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Woman Health Talk GW

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Fibroids vary in number and size. You can have a single fibroid or more than one. Some of these growths are too small to see with the eyes. Others can grow to the size of a grapefruit or larger. A fibroid that gets very big can distort the inside and the outside of the uterus. In extreme cases, some fibroids grow large enough to fill the pelvis or stomach area. They can make a person look pregnant. Many people have uterine fibroids sometime during their lives. But you might not know you have them, because they often cause no symptoms. Your health care professional may just happen to find fibroids during a pelvic exam or pregnancy ultrasound. Causes The exact cause of uterine fibroids isn't clear. But these factors may play roles: Gene changes. Many fibroids contain changes in genes that differ from those in typical uterine muscle cells. Hormones. Two hormones called estrogen and progesterone cause the tissue the lines the inside of the uterus to thicken during each menstrual cycle to prepare for pregnancy. These hormones also seem to help fibroids grow. Fibroids contain more cells that estrogen and progesterone bind to than do typical uterine muscle cells. Fibroids tend to shrink after menopause due to a drop in hormone levels. Other growth factors. Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth. Extracellular matrix (ECM). This material makes cells stick together, like mortar between bricks. ECM is increased in fibroids and makes them fibrous. ECM also stores growth factors and causes biologic changes in the cells themselves. Symptoms Many people who have uterine fibroids don't have any symptoms. In those who do, symptoms can be influenced by the location, size and number of fibroids. The most common symptoms of uterine fibroids include: Heavy menstrual bleeding or painful periods. Longer or more frequent periods. Pelvic pressure or pain. Frequent urination or trouble urinating. Growing stomach area. Constipation. Pain in the stomach area

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