Comprehensive Overview of Uterine Myoma-Fibroids – Etiology, Pathophysiology, and Management Strategies

Comprehensive Overview of Uterine Myoma-Fibroids – Etiology, Pathophysiology, and Management Strategies

Uterine myomas are benign uterine tumors from the smooth muscles of the uterus and are common in women between 30-40 years of age (Yang et al., 2021). Their etiology is still not quite understood, but hormonal impact (estrogen, progesterone), genetic predisposition, and growth factors are thought to play a role. These tumors range from incidental to symptomatic, including dysmenorrhea, urinary incontinence, and fertility problems for which management should be tailored.

Etiology

Uterine myomas arise from the smooth muscles of the uterine myometrium. Estrogen and progesterone, genetics, and growth factors are involved in their creation through the facilitation of the multiplication of the myometrial cells (Yang et al., 2021).

Epidemiology

Uterine fibroids are known to affect between 20% and 80% of women of reproductive age; however, the study found higher prevalence and higher severity in African American women (Sefah et al., 2023). It mostly occurs in women of childbearing age, between the ages of 30 and 40 years.

Pathophysiology

The pathophysiology of the disease includes the abnormal proliferation of the smooth muscle cells in the thickness of the uterine myometrium, as indicated by Yang et al. (2021). Factors such as hormones, genetic factors, and altered signaling pathways are considered to be the main causes of fibroids.

Clinical Manifestations

Signs of fibroids include irregular and prolonged menstrual periods, pelvic discomfort, frequent or painful urination, difficulty in bowel movements, and pain in the back (Hunsche et al., 2022). Fibroids can also cause fertility issues and repeated abortions due to the size, number, and location of the uterine muscle masses.

Work-up

The evaluation entails patient history, physical examination, including a pelvic examination, and imaging. TVS is routine in evaluating the size, position, and number of fibroids, among others (Yang et al., 2021). MRI may add further information for surgical planning or in cases of certain diagnoses.

Management

Management strategies include non-drug interventions and drug interventions. Changes such as exercising and changing one’s diet may also be useful in this case. According to Barseghyan et al. (2024), pharmacological treatments include hormonal (oral contraceptives, progestogens), GnRH analogs (agonists, antagonists with hormone replacement), NSAIDs in pain control and bleeding control by drugs like tranexamic acid or levonorgestrel-releasing intrauterine system. One of the treatments that have been advanced to reduce the size of fibroids is uterine artery embolization.

Education and Follow-up

Informed decision-making results from patient education. Physicians should explain the treatment plans, possible consequences, and implications for future pregnancies (Yang et al., 2021). These follow-up visits help in the assessment of the effectiveness of treatment and changes in fibroid and symptomatic status.

In conclusion, uterine fibroids are benign tumors that affect women of reproductive age across the globe. It is vital to comprehend their causes, symptoms, and treatment to ensure proper treatment and a better quality of life.

References

Barseghyan, M., Chae-Kim, J., & Catherino, W. H. (2024). The efficacy of medical management of leiomyoma-associated heavy menstrual bleeding: A mini-review. F&S Reports, 5(1), 4–8. https://doi.org/10.1016/j.xfre.2023.10.003

Hunsche, E., Rakov, V., Scippa, K., Witherspoon, B., & McKain, L. (2022). The burden of uterine fibroids from the perspective of US women participating in open-ended interviews. Women’s Health Reports, 3(1), 286–296. https://doi.org/10.1089/whr.2021.0086

Sefah, N., Ndebele, S., Prince, L., Korasare, E., Agbleke, M., Nkansah, A., Thompson, H., Al-Hendy, A., & Agbleke, A. A. (2023). Uterine fibroids — Causes, impact, treatment, and lens to the African perspective. Frontiers in Pharmacology, 13(13). https://doi.org/10.3389/fphar.2022.1045783

Yang, Q., Ciebiera, M., Bariani, M. V., Ali, M., Elkafas, H., Boyer, T. G., & Al-Hendy, A. (2021). A comprehensive review of uterine fibroids: Developmental origin, pathogenesis, and treatment. Endocrine Reviews, 43(4), 678–719. https://doi.org/10.1210/endrev/bnab039

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Week 3: Discussion Question – Gynecology Guidelines
Discussion Prompt
Discuss Etiology, Epidemiology, Pathophysiology, Clinical Manifestations, Work-up, Nonpharmacological and Pharmacological Management, Education, and Follow-up for a gynecology or pregnancy diagnosis or consideration. 500 words or less for the initial post. For peer posts and subsequent posts under the initial discussion board thread add in second and third-line treatments and additional considerations (250 words maximum for responses).

Comprehensive Overview of Uterine Myoma-Fibroids – Etiology, Pathophysiology, and Management Strategies

For example requirement, only evidence-based sources, such as AAFP, CDC, IDSA, ADA, JNC 8, etc. (textbook resources and internet sites affiliated with medical associations are considered credible sources to obtain the information on the most up-to-date guidelines). Add the link to the guideline(s) within the discussion board for further reading by your peers.