What are uterine fibroids and how do they affect the body? Let’s explore more details in the article below.
What are uterine fibroids?
Definition
Uterine fibroids (also known as uterine myomas or leiomyomas) are the most common benign pelvic tumors. They typically develop within the uterine muscle, are relatively round in shape, firm in consistency, and whitish in color.
Studies show that nearly 50% of women over the age of 35 develop uterine fibroids, and this figure rises to 70% among women over 45. In Vietnam, the prevalence may be even higher, as many women do not undergo regular gynecological examinations, and limited medical equipment in some healthcare facilities may fail to detect smaller fibroids.
No definitive research has identified the exact cause of uterine fibroids. However, several studies suggest that the condition is primarily associated with estrogen dominance, particularly in women of reproductive age.
Classification
Locations of uterine fibroids
Depending on their location, uterine fibroids can be classified into four types:
Subserosal fibroids: These develop on the outer surface of the uterus, with or without a stalk, and often compress surrounding organs, sometimes displacing the ovaries.
Intramural fibroids (located within the uterine muscle): These develop inside the uterine wall and may cause the uterus to enlarge and become distorted.
Submucosal fibroids: These tumors grow beneath the uterine lining, often with a stalk, and may lead to complications such as menorrhagia, endometrial necrosis, and the formation of intrauterine polyps.
Cervical fibroids: These develop in the posterior wall of the cervix or pelvic cavity, causing compression of the rectum and adjacent organs.
Symptoms of uterine fibroids
Uterine fibroids are benign gynecological tumors, and small fibroids often present without symptoms. They are usually detected during routine gynecological examinations or when patients experience issues related to infertility or subfertility.
For larger fibroids, typical symptoms may include:
Abnormal uterine bleeding outside of the menstrual period
Menorrhagia or prolonged bleeding
Menstrual disorders: extended periods, heavy menstrual flow, severe dysmenorrhea
Excessive vaginal discharge, sometimes foul-smelling
Pelvic pain, lower back pain, or discomfort radiating to the thighs
Urinary retention or bladder pressure
Constipation, painful or bloody bowel movements
Pain during sexual intercourse
Abdominal bloating or indigestion
A palpable mass in the lower abdomen, firm in consistency, with limited mobility
Uterine fibroids often cause recurrent abdominal pain.
If you experience any of the above abnormal symptoms, you should seek medical examination at a healthcare facility. To schedule gynecological surgery with our highly experienced obstetricians and gynecologists, please contact our hotline at 0886.621.046 or register via the form below.
How do uterine fibroids progress?
In most cases, uterine fibroids are benign and typically grow at a slow rate, with their development largely influenced by the patient’s hormonal levels. The majority of small fibroids do not cause complications and may even regress once a woman reaches menopause.
Uterine fibroids may also regress when their blood supply is interrupted. For this reason, uterine artery embolization has been applied as an effective treatment option for fibroids.
What causes uterine fibroids?
Although the exact cause has not been clearly identified, numerous studies suggest that uterine fibroids are associated with excessive production of reproductive hormones. This also explains why women of reproductive age are more susceptible to developing fibroids compared with those who have reached menopause.
In addition, genetic predisposition is considered one of the contributing factors that increase the risk of developing uterine fibroids. Several studies have demonstrated that women with a family history of fibroids particularly when the mother, sister, or daughter is affected may have up to a threefold higher risk of developing the condition.
Other contributing factors include early onset of menstruation, inadequate nutritional intake, and vitamin D deficiency.
Are uterine fibroids dangerous?
Large uterine fibroids may lead to serious complications.
Anemia: Submucosal uterine fibroids can cause menorrhagia and heavy menstrual bleeding. When this condition persists, patients may develop anemia, presenting with symptoms such as pallor, dizziness, or, in severe cases, circulatory collapse due to hemorrhagic shock.
Infection: Uterine fibroids may predispose patients to genital tract infections. In certain cases, torsion of a pedunculated fibroid can lead to necrosis of the tumor, posing a serious threat to health and potentially causing shock if not treated promptly.
Compression of adjacent organs: Large uterine fibroids may exert pressure on the ovaries and distort the uterine cavity. Depending on their size and location, fibroids can also compress surrounding structures, particularly the bladder and kidneys.
Pyelonephritis: In addition to causing lower back pain and pelvic discomfort, large uterine fibroids may compress the ureters, increasing the risk of hydronephrosis and pyelonephritis.
Torsion of a pedunculated fibroid: Subserosal fibroids with a stalk are prone to torsion, which can result in necrosis. In such cases, patients may experience sudden-onset abdominal pain that progressively worsens in intensity. They may also present with signs of shock and peritoneal irritation.
Large uterine fibroids can distort diagnostic results because they compress and alter the position of the ovaries. Many subserosal fibroids are often mistaken for ovarian cysts due to their excessive size.
Uterine fibroids generally have little impact on fertility; however, in cases where the fibroid is too large or located close to the endometrium, it may distort the uterine cavity and hinder embryo implantation.
During pregnancy, uterine fibroids may lead to several complications, including:
Compression and torsion of fibroids causing pain, necrosis, and infection
Obstructed labor due to abnormal fetal presentation, placenta previa, or placenta accreta associated with fibroids
Postpartum hemorrhage and uterine atony
Female infertility resulting from failure of embryo implantation in the uterine cavity
Uterine fibroids during pregnancy may lead to serious complications.
Diagnosis of uterine fibroids
There are several methods that physicians may use to diagnose uterine fibroids. Because small fibroids often do not present with typical symptoms, many patients are only incidentally diagnosed during routine health check-ups or gastrointestinal examinations.
Diagnosis based on clinical symptoms
Large uterine fibroids often present with typical symptoms such as menorrhagia, persistent abdominal pain, and abnormal abdominal enlargement. Physicians usually perform abdominal palpation below the umbilicus to assess the initial location and size of the fibroid.
In patients with uterine fibroids, vaginal examination may reveal an irregular, firm, and mobile uterus. In cases of torsion with necrosis, physicians may detect abnormal peritoneal signs.
Paraclinical diagnosis
Paraclinical diagnosis allows physicians to accurately determine the location, size, and characteristics of the fibroid.
Abdominal ultrasound: This is the most common diagnostic method. Ultrasound imaging enables physicians to identify fibroids and make appropriate treatment decisions.
Hysterography: In cases of large uterine fibroids, imaging often reveals uterine deformation with smooth margin defects.
Computed tomography (CT) and magnetic resonance imaging (MRI): These methods are indicated in cases of large fibroids that compress surrounding organs.
The diagnosis of uterine fibroids may also be made in relation to ovarian conditions such as ovarian tumors or endometrial cancer.
Differential diagnosis
In cases where uterine fibroids present with marked abdominal distension or amenorrhea, differential diagnosis with pregnancy is required. Therefore, in certain situations, physicians may request an HCG test and ultrasound before confirming the diagnosis.
Note: In postmenopausal women, the presence of large uterine fibroids accompanied by uterine bleeding requires endometrial biopsy to rule out the risk of endometrial cancer.
Treatment of uterine fibroids
Not all cases of uterine fibroids require treatment. According to gynecology specialists, small fibroids that show no signs of malignancy and cause no complications may simply be monitored without intervention. However, women are advised to undergo regular gynecological examinations to ensure timely detection and appropriate management should the fibroid enlarge.
According to the physicians, uterine fibroids are treated only when they have grown to a significant size, are suspected to be malignant, or have caused complications. Treatment options include medical management (pharmacotherapy) and surgical intervention.
Medical management
Medical treatment (pharmacotherapy) primarily aims to alleviate symptoms. This approach is effective only in certain patients, mainly those with small fibroids, slow disease progression, or those awaiting surgical intervention.
Some commonly prescribed medications include:
Oral contraceptives
Hormonal regulators
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Surgical management
Surgical treatment is mainly indicated for patients with large fibroids that have caused complications and require prompt removal. Surgical options include uterine artery embolization and myomectomy.
Uterine artery embolization: This treatment method reduces bleeding and halts fibroid growth by cutting off the blood supply to the tumor. However, it does not completely eradicate fibroids and may require repeat intervention after a certain period of time.
Gynecological surgery: This method is primarily applied to completely remove fibroids, including those located in anatomically challenging sites. In many cases, surgical removal of fibroids is considered the most optimal treatment option.
Subtotal hysterectomy: This procedure may be performed in cases of excessively large fibroids or when multiple fibroids are present.
Surgical methods for uterine fibroid removal
The primary and most definitive treatment for uterine fibroids is surgical removal. At present, reputable hospitals employ two approaches - open surgery and laparoscopic surgery depending on the location, size, and characteristics of the fibroid.
Open surgery is indicated for patients with large fibroids, those located in anatomically difficult sites, or in cases where malignancy is suspected and complete hysterectomy is required. However, this method has certain disadvantages, including prolonged recovery, extended postoperative pain, and significant blood loss.
Currently, laparoscopic surgery is widely applied and increasingly favored by women because it leaves minimal sequelae, reduces postoperative pain, and avoids visible scarring that may affect aesthetics. However, gynecological laparoscopic surgery requires physicians with specialized expertise and extensive experience. Therefore, women are advised to choose reputable and high-quality hospitals for treatment.
Depending on the patient’s health status, as well as the location and size of the fibroid, physicians may recommend different surgical options, which may include:
Myomectomy performed via abdominal, vaginal, or laparoscopic approach.
Subtotal hysterectomy: This procedure is primarily indicated for patients with very large submucosal fibroids and multiple fibroid nodules in the uterine body.
Subtotal hysterectomy: Indicated for patients with large fibroids located in the uterine isthmus, or in cases of malignancy requiring removal of the uterus to prevent cancer progression.
Surgical removal of uterine fibroids is indicated for large tumors or those at risk of causing complications that may affect women’s health.
Uterine fibroid surgery at Hong Ngoc General Hospital
The Department of Obstetrics and Gynecology at Hong Ngoc General Hospital has earned the trust of many women for gynecological consultations as well as for surgical treatment. Hong Ngoc General Hospital brings together a team of highly qualified physicians with many years of experience in obstetrics and gynecology, such as MSc, Specialist Level II Nguyen Khanh Toan (19 years of experience in obstetrics and gynecology, formerly at Thanh Nhan Hospital), and MSc, Specialist Level II Nguyen Van Xuyen (10 years of experience at the National Hospital of Obstetrics and Gynecology), among others.
Hong Ngoc General Hospital is equipped with state-of-the-art medical equipment imported directly from overseas. To date, the Department of Obstetrics and Gynecology at Hong Ngoc General Hospital has successfully performed numerous laparoscopic surgeries for large uterine fibroids.
During consultation and treatment at the hospital, women are carefully and thoroughly guided by medical staff and can benefit from high-quality services following the “hospital–hotel” model. In particular, patients are also able to discuss all their concerns with physicians in a private and confidential consultation room.
The information provided in this article by Hong Ngoc General Hospital is for reference only and should not replace professional medical diagnosis or treatment.
What are uterine fibroids and how do they affect the body? Let’s explore more details in the article below.
What are uterine fibroids?
Definition
Uterine fibroids (also known as uterine myomas or leiomyomas) are the most common benign pelvic tumors. They typically develop within the uterine muscle, are relatively round in shape, firm in consistency, and whitish in color.
Studies show that nearly 50% of women over the age of 35 develop uterine fibroids, and this figure rises to 70% among women over 45. In Vietnam, the prevalence may be even higher, as many women do not undergo regular gynecological examinations, and limited medical equipment in some healthcare facilities may fail to detect smaller fibroids.
No definitive research has identified the exact cause of uterine fibroids. However, several studies suggest that the condition is primarily associated with estrogen dominance, particularly in women of reproductive age.
Classification
Locations of uterine fibroids
Depending on their location, uterine fibroids can be classified into four types:
Subserosal fibroids: These develop on the outer surface of the uterus, with or without a stalk, and often compress surrounding organs, sometimes displacing the ovaries.
Intramural fibroids (located within the uterine muscle): These develop inside the uterine wall and may cause the uterus to enlarge and become distorted.
Submucosal fibroids: These tumors grow beneath the uterine lining, often with a stalk, and may lead to complications such as menorrhagia, endometrial necrosis, and the formation of intrauterine polyps.
Cervical fibroids: These develop in the posterior wall of the cervix or pelvic cavity, causing compression of the rectum and adjacent organs.
Symptoms of uterine fibroids
Uterine fibroids are benign gynecological tumors, and small fibroids often present without symptoms. They are usually detected during routine gynecological examinations or when patients experience issues related to infertility or subfertility.
For larger fibroids, typical symptoms may include:
Abnormal uterine bleeding outside of the menstrual period
Menorrhagia or prolonged bleeding
Menstrual disorders: extended periods, heavy menstrual flow, severe dysmenorrhea
Excessive vaginal discharge, sometimes foul-smelling
Pelvic pain, lower back pain, or discomfort radiating to the thighs
Urinary retention or bladder pressure
Constipation, painful or bloody bowel movements
Pain during sexual intercourse
Abdominal bloating or indigestion
A palpable mass in the lower abdomen, firm in consistency, with limited mobility
Uterine fibroids often cause recurrent abdominal pain.
If you experience any of the above abnormal symptoms, you should seek medical examination at a healthcare facility. To schedule gynecological surgery with our highly experienced obstetricians and gynecologists, please contact our hotline at 0886.621.046 or register via the form below.
How do uterine fibroids progress?
In most cases, uterine fibroids are benign and typically grow at a slow rate, with their development largely influenced by the patient’s hormonal levels. The majority of small fibroids do not cause complications and may even regress once a woman reaches menopause.
Uterine fibroids may also regress when their blood supply is interrupted. For this reason, uterine artery embolization has been applied as an effective treatment option for fibroids.
What causes uterine fibroids?
Although the exact cause has not been clearly identified, numerous studies suggest that uterine fibroids are associated with excessive production of reproductive hormones. This also explains why women of reproductive age are more susceptible to developing fibroids compared with those who have reached menopause.
In addition, genetic predisposition is considered one of the contributing factors that increase the risk of developing uterine fibroids. Several studies have demonstrated that women with a family history of fibroids particularly when the mother, sister, or daughter is affected may have up to a threefold higher risk of developing the condition.
Other contributing factors include early onset of menstruation, inadequate nutritional intake, and vitamin D deficiency.
Are uterine fibroids dangerous?
Large uterine fibroids may lead to serious complications.
Anemia: Submucosal uterine fibroids can cause menorrhagia and heavy menstrual bleeding. When this condition persists, patients may develop anemia, presenting with symptoms such as pallor, dizziness, or, in severe cases, circulatory collapse due to hemorrhagic shock.
Infection: Uterine fibroids may predispose patients to genital tract infections. In certain cases, torsion of a pedunculated fibroid can lead to necrosis of the tumor, posing a serious threat to health and potentially causing shock if not treated promptly.
Compression of adjacent organs: Large uterine fibroids may exert pressure on the ovaries and distort the uterine cavity. Depending on their size and location, fibroids can also compress surrounding structures, particularly the bladder and kidneys.
Pyelonephritis: In addition to causing lower back pain and pelvic discomfort, large uterine fibroids may compress the ureters, increasing the risk of hydronephrosis and pyelonephritis.
Torsion of a pedunculated fibroid: Subserosal fibroids with a stalk are prone to torsion, which can result in necrosis. In such cases, patients may experience sudden-onset abdominal pain that progressively worsens in intensity. They may also present with signs of shock and peritoneal irritation.
Large uterine fibroids can distort diagnostic results because they compress and alter the position of the ovaries. Many subserosal fibroids are often mistaken for ovarian cysts due to their excessive size.
Uterine fibroids generally have little impact on fertility; however, in cases where the fibroid is too large or located close to the endometrium, it may distort the uterine cavity and hinder embryo implantation.
During pregnancy, uterine fibroids may lead to several complications, including:
Compression and torsion of fibroids causing pain, necrosis, and infection
Obstructed labor due to abnormal fetal presentation, placenta previa, or placenta accreta associated with fibroids
Postpartum hemorrhage and uterine atony
Female infertility resulting from failure of embryo implantation in the uterine cavity
Uterine fibroids during pregnancy may lead to serious complications.
Diagnosis of uterine fibroids
There are several methods that physicians may use to diagnose uterine fibroids. Because small fibroids often do not present with typical symptoms, many patients are only incidentally diagnosed during routine health check-ups or gastrointestinal examinations.
Diagnosis based on clinical symptoms
Large uterine fibroids often present with typical symptoms such as menorrhagia, persistent abdominal pain, and abnormal abdominal enlargement. Physicians usually perform abdominal palpation below the umbilicus to assess the initial location and size of the fibroid.
In patients with uterine fibroids, vaginal examination may reveal an irregular, firm, and mobile uterus. In cases of torsion with necrosis, physicians may detect abnormal peritoneal signs.
Paraclinical diagnosis
Paraclinical diagnosis allows physicians to accurately determine the location, size, and characteristics of the fibroid.
Abdominal ultrasound: This is the most common diagnostic method. Ultrasound imaging enables physicians to identify fibroids and make appropriate treatment decisions.
Hysterography: In cases of large uterine fibroids, imaging often reveals uterine deformation with smooth margin defects.
Computed tomography (CT) and magnetic resonance imaging (MRI): These methods are indicated in cases of large fibroids that compress surrounding organs.
The diagnosis of uterine fibroids may also be made in relation to ovarian conditions such as ovarian tumors or endometrial cancer.
Differential diagnosis
In cases where uterine fibroids present with marked abdominal distension or amenorrhea, differential diagnosis with pregnancy is required. Therefore, in certain situations, physicians may request an HCG test and ultrasound before confirming the diagnosis.
Note: In postmenopausal women, the presence of large uterine fibroids accompanied by uterine bleeding requires endometrial biopsy to rule out the risk of endometrial cancer.
Treatment of uterine fibroids
Not all cases of uterine fibroids require treatment. According to gynecology specialists, small fibroids that show no signs of malignancy and cause no complications may simply be monitored without intervention. However, women are advised to undergo regular gynecological examinations to ensure timely detection and appropriate management should the fibroid enlarge.
According to the physicians, uterine fibroids are treated only when they have grown to a significant size, are suspected to be malignant, or have caused complications. Treatment options include medical management (pharmacotherapy) and surgical intervention.
Medical management
Medical treatment (pharmacotherapy) primarily aims to alleviate symptoms. This approach is effective only in certain patients, mainly those with small fibroids, slow disease progression, or those awaiting surgical intervention.
Some commonly prescribed medications include:
Oral contraceptives
Hormonal regulators
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Surgical management
Surgical treatment is mainly indicated for patients with large fibroids that have caused complications and require prompt removal. Surgical options include uterine artery embolization and myomectomy.
Uterine artery embolization: This treatment method reduces bleeding and halts fibroid growth by cutting off the blood supply to the tumor. However, it does not completely eradicate fibroids and may require repeat intervention after a certain period of time.
Gynecological surgery: This method is primarily applied to completely remove fibroids, including those located in anatomically challenging sites. In many cases, surgical removal of fibroids is considered the most optimal treatment option.
Subtotal hysterectomy: This procedure may be performed in cases of excessively large fibroids or when multiple fibroids are present.
Surgical methods for uterine fibroid removal
The primary and most definitive treatment for uterine fibroids is surgical removal. At present, reputable hospitals employ two approaches - open surgery and laparoscopic surgery depending on the location, size, and characteristics of the fibroid.
Open surgery is indicated for patients with large fibroids, those located in anatomically difficult sites, or in cases where malignancy is suspected and complete hysterectomy is required. However, this method has certain disadvantages, including prolonged recovery, extended postoperative pain, and significant blood loss.
Currently, laparoscopic surgery is widely applied and increasingly favored by women because it leaves minimal sequelae, reduces postoperative pain, and avoids visible scarring that may affect aesthetics. However, gynecological laparoscopic surgery requires physicians with specialized expertise and extensive experience. Therefore, women are advised to choose reputable and high-quality hospitals for treatment.
Depending on the patient’s health status, as well as the location and size of the fibroid, physicians may recommend different surgical options, which may include:
Myomectomy performed via abdominal, vaginal, or laparoscopic approach.
Subtotal hysterectomy: This procedure is primarily indicated for patients with very large submucosal fibroids and multiple fibroid nodules in the uterine body.
Subtotal hysterectomy: Indicated for patients with large fibroids located in the uterine isthmus, or in cases of malignancy requiring removal of the uterus to prevent cancer progression.
Surgical removal of uterine fibroids is indicated for large tumors or those at risk of causing complications that may affect women’s health.
Uterine fibroid surgery at Hong Ngoc General Hospital
The Department of Obstetrics and Gynecology at Hong Ngoc General Hospital has earned the trust of many women for gynecological consultations as well as for surgical treatment. Hong Ngoc General Hospital brings together a team of highly qualified physicians with many years of experience in obstetrics and gynecology, such as MSc, Specialist Level II Nguyen Khanh Toan (19 years of experience in obstetrics and gynecology, formerly at Thanh Nhan Hospital), and MSc, Specialist Level II Nguyen Van Xuyen (10 years of experience at the National Hospital of Obstetrics and Gynecology), among others.
Hong Ngoc General Hospital is equipped with state-of-the-art medical equipment imported directly from overseas. To date, the Department of Obstetrics and Gynecology at Hong Ngoc General Hospital has successfully performed numerous laparoscopic surgeries for large uterine fibroids.
During consultation and treatment at the hospital, women are carefully and thoroughly guided by medical staff and can benefit from high-quality services following the “hospital–hotel” model. In particular, patients are also able to discuss all their concerns with physicians in a private and confidential consultation room.
The information provided in this article by Hong Ngoc General Hospital is for reference only and should not replace professional medical diagnosis or treatment.
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