Uterine fibroids are a common concern for many women, with up to 80% developing at least one fibroid by age 50. Most fibroids remain minimally noticeable or asymptomatic and do not require medical treatment, nearly half of all cases can lead to abnormal bleeding, fertility issues, anemia, and even bulk symptoms such as an enlarged abdomen. The question for many women is not if they will develop fibroids, but rather why, and management options.
What Are Uterine Fibroids?
Uterine fibroids, also known as leiomyomas, are non-cancerous smooth muscle tumors. Unlike normal uterine musclular tissues, fibroids grow unchecked, forming dense, round masses. Despite being classified as tumors, fibroids are benign and not linked to cancer.
Why Do Fibroids Form?
The exact cause of fibroid formation remains a subject of ongoing research. However, the following factors contribute to their development and growth:
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Hormonal Influence:
- Fibroid cells have an increased number of progesterone receptors, making them highly responsive to this hormone.
- Estrogen and progesterone fuel fibroid growth, which is why fibroids tend to shrink after menopause when hormone levels decline.
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Genetic & Cellular Changes:
- Some women inherit a genetic predisposition to developing fibroids.
- A single uterine muscle cell begins to multiply uncontrollably, forming a fibroid.
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Uterine Growth Factors:
- Besides hormones, local uterine growth factors play a crucial role in fibroid development.
- Transforming Growth Factor Beta (TGF-β)—particularly TGF-β1, TGF-β2, and TGF-β3—is a polypeptide that significantly promotes fibroid growth.
- Other contributing factors include Activin-A, Platelet-Derived Growth Factor (PDGF), and Cytokines such as TNF-α.
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Matrix Formation & Fibroid Structure:
- Fibroids form when abnormal uterine cells are encased in a unique extracellular matrix (ECM), often described as the “glue” that holds them together.
- Researchers are exploring whether Vitamin D and Resveratrol may help prevent or reduce fibroid growth by targeting this matrix.
How Fast Do Fibroids Grow?
Fibroid growth rates vary depending on age, genetics, and hormonal levels. A 2017 NIH study found that:
- Most fibroids grow less than 20% over six months.
- The median growth rate is approximately 9% in six months.
- Many fibroids shrink after menopause due to declining hormone levels.
Routine pelvic exams and ultrasounds help monitor fibroid growth and assess whether intervention is necessary.
How Do Fibroids Affect Your Health?
While some fibroids remain small and asymptomatic, others can cause:
- Heavy menstrual bleeding and prolonged periods.
- Protruding abdomen and discomfort with exercise.
- Anemia due to excessive blood loss.
- Pelvic pain and pressure, often mistaken for bloating.
- Painful sexual intercourse.
- Frequent urination or even incontinence, if the fibroid presses on the bladder.
- Fertility challenges, especially if fibroids distort the uterine cavity.
Treatment Strategies for Fibroids
Because fibroids thrive on hormones, most treatments focus on reducing progesterone influence or blocking hormone receptors to prevent growth. Treatment options include:
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Hormonal Therapies:
- Birth control pills, patches, and rings may help control bleeding but do not shrink fibroids.
- GnRH agonists (e.g., Lupron) can temporarily shrink fibroids but are not long-term solutions due to side effects.
- Progesterone receptor modulators (such as Ulipristal Acetate) are being studied for fibroid management.
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Non-Hormonal Medical Approaches:
- Anti-inflammatory medications (NSAIDs) can help with pain but do not impact fibroid growth.
- Tranexamic acid (Lysteda) can reduce heavy menstrual bleeding without affecting hormones.
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Minimally Invasive Procedures:
- Uterine Fibroid Embolization (UFE) cuts off blood supply to fibroids, causing them to shrink.
- MRI-Guided Focused Ultrasound uses heat to break down fibroid tissue.
- Endometrial Ablation is an option for fibroid-related heavy bleeding but is not suitable for women seeking future pregnancies.
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Surgical Options:
- Myomectomy removes fibroids while preserving the uterus, making it an option for women who want to conceive.
- Hysterectomy is the only permanent solution, as it removes the entire uterus, eliminating fibroids completely.
Monitoring & Next Steps
If you suspect you have fibroids or have experienced symptoms such as heavy periods, pelvic pain, or difficulty conceiving, it’s essential to get evaluated.
At Women’s Health Practice, we offer diagnostic evaluations and access to clinical research trials investigating cutting-edge treatments for fibroids. If you’re interested in learning more about non-surgical treatments or innovative therapies, contact us to discuss your options.
While fibroids are common, they don’t have to interfere with your health and quality of life. Early detection and proactive management can help you regain control of your reproductive health.
