D25.2

Clinical Causes: Hormonal factors, especially estrogen and progesterone, which promote the growth of fibroids. Genetic predisposition, with a family history increasing risk. Ethnicity, with higher prevalence observed in women of African descent. Obesity, which can influence hormone levels. Age, particularly women aged 30 to 50, as fibroids tend to develop during the reproductive years. Certain lifestyle factors, such as diet and stress, may also play a role.

Key Symptoms: Pelvic pressure or pain, especially if the fibroid enlarges. Feeling of fullness or heaviness in the lower abdomen. Menstrual irregularities, including heavier or prolonged periods. Lower backache or leg pain in some cases. Frequent urination due to pressure on the bladder. Constipation if the fibroid presses against the rectum. Many women with subserosal leiomyomas experience no symptoms and may only discover them during routine examinations.

Diagnosis Path: Diagnosis often involves a combination of medical history, physical examination, and imaging tests. An ultrasound is the most common initial method to visualize uterine fibroids and determine their size and location. In some cases, MRI or hysterosonography may be utilized for more detailed assessment. A healthcare provider may also perform a pelvic exam to identify or evaluate the size and shape of the uterus.

Treatment Protocols: Treatment options depend on the size, number, symptoms, and the patient's reproductive plans. They include: - **Observation:** Monitoring with regular check-ups if the fibroid is small and asymptomatic. - **Medications:** Such as hormone therapy to shrink fibroids or manage symptoms, including gonadotropin-releasing hormone (GnRH) agonists. - **Minimally invasive procedures:** Including uterine artery embolization, which cuts off blood supply to the fibroid. - **Surgical options:** Myomectomy to remove fibroids while preserving the uterus or hysterectomy if removal of the entire uterus is appropriate. - **Alternative therapies:** Lifestyle modifications and herbal treatments are sometimes considered, but their effectiveness varies. It is essential to consult healthcare professionals to determine the most suitable approach based on individual circumstances.