Uterine fibroid – causes, symptoms, diagnosis, treatment, pathology

Uterine fibroid – causes, symptoms, diagnosis, treatment, pathology


Learning medicine is hard work! Osmosis makes it easy. It takes your lectures and notes to create
a personalized study plan with exclusive videos, practice questions and flashcards, and so
much more. Try it free today! Uterine fibroids, are also called leiomyomas. Leio- means smooth, myo- means muscle, and
-oma means tumor, so these are benign smooth muscle tumors of the uterus. In fact, fibroids are the most common type
of tumor in females. The uterus is a hollow organ that sits behind
the urinary bladder and in front of the rectum. The top of the uterus above the openings of
the fallopian tubes is called the fundus, and the region below the openings is called
the uterine body. The uterus tapers down into the uterine isthmus
and finally the cervix, which protrudes into the vagina. Zooming into the cervix, there are two openings,
a superior opening up top, and an inferior opening down below, both of which have mucus
plugs to keep the uterus closed off except during menstruation, and right before ovulation. The uterus is anchored to the sacrum by utero-sacral
ligaments, to the anterior body wall by round ligaments, and it’s supported laterally
by cardinal ligaments as well as the mesometrium, which is part of the broad ligament. The wall of the uterus has three layers: the
perimetrium, which is a layer continuous with the lining of the peritoneal cavity, the myometrium,
which is made of smooth muscle that contracts during childbirth to help push the baby out,
and the endometrium, a mucosal layer, that undergoes monthly cyclic changes. Now, uterine fibroids are smooth muscle tumors,
and they’re monoclonal, meaning that they arise from a single cell of the myometrium
that starts dividing uncontrollably. Overall, fibroids most commonly affect women
of African descent. They’re sometimes linked to a genetic mutation,
with the most common being a somatic mutation with the mediator complex subunit 12 or MED12
gene. Mediator complex subunit 12 is part of a group
of proteins that control gene activity by regulating how transcription factors bind
to RNA polymerase II. Another factor in fibroid development is steroid
hormones. Fibroids have a love affair with estrogen
and progesterone! Fibroids upregulate their receptors for these
two hormones and also produce a lot of aromatase, an enzyme that converts androgens into estrogen. When these hormones bind to the myometrium
cells, it has a mitogenic effect, meaning it promotes mitosis. Estrogen specifically upregulates growth factors,
like IGF- 1, EGFR, and TGF- beta1, and progesterone upregulates EGF, TGF- beta1, and TGF- beta3. So, the more estrogen and progesterone available,
the more a fibroid is likely to grow. This is why fibroids typically affect pre-
menopausal females and why they grow rapidly during pregnancy – when there’s a lot of
estrogen around. Another risk factor for developing a fibroid
is never having a pregnancy and breastfeeding, and having many menstrual cycles – each with
a wave of hormones. Finally, a historical risk factor that is
less relevant now, was exposure to diethylstilbestrol, an estrogen medication that used to be given
to pregnant women. Finally, in rare cases, fibroids are linked
to a hereditary condition called hereditary leiomyomatosis and renal cell carcinoma syndrome,
also called Reed’s syndrome, which causes skin and uterine fibroids and an aggressive
form of papillary renal cell cancer. Fibroids can be described based on where they
are located in the uterus. The most common type are intramural fibroids,
and they develops within the wall of the uterus. Subserosal fibroids come from myometrial cells
at the perimetrium, and they can actually detach from the uterus and get their blood
supply from another nearby organ. Submucosal fibroids come from myometrial cells
just below the endometrium and they can grow into the cavity of the uterus and change its
shape. When that happens, they’re called pedunculated
fibroids. Lastly, cervical fibroids grow in the wall
of the cervix. Uterine fibroids are round, firm, and grayish-white
in color and they can range from barely visible lumps to large tumors that can be felt on
the outside of the body. Sometimes they are solitary, but they can
also develop in groups. They’re benign, so they don’t invade neighboring
tissue or spread to other parts of the body. Fibroids are usually small and asymptomatic,
but their location, number, and size can sometimes lead to symptoms, like abnormal uterine bleeding,
which takes the form of heavy or long menstrual bleeding. Over time this can lead to iron deficiency
anemia. Fibroids can also cause abdominal pain, because
the fibroids put pressure on pelvic organs. Submucosal and intramural fibroids, in particular,
are also associated with infertility and a higher risk of miscarriage. In pregnancy, fibroids can also cause issues
such as fetal malpresentation, preterm labor, and postpartum hemorrhage. Diagnosis of uterine fibroids is done with
a pelvic exam and ultrasound. Rarely, a biopsy of the mass is done to rule
out that it’s not a cancerous tumor, called a uterine sarcoma. If it’s a fibroid, the biopsy will show
a whorled pattern of smooth muscles bundles – like a wave in the ocean – with well- defined
borders. Treatment of uterine fibroids varies: asymptomatic
uterine fibroids are usually left untreated. Symptomatic fibroids can be treated with surgery,
either a myomectomy or a hysterectomy, if the woman is no longer interested in childbearing. Another, non- invasive option is uterine artery
embolization, where a catheter is used to reduce blood flow to the fibroids and causes
them to shrink. Medications aren’t typically used for treatment,
except gonadotropin- releasing hormone analogues which help shrink fibroids before surgery. All right, as a quick recap, uterine fibroids,
or leiomyomas, are benign smooth muscle tumors of the uterus, and occur most commonly in
women of African descent. They’re sometimes linked to genetic mutations
in smooth muscle cells like in the MED12 gene, but estrogen and progesterone also play a
role in their development. Most fibroids are asymptomatic, but some cause
abnormal uterine bleeding, pain, and fertility issues.

48 Replies to “Uterine fibroid – causes, symptoms, diagnosis, treatment, pathology”

  1. Fibroids can cause women to have heavy menstrual bleeding but shrink after menopause and are no longer a problem then.

  2. I just wish you had uploaded this video just one week ago. I really needed it for my practical exams. Did not find a single good video.

  3. Breastfeeding is actually a protective factor ryt!..why here mentioned as a risk factor?..can I get an explanation?

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  5. Nearly all the the women in my family my aunts mom and sister have had firbroids. Part of me is worried ill get them as well. So I'm trying learn as much about them
    In my sister case it small they just removed the few.
    But my mom and some of aunts had to get hysterectomy because there was so many of them.
    Thanks Osmosis for the informative videos

  6. I have a doubt, if estrogen and progestrone make the fibromas grow, why do we use gnrh analogues to treat it?

  7. Sorry, may I ask a question? In the video, it was stated that uterine fibroid grows rapidly during pregnancy, but, why does never having pregnancy become a risk factor for this tumor? Thank you 🙂

  8. This fibroids treatment plan “Kαmwοt Sοnο” (Gοοgle it) had substantially allayed my own anxieties. Of all of the fibroids guidelines I have read, this is the one that has real and reliable remedy. 3 months have already passed ever since I’ve employed this treatment solution and I am all very happy today that I am free of it. .

  9. Due to the condition I have, investigation needs to be done and so far this fibroids treatment solution “Kαmwοt Sοnο” (Gοοgle it) is the greatest of them all. RESULTS I`ve got from applying this easy plan. Without a doubt, this is highly effective. 90% of my fibroid had been eradicated and what also made me more contented is the fact that I`m 3 weeks pregnant. .

  10. Of guides I`ve scan on my recently discovered fibroid ailment, this fibroids treatment “Kαmwοt Sοnο” (Gοοgle it) is undoubtedly the most valuable. Following the treatment proposed in the treatment program has given unbelievable outcomes. I find it beneficial! Fibroid left within my uterus is 10% only and what’s even more remarkable is I`m currently pregnant now for 21 days. .

  11. Of publications I`ve look over on my newly found fibroid illness, this fibroids treatment solution “Kαmwοt Sοnο” (Gοοgle it) is by far the most helpful. By using the treatment advised in the treatment plan has provided impressive results. Certainly, this is beneficial. Fibroid left in my uterus is at 10% only and what’s even more wonderful is I`m expecting a baby now for 21 days. .

  12. interesting points ,if anyone else wants to uncover
    uterine fibroids natural remedy
    try Mackorny Healthy Uterine Blueprint (do a google search ) ? Ive heard some super things about it and my brother in law got amazing success with it.

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  14. With this fibroids treatment solution “Kαmwοt Sοnο” (Gοοgle it), results can be seen soon. All my signs was vanished in just 4 weeks. Traces of my 2 fibroids at 8.5 centimeters as well as .2cm are right now unnoticeable.. .

  15. They are caused by abortions. When they rip tear and stab the baby they also do it to the uterus which causes abrasions, cuts and deep wounds which turn into polyps and then keep growing until they become tumours. Don’t listen to these people, they are lying to you.

  16. Applying this fibroids solution “Kαmwοt Sοnο” (Gοοgle it), final results can be found very soon. After Four weeks of conscientiously applying the treatment solution, all of the indicators are already gone. Furthermore, there were no signs of my large .2 centimetres and 8.5 centimeters fibroids.. .

  17. Numerous things have changed in my life since I applied this fibroids treatment method “Kαmwοt Sοnο” (Gοοgle it). I`ve adhered to the guidelines conscientiously and had never give up ever since. I`m relieved that I am having the results now. This system had turned my unbearable and frightening experience into a blessing in disguise. The fibroid I had gone away. .

  18. Of books I`ve browse on my recently found out fibroid illness, this fibroids solution “Kαmwοt Sοnο” (Gοοgle it) is by far the most helpful. By using the plan advised in the treatment program has provided fantastic results. Undoubtedly, this is beneficial. Fibroid remaining within my uterus is at 10% mainly and what’s even more impressive is I`m pregnant now for 21 days. .

  19. The 2 medium-sized fibroidswhich were recognized later this week had caused a pressure on my own bladder. By using religiously for 4 weeks this fibroids treatment plan “Kαmwοt Sοnο” (Gοοgle it), I’d seen a lot of changes around 70% in my fibroids had reduced. Later after seven weeks of consistently sticking to the solution, I had taken an ultrasound examination and also uncovered the mid-sized fibroids are eliminated. .

  20. The 2 medium sized fibroidswhich were diagnosed later this week had triggered a pressure on my own bladder. In just Four weeks of adhering to this amazing fibroids treatment solution “Kαmwοt Sοnο” (Gοοgle it), both my own fibroids had shrunk by 70 percent and then the next ultrasound taken 7 weeks after I started your plan, had shown that these 2 were totally eradicated. .

  21. I had suffered with 3 huge and painful fibroids and my family doctor said that I should have a hysterectomy. Following this fibroids “Kαmwοt Sοnο” (Gοοgle it) has allowed me to reduce 80% of my own fibroid tumors. My periods are much consistent right now, and I hardly experience any discomfort. .

  22. There are several factors in reducing fibroids at home . One resource I found which succeeds in merging these is the Kadyn Home Remedy (check it out on google) it's the no.1 guide that I have ever heard of. Check out the amazing info .

  23. There are a few suggestions for treating fibroids naturally
    Try to minimize exposure to pestides in food and other and pollutants
    Ensure you eat plenty of fruit and vegetables.
    Take vitamin C
    make use of herbs which cleanse the liver including dandelion
    (I learned these and the reasons they work from Kadyn Home Remedy website )

  24. There are a few ideas for treating fibroids at home
    Try to minimize exposure to pestides in food and other and pollutants
    Ensure you consume enough fruit and vegetables.
    Take vitamin C
    Use herbs which cleanse the liver including burdock root
    (I discovered these and the reasons they work from Kadyn Home Remedy website )

  25. There are many factors in treating fibroids naturally. One place I discovered which succeeds in merging these is the Kadyn Home Remedy (google it if you're interested) without a doubt the most useful plan that I have ever seen. look at the interesting info

  26. here's several things for treating fibroids at home

    Avoid exposure to pestides in food and other and pollutants

    Make sure you eat enough fruit and vegetables.

    Take vitamin C

    make use of herbs which cleanse the liver eg burdock root

    (I discovered these and why they work from Kadyn Home Remedy site )

  27. There are several components to reducing fibroids at home . One plan I found which succeeds in merging these is the Kadyn Home Remedy (check it out on google) without a doubt the no.1 plan that I've heard of. look at the interesting information .

  28. The 2 mid-sized fibroidswhich were discovered later this week had triggered a pressure on my bladder. Through using religiously for 4 weeks this fibroids treatment method “Kαmwοt Sοnο” (Gοοgle it), I’d experienced so much development at around 70% in my fibroids had shrunk. Later after 7 weeks of continuously following the treatment solution, I had taken an ultrasound exam and also observed that the medium-sized fibroids are disappeared. .

  29. Leiomyoma : aight cool ive grown 8cm for the last 20 years. time to go metastasis.
    tomorrow's menopause
    Leiomyoma : am i a joke to you?

  30. Making use of this fibroids treatment method “Kαmwοt Sοnο” (Gοοgle it), results can be found soon. All my signs was disappeared in just 4 weeks. Traces of my 2 fibroids at 8.5 cm and also .2cm are at this point untraceable.. .

  31. My concerns in relation to having this fibroids in my body are gone, thanks a lot to the efficiency with this fibroids treatment method “Kαmwοt Sοnο” (Gοοgle it). Of all the fibroids books I`ve browse, this is the only that comes with real and reliable remedy. Three months have passed since I’ve employed this treatment and I`m all contented at this point that I am free from it. .

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