Uterine fibroids (also known as leiomyomas or myomas) are common, non-cancerous growths composed of muscle and connective tissue that develop in the wall of the uterus. These growths affect a significant number of people with a uterus. Uterine fibroids are not infectious or contagious and cannot be transmitted from one person to another through sexual contact or any other means.
Why Fibroids Are Not Sexually Transmitted
Uterine fibroids are benign tumors that form within the smooth muscular tissue of the uterus, called the myometrium. They are not caused by bacteria, viruses, or other pathogens responsible for sexually transmitted infections (STIs). A fibroid begins as a single, abnormal muscle cell that divides repeatedly to form a firm, rubbery mass. Since the growth is localized and anchored in the uterine wall, it is impossible to pass to a partner. The biological mechanism of fibroid development is entirely separate from the infectious pathways of STIs.
Defining the True Causes and Risk Factors
The exact reason fibroids develop is not fully understood, but their growth is closely tied to several specific factors within the body. The female reproductive hormones, estrogen and progesterone, play a significant role in promoting their growth. Fibroid tumors contain more receptors for these hormones than normal uterine muscle cells, which is why they tend to grow during the reproductive years when hormone levels are high.
Genetic predisposition is another strong influence, as fibroids often run in families. If an immediate family member, such as a mother or sister, has had fibroids, the risk is approximately three times higher than average. Many fibroids also show changes in genes, with a mutation in the MED12 gene being the most common genetic alteration identified.
Other established risk factors include age, as fibroids are most prevalent in people in their 30s and 40s. African American individuals have a higher likelihood of developing fibroids, often at younger ages and with more severe symptoms. Additional factors such as obesity and a deficiency in Vitamin D are also thought to increase the overall risk of developing these growths.
Recognizing Common Symptoms
While many people with fibroids remain unaware because they cause no symptoms, others experience significant discomfort. The most frequent symptom is heavy or prolonged menstrual bleeding, which can lead to anemia due to excessive blood loss. This heavy bleeding can be accompanied by painful periods or bleeding between cycles.
Depending on their size and location, fibroids can also cause pressure-related symptoms. These include a sense of fullness or pressure in the lower abdomen, or even enlargement of the stomach area. If a fibroid presses against the bladder, it can cause frequent urination or difficulty emptying the bladder completely.
Fibroids pressing on the rectum can lead to constipation or a feeling of rectal pressure. Pain during sexual intercourse (dyspareunia) can also occur, particularly if the fibroids are located near the cervix. Diagnosis often begins with a routine pelvic exam, followed by imaging tests like an ultrasound to confirm the presence, size, and location of the fibroids.
Overview of Treatment Options
Treatment is determined by the severity of symptoms, the size and location of the growths, and the individual’s desire to maintain fertility. For those with no or mild symptoms, a “watchful waiting” approach is often recommended, involving monitoring the fibroids over time. Since fibroids often shrink after menopause due to the drop in hormone levels, this may be a preferred strategy as a person approaches that stage of life.
Medical management focuses on controlling symptoms, particularly heavy bleeding. Hormonal therapies, such as birth control pills and levonorgestrel-releasing intrauterine systems, can help reduce blood flow. Medications known as gonadotropin-releasing hormone (GnRH) agonists or antagonists can temporarily shrink fibroids by inducing a low-estrogen state, and are sometimes used before surgery.
For more severe cases, procedural or surgical options are available to remove the fibroids or the uterus entirely. Myomectomy removes only the fibroids, preserving the uterus, and is often chosen by those who wish to become pregnant. Non-surgical procedures like uterine fibroid embolization (UFE) involve blocking the blood vessels that supply the fibroid, causing it to shrink. The definitive cure is a hysterectomy, the removal of the entire uterus, reserved for individuals who do not wish to retain their fertility.