Epidemiology of Uterine Myomas: A Review

Abstract

Myomas are the most common benign tumors of the genital organs in women of childbearing age, causing significant morbidity and impairing their quality of life. In our investigation, we have reviewed the epidemiological data related to the development of myomas in order to homogenize the current data. Therefore, a MEDLINE and PubMed search, for the years 1990-2013, was conducted using a combination of keywords, such as "myoma," "leiomyoma," "fibroids," "myomectomy," "lifestyle," "cigarette," "alcohol," "vitamins," "diet," and "hysterectomy". Randomized controlled studies were selected based upon the authors' estimation. Peer-reviewed articles examining myomas were sorted by their relevance and included in this research. Additional articles were also identified from the references of the retrieved papers and included according to authors' estimation. Many epidemiologic factors are linked to the development of myomas; however, many are not yet fully understood. These factors include age, race, heritage, reproductive factors, sex hormones, obesity, lifestyle (diet, caffeine and alcohol consumption, smoking, physical activity and stress), environmental and other influences, such as hypertension and infection. Some of the epidemiological data is conflicting. Thus, more research is needed to understand all the risk factors that contribute to myoma formation and how they exactly influence their onset and growth.

Keywords: Fibroid; Leiomyoma; Uterine Myoma.

Fig.1

A composed image in clockwise fashion showing: A. Transvaginal transversal scan showing a posterior corporal myoma, B. An eco Doppler transvaginal scan detecting the myoma pseudocapsule as a "ring of fire", C. A T2 pelvic MRI showing a posterior corporal myoma enhanced by a white ring, D. Laparoscopic image showing the myoma enucleation surrounded by pseudocapsule. The arrows indicate the myoma pseudocapsule, as a fibrovascular connective network surrounding myoma and E. A laparotomic image showing a large uterine myoma surrounded by pseudocapsule during enucleating from myometrium.