Uterine Fibroids and Related Conditions

Also known as:
- Fibromyomas
- Leiomyomas
- Myomas
Definition:
- Noncancerous growths of the uterus that often appear during childbearing years.
Prevalence:
- Three out of four women will have uterine fibroids.
- Only one out of four women experience symptoms.
Symptoms:
- Menorrhagia: Abnormally long, heavy menstrual bleeding.
- Metrorrhagia: Irregular bleeding between menstrual periods.
- Polymenorrhea: Occurs when periods are too frequent (more often than every 21 days) and no ovulation is observed in the cycle.
- Pelvic pressure: Symptoms can include low-back pain, urinary incontinence, and frequency.
Growth Characteristics:
- Uterine fibroids arise in the myometrium and produce a pale, firm, rubbery mass.
- They can vary significantly in size, from small seedlings to large masses that distort the uterus.
- Fibroids can protrude into the uterine cavity, causing symptoms like menorrhagia, or project outward, which may press on the bladder or rectum.

Dysfunctional Uterine Bleeding (DUB):
- A term applied when no specific cause can be determined for a patient's menorrhagia.
Endometrial Polyps:
- Benign extensions of the endometrium that can result in irregular and heavy bleeding.
- Surgical removal may be accomplished via hysteroscopy or dilation and curettage (D&C).

Definition:
- Menopause is diagnosed when a woman has not menstruated for a full year and is not pregnant, marking the phase referred to as "the change of life."
Biological Process:
- This is a natural process associated with reproductive aging, where levels of estrogen and progesterone decline often beginning around age 40.
- Most women experience cessation of menstruation between ages 45 and 55.
Implications of Hormonal Changes:
- The significant reduction in estrogen and progesterone prevents the endometrial lining of the uterus from growing and being shed during menstruation.
- Without these hormones, the uterus, vagina, and breasts may atrophy, and there may be an increased loss of bone mass.
- Fluctuations in blood vessel activity from hormone changes can lead to hot flashes.

Overview:
- Endometrial cancer is the fourth most common cancer among women, following lung, breast, and colon cancer.
Statistics:
- Approximately 40,000 new cases are diagnosed annually, primarily in women aged 60 to 70.
Symptoms:
- The most common symptom is vaginal bleeding occurring after menopause.
- Other symptoms may include vaginal discharge, pelvic pain, and dyspareunia (painful intercourse).
Risk Factors:
- Elevated levels of estrogen are believed to pose a risk for developing endometrial cancer.

Prevalence:
- Cervical cancer is less common than endometrial cancer, with 50% of cases occurring between the ages of 35 and 55.
- In 2020, it was estimated that 13,800 cases of invasive cervical cancer will be diagnosed in the United States.
Symptoms:
- Early-stage cervical cancer typically presents no noticeable symptoms, which can make it challenging to detect without screening (routine Pap tests).
Precancerous Stage:
- In its precancerous state, abnormal cells known as dysplasia may be limited to the outer layer of the cervix.
Human Papilloma Virus (HPV):
- Thirteen types of HPV have been identified as capable of converting dysplastic cells into cancer cells.
- Vaccines have been developed to provide immunity against two of the most prevalent types of HPV.

Definition:
- Salpingitis refers to inflammation of the uterine (fallopian) tubes, often associated with pelvic inflammatory disease (PID).
Causes:
- Typically results from a bacterial infection, which often originates from a sexually transmitted disease (STD) that spreads from the vagina through the cervix and uterus.
Symptoms:
- Clinical manifestations may include:
- Lower abdominal pain
- Fever
- Vaginal discharge