Uterine Fibroids: Signs, Causes & Diagnosis!

Uterine fibroids also known as uterine leiomyomas are non cancerous smooth muscles tumors of the uterus. They typically occur in the middle & latter reproductive years.


  • Abdominal pain
  • Anemia
  • Iron deficiency
  • Pain during sexual intercourse
  • Rectal pressure
  • Growing of the abdomen mimicking pregnancy
  • Large fibroids extend out through the cervix
  • Painful & heavy menstruation
  • Frequent need to urinate
  • Constipation
  • Bloating
  • Lower back pain.


  • During pregnancy;
  • Uterine bleeding
  • Premature labour
  • Interference with the position of the fetus
  • Miscarriage
  • Compression of the ureter may lead to hydronephrosis
  • Endometriosis
  • In very rare cases, malignant tumors may arise in the myometrium, called leiomyosarcoma.


  • Obesity
  • Diet like, eating red meat
  • Genetic abnormality due to a change in the chromosomes.
  • Racial background: Black women are way more likely to develop uterine fibroids than white women.
  • Diabetes
  • Hypertension
  • Never having given birth
  • Hormones like estrogen, progesterone & aromatase have a significant contribution in the growth of these fibroids.


  • Polycystic ovary syndrome (PCOS)
  • Renal cell cancer
  • Reed’s Syndrome
  • Endometriosis.


  1. Ultrasound is the primary & standard method for the evaluation of uterus & the detection of fibroids.
  2. An MRI done for depiction of the size & location of the fibroids.
  3. CT scan applied for obtaining suitable images of the uterine fibroids.
  4. Hysterosalpingography: Utilizes application of a radiographic dye which taken the shape of the fibroids, assisting in mapping of the size & location of the outgrowth, as seen under an X-ray.
  5. Hysteroscopy: A viewing scope called a hysteroscope is inserted through the cervix into the uterus, the uterus is pre-dilated & the uterine cavity is assessed for fibroid growth.



  • NSAIDs are used to reduce pain in menstruation.
  • Iron supplements for anemia & weakness.
  • Levonorgestrel IUDs, which releases Levonorgestrel in small concentrations at fixed times is effective in limiting menstrual blood flow.
  • Oral contraceptive pills are prescribed to reduce menstrual bleeding & cramps.
  • Cabergoline, an ergot alkaloid finds use due to its effectiveness in shrinking of the fibroids.
  • Ulipristal acetate, a synthetic selective progesterone receptor modulator (SPRM) is used before surgerical treatment of fibroids.
  • Danazol used to shrink fibroids & control symptoms.
  • Gonadotropin-releasing hormone analogs/modulators are used before operation due to their property of decreasing estrogen levels which helps in temporarily shrinking the fibroids.
  • Progesterone antagonists like mifepristone.
  • Aromatase inhibitors like anastrozole.

Surgical & other procedures:

  • Uterine artery embolization (UAE) is a noninvasive procedure that blocks blood flow to fibroids, causing them to shrink.
  • Uterine artery ligation, a minimally invasive method to limit blood supply of the uterus by a small surgery that can be performed transvaginally or laparoscopically.
  • Hysterectomy, the surgical removal of uterus.
  • Endometrial ablation, is a surgical procedure to destroy the endometrial lining in the uterus. This particular procedure is performed only when the fibroids are relatively small & within the uterus.
  • Radiofrequency ablation is a minimally invasive procedure in which a needle like device is inserted in the fibroids through the abdomen and heated with a radio frequency electrical energy to cause necrosis of the fibroid cells.
  • Magnetic resonance guided focused ultrasound, a non-invasive procedure (requiring no incision) that uses high intensity focused ultrasound waves to destroy tissue in combination with magnetic resonance imaging (MRI), which guides and monitors the treatment.
  • Myomectomy: Surgery to remove one or more fibroids. Three types of this surgery are classified as:
  1. Hysteroscopic myomectomy
  2. Laparoscopic myomectomy
  3. Laparotomic myomectomy.


  • Management of underlying conditions like PCOS, hypertension, diabetes, etc.
  • Diet high in Vitamin A, C, D & E can reduce chances of developing uterine fibroids.
  • Diet rich in phytoestrogens, carotenoids & omega-3 fatty acids.
  • Low consumption of red meat.