Women's Health/ Uterine Leiomyomas

Question 1

What are uterine leiomyomas (fibroids)?

Answer 1

Benign tumors composed of uterine smooth muscle cells

Question 2

What are the three types of uterine leiomyomas?

Answer 2

1. Submucosal
2. Intramural
3. Subserosal

Question 3

Why is the incidence of fibroids higher in reproductive age women than in menopausal women?

Answer 3

Estrogen and progesterone increase fibroid growth

Question 4

What are the risk factors for uterine leiomyomas?

Answer 4

• nulliparity (pregnancy promotes fibroid regression)
• obesity (increased estrogen exposure),
• African descent

Question 5

How do OCPs affect uterine leiomyomas?

Answer 5

Combined OCPs reduce the relative risk of fibroids

Question 6

What are the three typical signs and symptoms associated with uterine leiomyomas?

Answer 6

1. Menorrhagia
2. Pelvic pressure and pain
3. Decreased fertility

Question 7

What bimanual examination findings suggest uterine leiomyomas?

Answer 7

Enlarged and irregular uterus

Question 8

What imaging test can be used to confirm the diagnosis of uterine leiomyomas?

Answer 8

Transvaginal ultrasound (95% sensitivity)

Question 9

Describe the medical treatments for uterine leiomyomas.

Answer 9

• NSAIDs for pain control
• GnRH agonists (eg, leuprorelin) to decrease bleeding and fibroid size
• androgens (eg, danazol) to decrease bleeding

Question 10

How do danazol and GnRH agonists work?

Answer 10

By decreasing pituitary gonadotropins

Question 11

Will medicinal therapy for uterine leiomyomas improve fertility?

Answer 11

No

Question 12

What are the surgical treatments for uterine leiomyomas?

Answer 12

Myomectomy or hysterectomy

Question 13

Can a myomectomy for uterine leiomyoma improve fertility ?

Answer 13

Yes

Question 14

What is the name for the interventional radiology procedure for leiomyomas that injects small particles into the uterine arteries to decrease blood flow and cause regression?

Answer 14

Uterine artery embolization