A COMPREHENSIVE REVIEW OF UTERINE FIBROIDS: PATHOGENESIS, DIAGNOSIS, TREATMENT, AND FUTURE PERSPECTIVES

Abstract

Fibroid, myoma, and leiomyoma are interchangeable terms used to describe the most common gynecological tumors, which are benign neoplasms originating in the smooth muscles of the uterus. These tumors are a leading cause of hysterectomies. The prevalence of fibroids varies between studies and countries, ranging from 4.5% to 68.6%, with their occurrence increasing with age, peaking in one's early 40s. Age and race are the primary risk factors for uterine fibroids, with African American women experiencing higher incidence rates compared to Caucasian women. A family history of uterine fibroids also increases the risk of developing them. Lifestyle factors such as obesity, dietary choices, sedentary living, and smoking have been linked to fibroid occurrence, possibly due to their influence on estrogen production. Stress may also be a contributing risk factor for fibroids, as it is associated with a higher body mass index. A diet rich in red meat has been connected to a 70% increased risk of fibroids. These tumors are often asymptomatic, but when symptoms do occur, they typically manifest as menorrhagia, pelvic pain, pressure symptoms, or infertility. Diagnosis relies on a combination of medical history, physical examination, and imaging studies, such as ultrasound and MRI. Medical treatment, including hormonal and non-hormonal options, can be employed to manage symptoms, especially heavy menstrual bleeding. Surgical interventions, such as hysterectomy, myomectomy, and uterine artery embolization, are available based on the patient's specific needs and desire for fertility preservation. It's worth noting that large fibroids can impact the uterine cavity's configuration, potentially affecting embryo implantation and increasing the risk of miscarriage.