Pathophysiology and Clinical Management of Uterine Fibroids (Leiomyomas)
Uterine fibroids are non-cancerous growths of the uterus that frequently appear during childbearing years. Also called leiomyomas or myomas, these tumors develop from the smooth muscle tissue of the uterus (myometrium). A single cell divides repeatedly, eventually creating a firm, rubbery mass distinct from neighboring tissue.
Growth Patterns and Classification
Fibroids are categorized by their location:
Intramural: Grow within the muscular uterine wall.
Submucosal: Bulge into the uterine cavity; these are most associated with heavy menstrual bleeding.
Subserosal: Project to the outside of the uterus.
Hormonal Influence
Growth is heavily influenced by estrogen and progesterone. Fibroids contain more estrogen and progesterone receptors than normal uterine muscle cells do. They tend to swell during pregnancy when hormone levels are high and shrink after menopause when hormone levels decline. Treatment ranges from hormonal suppression to surgical interventions like myomectomy or uterine artery embolization.