Leiomyoma: Symptoms, Causes & Treatment

Uterine fibroids, also known as leiomyomas, are benign (non-cancerous) tumors that grow from the muscular tissue of the uterus. They are among the most common pelvic tumors in women of reproductive age, and vary greatly in their number, size, and location: they may be very small and invisible to the eye, or large and distort the uterus's shape. It is important to emphasize that fibroids are not cancer and very rarely turn into it, and their presence does not mean a cancer risk.

Many women with fibroids have no symptoms, and the tumor is found incidentally during a routine examination or ultrasound. But when symptoms appear, they depend on the tumor's location and size, foremost: heavy or prolonged menstrual bleeding that may lead to anemia, pelvic and lower-abdominal pain or pressure, frequent or difficult urination (when the tumor presses on the bladder), constipation (when it presses on the bowel), pain during intercourse, and sometimes abdominal bloating. In some cases fibroids may affect fertility or pregnancy depending on their location. The chances of developing them increase with factors such as family history and obesity, and they tend to shrink after menopause with the drop in hormones.

The treatment decision depends on several factors: the presence and severity of symptoms, the tumor's size and location, and the woman's age and desire to have children in the future. Small, symptomless fibroids may need only periodic ultrasound monitoring. When there are bothersome symptoms, multiple options are available: medications to relieve bleeding and pain or to temporarily shrink the tumor, less invasive procedures (such as removing the tumor by endoscopy or blocking its feeding vessels), up to surgical removal of the tumor (preserving the uterus for those wishing to have children) or removal of the uterus in severe cases for those who have completed childbearing. Because each case has its specifics, the treatment plan is determined jointly by the woman and the gynecologist according to her priorities.

• Heavy or prolonged menstrual bleeding (may cause anemia).
• Pelvic and lower-abdominal pain or pressure.
• Frequent or difficult urination, and constipation (pressure on the bladder or bowel).
• Pain during intercourse, and sometimes effect on fertility (many are symptomless).

• Benign growth from the uterus's muscular tissue (the exact cause is uncertain).
• Influence of hormones (estrogen and progesterone).
• Risk factors: family history and obesity.

• Gynecological examination and ultrasound (the basis of diagnosis).
• Sometimes MRI to precisely determine size and location.
• Assessing anemia with heavy bleeding.

Monitoring

• Small, symptomless fibroids may need only periodic ultrasound monitoring.

Medications

• To relieve bleeding and pain or to temporarily shrink the tumor.

Procedures and surgery

• Removing the tumor by endoscopy or blocking its feeding vessels.
• Removing the tumor (preserving the uterus for those wishing to have children) or removing the uterus in severe cases.

The plan is determined jointly with the gynecologist according to symptoms and the desire to have children. This content is educational and does not replace medical advice.

• Anemia from heavy bleeding.
• Effect on fertility or pregnancy depending on location.
• Pressure on the bladder or bowel causing bothersome symptoms.

• There is no proven prevention, but maintaining a healthy weight may help.
• Regular gynecological follow-up to detect and monitor them.
• Not neglecting heavy bleeding or persistent pelvic pain.