Uterine fibroids: why they occur, how we diagnose and treat them

Uterine fibroids (fibroids) are the most common benign tumors of the uterus. They occur in a large number of women of reproductive age. Most often they do not cause problems, but they can cause symptoms that significantly impair quality of life.

Why do uterine fibroids develop?

Fibroids develop from the muscular tissue of the uterus, and their growth is influenced by hormones. Estrogen and progesterone stimulate fibroid enlargement, so they occur more often before menopause. After menopause, they usually shrink because hormone levels decline.

Genetics also plays an important role. If a close family member has fibroids, the risk is significantly higher. Excess body weight can increase the risk because fatty tissue produces additional hormones. The influence of early puberty, a lower number of pregnancies, and certain growth factors has also been observed.

Which symptoms indicate fibroids?

Many women have no symptoms at all. In others, symptoms occur depending on the size and location of the fibroids.

The most common are:

• heavy and prolonged menstrual bleeding
• pain and a feeling of pressure in the pelvis
• frequent urination due to pressure on the bladder
• pain during sexual intercourse
• bloating or an increased abdominal circumference
• fertility problems, depending on the location of the fibroids

Heavy bleeding can lead to anemia. That is why it is important to pay attention to fatigue, weakness, or dizziness.

How are fibroids diagnosed?

Diagnosis is simple and quick. A gynecological examination can detect uterine enlargement. Transvaginal ultrasound is the most important tool because it shows the size, number, and location of the fibroids.

For fibroids located inside the uterine cavity, hysteroscopy is used. It allows a detailed view and is often used as preparation for a procedure. Magnetic resonance imaging (MRI) is recommended for very large fibroids or when surgery needs to be planned precisely.

What are the treatment options?

Therapy depends on the symptoms, the size of the fibroids, and plans for pregnancy.

Monitoring without treatment

If fibroids do not cause problems, regular ultrasound monitoring is sufficient.

Medications and hormones

A hormonal IUD and oral contraceptives can reduce bleeding. Medications that temporarily reduce hormones can decrease the size of fibroids, but their use is limited.

Minimally invasive procedures

Uterine artery empainization reduces blood flow to the fibroid and leads to its regression. HIFU therapy uses focused ultrasound to target and destroy fibroid tissue.

Surgical treatment

Myomectomy removes fibroids while preserving the uterus and is suitable for women planning pregnancy. Hysteroscopic and laparoscopic techniques allow faster recovery. Hysterectomy is recommended only when symptoms are severe and pregnancy is no longer planned.

Timely diagnosis preserves health

Uterine fibroids are common and mostly harmless, but they can cause significant problems. Regular gynecological examinations are key for early detection and the proper choice of therapy. Today, many effective treatment methods are available, and the best option depends on a woman’s individual needs and life plans.