Clinical Features and Epidemiology of Uterine Fibroids

Introduction to Uterine Fibroids

Uterine fibroids are the most common benign neoplasm of the uterus, composed of smooth muscle cells embedded in an extracellular matrix of collagen, fibronectin, and proteoglycan, with menorrhagia being the most frequent symptom, often resulting in iron deficiency anemia, according to the American College of Radiology 1
The American College of Radiology recommends considering uterine fibroids in women presenting with dysmenorrhea, pelvic pain and pressure, urinary urgency and frequency, constipation, and potential impairment of fertility or obstetric complications 1

The prevalence of uterine fibroids varies significantly by race, with Black women having an estimated incidence exceeding 80% by age 50, whereas White women have an incidence approaching 70%, as reported by the American College of Radiology 1
Black women are more likely to develop clinically significant disease at an earlier age and experience racial disparities, including higher rates of surgical intervention and lower rates of minimally invasive approaches, according to the American College of Radiology 1
Risk factors for uterine fibroids include age, nulliparity, race, family history, obesity, and body mass index, as identified by the American College of Radiology 1

The total estimated societal costs of uterine fibroids range from $5.9 to $34.4 billion annually, with lost work hours accounting for the largest proportion of these costs, as estimated by the American College of Radiology 1

Menorrhagia is the most frequent symptom of uterine fibroids, often resulting in iron deficiency anemia, and may present as prolonged menstrual bleeding or intermenstrual bleeding, according to the American College of Radiology 1 and Praxis Medical Insights 2
The American College of Radiology recommends physical examination, including abdominal examination, speculum examination, and bimanual pelvic evaluation, to characterize the location, shape, and mobility of the fibroids 3
Suspect fibroid degeneration if a patient presents with severe sudden-onset pain, fever, nausea, and leukocytosis, requiring supportive care with NSAIDs and observation, as recommended by Praxis Medical Insights 2

Rapid growth of fibroids can occasionally indicate malignant transformation, although this is rare and should prompt urgent referral, as warned by Praxis Medical Insights 4