity and high circulating
estrogen levels
â–ª Hypertensive women have a fivefold increase for diagnosis
â–ª Intake of food additives and soybean increase risk; soybean has a 2.5 fold increase
â–ª Consumption of red meat increases risk for fibroids
â–ª Higher parity is associated with a reduced risk (80% reduction with 3 or more deliveries)
â–ª 3 to 5x more common in premenopausal women than postmenopausal women
â–ª Women who began taking oral contraceptives before the age of 16 are at a greater risk
â–ª However, using progestin-only contraceptives is associated with a reduced risk of fibroids.