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Causes
By Mayo Clinic staffUterine fibroids develop from the smooth muscular tissue of the uterus (myometrium). A single cell reproduces repeatedly, eventually creating a pale, firm, rubbery mass distinct from neighboring tissue.
Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. They can be single or multiple, in extreme cases expanding the uterus so much that it reaches the rib cage.
Doctors don't know the cause of uterine fibroids, but research and clinical experience point to several factors:
- Genetic alterations. Many fibroids contain alterations in genes that code for uterine muscle cells.
- Hormones. Estrogen and progesterone, two hormones that stimulate development of the uterine lining in preparation for pregnancy, appear to promote the growth of fibroids. Fibroids contain more estrogen and estrogen receptors than do normal uterine muscle cells.
- Other chemicals. Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth.
- Haney AF. Leiomyomata. In: Gibb RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:916.
- Baird DD, et al. High cumulative incidence of uterine leiomyoma in black and white women: Ultrasound evidence. American Journal of Obstetrics and Gynecology. 2003;188:100.
- Stewart EA. Epidemiology, clinical manifestations, diagnosis, and natural history of uterine leiomyomas. http://www.uptodate.com/home/index.html. Accessed April 22, 2009.
- The American College of Obstetrics and Gynecologists. Alternatives to hysterectomy in the management of leiomyomas. Obstetrics & Gynecology. 2008;112:387.
- Evans P, et al. Uterine fibroid tumors: Diagnosis and treatment. American Family Physician. 2007;75:1503.
- Uterine fibroids: Frequently asked questions. The National Women's Health Information Center. http://womenshealth.gov/faq/uterine-fibroids.cfm. Accessed April 22, 2009.
- Uterine fibroids. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp074.cfm. Accessed April 22, 2009.
- Stewart EA. Pathogenesis of uterine leiomyomas. http://www.uptodate.com/home/index.html. Accessed April 22, 2009.
- Management of uterine fibroids: An update of the evidence. Rockville, Md.: Agency for Healthcare Research and Quality. http://www.ahrq.gov/downloads/pub/evidence/pdf/uterupdate/uterup.pdf. Accessed April 29, 2009.
- Stewart EA. Overview of treatment of uterine leiomyomas. http://www.uptodate.com/home/index.html. Accessed April 22, 2009.
- Marshall LM, et al. A prospective study of reproductive factors and oral contraceptive use in relation to the risk of uterine leiomyomata. Fertility and Sterility. 1998;70:432.
- Faerstein E, et al. Risk factors for uterine leiomyoma: A practice-based case control study. I. African-American heritage, reproductive history, body size, and smoking. American Journal of Epidemiology. 2001;153:1.
- Chiaffarino F, et al. Use of oral contraceptives and uterine fibroids: Results from a case-control study. British Journal of Obstetrics and Gynaecology. 1999;106:857.
- Stewart EA (expert opinion). Mayo Clinic, Rochester, Minn. May 13, 2009.
