Uterine fibroids (UFs), also known as uterine leiomyomas, are benign smooth muscle neoplasms of the uterus that affect women of reproductive age.1-3 They may be asymptomatic or cause a range of severe and chronic symptoms. American Journal of Obstetrics and Gynecology. 3 Incidence increases with age from menarche to perimenopausal ages. USA.gov. EAS, CC, RAG and RSR contributed to the design of the study, and the analysis and interpretation of the data. For consistency, one person made final decisions for screening the manuscripts and data extraction. The most common presenting symptom is heavy menstrual bleeding, which can lead to anaemia, and fatigue and painful periods.4-9 Other UF symptoms include non‐cyclic pain, abdominal protuberance, painful intercourse or pelvic pressure, and bladder or bowel dysfunction resulting in urinary incontinence or retention, pain or constipation.4-10 UFs may also be associated with reproductive problems, including impaired fertility, pregnancy complications and loss, and adverse obstetric outcomes.11-18 UFs are one of the leading causes of hospitalisations for gynaecological disorders, and are the most frequent reason for hysterectomy in the USA.19-24, Uterine fibroids are the most common neoplasm affecting women, and it has been postulated that they occur in over 70% of women by the onset of menopause.25-27 They are estimated to be clinically apparent in 25% of women of reproductive age and cause symptoms severe enough in approximately 25% of women with UFs to require treatment.4, 28, 29 The frequency of the condition is, however, likely to be underestimated because in many women it is asymptomatic, or symptoms develop insidiously, and therefore remains undiagnosed.30, 31 The unknown extent and impact of undetected UFs bias the epidemiological data and evidence on associated factors to reflect severe disease.32. This finding was due, perhaps in part, to secular trends of decreasing hysterectomies. 2020 Jul-Aug;12(4):176-181. doi: 10.4103/ijt.ijt_37_20. Use the link below to share a full-text version of this article with your friends and colleagues. Oxytocin selectively reduces blood flow in uterine fibroids without an effect on myometrial blood flow: a dynamic contrast enhanced MRI evaluation. prospective or retrospective); patient group (e.g. Intrauterine Instillation of Tranexamic Acid in Hysteroscopic Myomectomy: A double blind Placebo Controlled Parallel Groups Randomized Clinical Trial. Elguindy A, Hemeda H, Shawky ME, Elsenity M, Elsayed MA, Fahim A, Afifi K, Nawara M. BMC Womens Health. For some, this may be a sign of uterine fibroids, or myomas or leiyomyomas, which are noncancerous growths that develop in or around the uterus. Owing to the heterogeneity of the data extracted (e.g. Time since last birth was reported to increase UF risk in two registry studies.51, 60 In some analyses, however, this risk was not adjusted for age and may therefore be partly due to the effect of increasing age. African and Black Diaspora: An International Journal. High-quality prospective observational data are needed to improve our understanding of UF epidemiology, and thus its aetiology and optimal management. These include age, race, endogenous and exogenous hormonal factors, obesity, uterine infection, and lifestyle (diet, caffeine and alcohol consumption, physical activity, stress, and smoking). The association between chronic psychological stress and uterine fibroids risk: A meta‐analysis of observational studies. Correlation of low serum vitamin-D with uterine leiomyoma: a systematic review and meta-analysis. [ 1, 2] Despite the … 4 Both estrogen and … Role of Hormones in Common Benign Uterine Lesions: Endometrial Polyps, Leiomyomas, and Adenomyosis. Uterine fibroids (myomas or leiyomymas) are benign, monoclonal tumors of the smooth muscle cells found in the human uterus. J Obstet Gynaecol Can. Background: Uterine fibroids (UFs) are the most common neoplasm affecting women that can cause significant morbidity and may adversely impact fertility. Nomogram to predict postpartum hemorrhage in cesarean delivery for women with scarred uterus: A retrospective cohort study in China. Intra‐ and Inter‐Rater Agreement Describing Myometrial Lesions Using Morphologic Uterus Sonographic Assessment: A Pilot Study. Vilos GA, Allaire C, Laberge PY, Leyland N; SPECIAL CONTRIBUTORS. Selection bias was present in most of the included studies, with study populations being randomly selected in only five studies. Efficacy and safety of vilaprisan in women with uterine fibroids: Data from the phase 2b randomized controlled trial ASTEROID 2. Treatment of patients with uterine myoma in the period of menopausal transition. Management of Cesarean Myomectomy in a Patient with Multiple Fibroids and an Obstructing Lower Uterine Segment Fibroid. In at least one third of the studies (≥35%; ≥21/60), the study population was mixed, consisting of both participants with symptomatic UFs and those with asymptomatic UFs. NIH Archives of Insect Biochemistry and Physiology. The true incidence and prevalence of uterine fibroids in the general female population are unknown because the condition is frequently asymptomatic and therefore not identified. Int J Trichology. Familial predisposition to uterine leiomyoma: searching for genetic factors that increase the risk of leyomyoma development. Ulipristal Acetate Before Hysteroscopic Myomectomy. Most women have no symptoms while others may have painful or heavy periods. Best Pract Res Clin Obstet Gynaecol. For each study, we extracted data on: study period; study type (e.g. Best Pract Res Clin Obstet Gynaecol. Myomatous erythrocytosis syndrome: A case series, www.calteachersstudy.org/WebsiteGraphs.html#IDX2, In women with low BMI, current smoker vs never. Data on the incidence of UFs reported in four large US registry studies (N, 9910–1 795 473; median, 42 098) ranged widely, from 217 cases per 100 000 women‐years in the California Teachers Study to 3745 cases per 100 000 women‐years in the Black Women's Health Study (Figure 1A).44, 48-70 The incidence reported from the Black Women's Health Study, in which all participants were black, was consistently higher than that in the California Teachers Study and the Nurses’ Health Study II (845–1348 cases per 100 000 women‐years), in which 3% and 1% of participants were black, respectively.44, 48-70 In the Nurses’ Health Study II, the incidence of UFs among Hispanic, Asian and white women was similar, but the incidence in black women was approximately three times higher than in the other populations (Figure 1B).44 This pattern was unchanged by the method of diagnosis of UF. survey respondents), and were gynaecological patients in nearly one third of the studies (30%; 18/60). Tumors of the Female Reproductive Organs. If large enough, they may push on the bladder causing a frequent need to … Characteristics associated with prolonged length of stay after myomectomy for uterine fibroids. Risk ratios for developing uterine fibroids (UFs) by: (A) race and ethnicity in four registry studies; BJOG: An International Journal of Obstetrics & Gynaecology, International Journal of Gynecology & Obstetrics, Acta Obstetricia et Gynecologica Scandinavica, Australian and New Zealand Journal of Obstetrics and Gynaecology, Journal of Obstetrics and Gynaecology Research, I have read and accept the Wiley Online Library Terms and Conditions of Use, Smooth muscle, endometrial stromal, and mixed Mullerian tumors of the uterus, Uterine myomas in adolescents: case reports and a review of the literature, Uterine leiomyomata: etiology, symptomatology, and management, Uterine leiomyomas. Characterization of the role of Activator Protein 1 signaling pathway on extracellular matrix deposition in uterine leiomyoma. Mass spectrometry imaging: An emerging technology for the analysis of metabolites in insects. The risk factor with the greatest magnitude was age, which was found to increase the risk of UFs by up to approximately tenfold. COVID-19 is an emerging, rapidly evolving situation. J Womens Health (Larchmt). Journal of Gynecology Obstetrics and Human Reproduction. T1 - Epidemiology of uterine fibroids. The important protective factors were oral or injectable contraceptive use, smoking in women with low BMI and parity. Benign metastasizing uterine leiomyoma with lung metastasis: problems of diagnosis and treatment. 2021 Jan 1;20(1):1. doi: 10.1186/s12939-020-01327-9. These tumors, commonly known as fibroids, affect women mainly during their reproductive years and are diagnosed in up to 70% of white women and more than 80% of women of African ancestry during their lifetime. The reported incidences of UFs also ranged widely (217–3745 cases per 100 000 women‐years; Figure 1A).48, 66 Only one study reported solely on women with asymptomatic UFs,47 and at least one third of studies described mixed populations of women with symptomatic and asymptomatic UFs. Working off-campus? A systematic search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) statement.42 MEDLINE and Embase were searched to identify studies related to the epidemiology of UFs, without selecting for symptomatic or asymptomatic UFs, published in English between 1 January 1995 and 22 April 2015 (Figure S1). This study did not require ethical approval as the data used have been published previously. The factor with the greatest protective effect was parity: giving birth was associated with a fivefold reduction in risk of UFs requiring surgical treatment than nulliparity in a single‐centre study.79 The effect of parity on UF prevalence may result from changes in hormone exposure due to pregnancy and decreased menstrual cycling, or from myometrial ischaemia involution and remodelling during and after parturition.40, 41, 60, 89-93 The role of parity in UF risk is, however, difficult to evaluate due to possible confounding effects such as the negative impact of UFs on fertility. Uterine fibroids (leiomyomas) are common benign smooth muscle tumors [].Fibroids may develop anywhere within the muscular wall of the uterus, including submucosal, intramural, or subserosal positions ().For patients with a pedunculated submucosal fibroid that is contained within the uterine cavity, removal is typically performed using hysteroscopy. Independent. Herein, we review the epidemiology of UL from published studies to date. Topics ranged from molecular techniques for mapping uterine fibroid cells to the use of green tea extract as a potential treatment. Eleven other factors affected UF risk to a magnitude similar to or greater than race. The incidence of … Topics. Study and reporting quality was good in all the registry studies and most of the ‘other observational’ studies, but poorer in over two thirds of the single‐centre studies. Additionally, the variety of diagnostic methods and data sources used may have resulted in detection bias in some studies (Table S3). Childbirth and myoma treatment by uterine artery occlusion: do they share a common biology? Uterine Fibroids and Hypertension: Steps Toward Understanding the Link. Mayo Clinic researchers are involved in all areas of uterine fibroid research. Following screening of the full text, 60 publications were included [16 single‐centre studies, 37 registry studies (including 16 reporting on the Black Women's Health Study and nine on the Nurses’ Health Study II) and seven ‘other observational’ studies]. The Prevalence of Uterine Fibroids in African American Women with Hemoglobin SS Sickle Cell Disease as Determined by Pelvic Magnetic Resonance Imaging. Narasimman M, De Bedout V, Castillo DE, Miteva MI. Incidence of Gynecologic Cancers in Women after Uterine Artery Embolization. In our systematic review of the epidemiology of UFs, we found wide variations in both the methodology and quality of the 60 selected studies, and also in the epidemiological data they report, with UF incidence ranging between 217 and 3745 cases per 100 000 women‐years and UF prevalence ranging between 4.5% and 68.6%. © 2017 IPAS. Immunological and clinical risk factors differ between recurrent implantation failure and recurrent miscarriage. Perioperative nonhormonal pharmacological interventions for bleeding reduction during open and minimally invasive myomectomy: a systematic review and network meta-analysis. Choose one . Current Opinion in Obstetrics & Gynecology. Studies of genetics relating to risk of UFs were beyond the scope of the current review and were also excluded. This is the first systematic review of the epidemiology of UFs to analyse the incidence and prevalence of UFs and evaluate the risk factors associated with the condition, and to identify those risk factors with the largest effects. There was a large variation in the data on UF prevalence, ranging from 4.5% to 68.6% (Figure 2),9 and no consistent associations between prevalence and country/region, study methodology or population were seen across the studies. Age, premenopausal state, hypertension, family history, time since last birth, and food additive and soybean milk consumption increased UF risk; use of oral contraceptives or the injectable contraceptive depot medroxyprogesterone acetate, smoking in women with low body mass index and parity reduced UF risk. | Learn more. Laparoscopic management of a degenerating cystic leiomyoma imitating an ovarian cyst: A case report. Premenopausal state was associated with a significantly higher UF risk than postmenopausal state, reflecting the role of female gonadal steroid hormones in stimulating UF growth.26, 48, 75, 88 UFs may, however, be under‐reported by postmenopausal women because they do not experience menstruation‐associated symptoms. Uterine fibroids are common benign neoplasms, with a higher prevalence in older women and in those of African descent. The Journal of Clinical Endocrinology & Metabolism. Office-based Approach to Evaluation and Management of Abnormal Uterine Bleeding. Package inserts of oral contraceptives in Italy, Prevalence of uterine leiomyomas in the first trimester of pregnancy: an ultrasound‐screening study, Hair relaxer use and risk of uterine leiomyomata in African‐American women, Cervical neoplasia‐related factors and decreased prevalence of uterine fibroids among a cohort of African American women, Heritability and risk factors of uterine fibroids – the Finnish Twin Cohort study, The burden of uterine fibroids in five European countries, Prevalence of self‐reported medical diagnosis of uterine leiomyomas in a Brazilian population: demographic and socioeconomic patterns in the pro‐saude study, Uterine fibroids: a ten‐year clinical review in Ilorin, Nigeria, Management of uterine fibroids in Enugu, Nigeria, Myomectomy at the Federal Medical Centre Gombe, Uterine leiomyoma at the surgical department of the Teaching Hospital of Dakar, Report of 140 cases operated in two years, The relationship between thyroid nodules and uterine fibroids, Association of intakes of fat, dietary fibre, soya isoflavones and alcohol with uterine fibroids in Japanese women, Population‐based case‐control study on risk factors of uterine myomas, Incidence and characteristics of uterine leiomyomas with FDG uptake, Self‐report versus ultrasound measurement of uterine fibroid status, Association of hypertension, hyperglycemia, hyperlipemia with the risk of uterine leiomyomata for female staffs in railway system, Epidemiological data for uterine fibroids in France in 2010‐2012 in medical center – analysis from the French DRG‐based information system (PMSI). 3'RNA Sequencing Accurately Classifies Formalin-Fixed Paraffin-Embedded Uterine Leiomyomas. Journal of Assisted Reproduction and Genetics. The publications retrieved were divided into five categories: registries; single‐centre studies; ‘other observational’ studies (such as community‐based investigations conducted in more than one centre); hysterectomy studies; and pregnancy studies. ing history. … This disease has a profound impact on health care delivery and costs worldwide. Search strategy: Yonsei Med J. Developing risk models for multicenter data using standard logistic regression produced suboptimal predictions: A simulation study. Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. 2020 Dec;61(12):1054-1059. doi: 10.3349/ymj.2020.61.12.1054. Epidemiology and Risk Factors of Uterine Fibroids. This analysis supports the finding that black women are at greater risk of UFs than white women. Objectives: To examine UF epidemiology … Information on the 60 publications from which data were extracted is presented in Table S1. This evaluation reveals the important risk factors to be age, premenopausal state, hypertension, family history, time since last birth, and food additive and soybean milk consumption. over 60 years old, UF risk declined.48, 75 A similar retrospective review of ultrasound records in the UK found that women aged over 40 years were four times more likely to have UFs than those under the age of 40 years (Table 1).76, A family history of fibroids was also shown to increase UF risk in a multicentre case–control study of hospitalised women in Thailand. 2008 Aug;22(4):571-88. doi: 10.1016/j.bpobgyn.2008.04.002. Over half the studies relied on self‐report and may therefore have been affected by recall bias. Tissue Extraction in Gynecologic Surgery. Four women, for women: Caribbean diaspora artists reimag(in)ing the fine art canon. Validation of a menstrual pictogram and a daily bleeding diary for assessment of uterine fibroid treatment efficacy in clinical studies. 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