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Uterine fibroids

Última revisión: 18 Aug 2025
Última actualización: 21 Jun 2024

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • asymptomatic
  • heavy menstrual bleeding
  • irregular firm central pelvic mass
Todos los datos

Otros factores de diagnóstico

  • pelvic pain
  • pelvic pressure
  • dysmenorrhea
  • bloating
  • fatigue and loss of productivity in working
  • infertility
  • urinary complaints
  • constipation
  • enlarged uterus (regular contour)
  • dyspareunia
Todos los datos

Factores de riesgo

  • increased patient weight
  • age in the 40s
  • black ethnicity
  • hypovitaminosis of vitamin D
  • hypertension
  • early menarche (under 10 years)
  • use of oral contraceptives (if started before age 16 years)
  • nulliparity
  • younger age at first birth
  • poor vitamin A intake
  • dietary intake high in beef and other red meat
  • sex hormone exposure
  • menstrual history
  • smoking
  • alcohol consumption
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • ultrasound
  • endometrial biopsy
Todos los datos

Pruebas diagnósticas que deben considerarse

  • sonohysterography
  • hysteroscopy
  • MRI
  • laparoscopy
Todos los datos

Pruebas emergentes

  • sonoelastography
  • MR elastography

Algoritmo de tratamiento

En curso

fertility desired

fertility not desired

Colaboradores

Autores

Ayman Al-Hendy, MD PhD FRCSC FACOG CCRP

Professor (visiting) and Director

Translational Research

Department of Obstetrics and Gynecology

University of Illinois

Chicago

IL

Divulgaciones

AAH serves on the external advisory board of Bayer, AbbVie, Myovant, Pfizer, ObsEva and Allergan, and has received research funding from the National Institutes of Health. AAH is an author of references cited in this topic.

Obianuju Sandra Madueke-Laveaux, MD MPH

Assistant Professor of Obstetrics and Gynecology

Department of Obstetrics and Gynecology

University of Illinois

Chicago

IL

Divulgaciones

OSML declares that she has no competing interests. OSML is an author of references cited in this topic.

Vuslat Lale Bakir, MD

Assistant Professor of Obstetrics and Gynecology

Department of Obstetrics and Gynecology

Haseki Training and Research Hospital

Health Sciences University

Istanbul

Turkey

Divulgaciones

VLB declares that she has no competing interests.

Agradecimientos

Dr Al-Hendy, Dr Madueke-Laveaux, and Dr Bakir would like to gratefully acknowledge Dr Mohamed Mitwally, Dr Intisar Elnahhas, and Dr Robert J. Fischer, the previous contributors to this topic.

Disclosures

MM, IE, and RJF declare that they have no competing interests.

Peer reviewers

Everett Magann, MD

Chairman

Department of Obstetrics and Gynecology

Naval Medical Center

Portsmouth

VA

Disclosures

EM declares that he has no competing interests.

Amy Niederhauser, MD

Doctor

Department of Obstetrics and Gynecology

Naval Medical Center

Portsmouth

VA

Disclosures

AN declares that she has no competing interests.

Adam Magos, BSc, MB, BS, MD, FRCOG

Consultant Gynaecologist

University Department of Obstetrics and Gynaecology

Royal Free Hospital

London

UK

Disclosures

AM declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Stewart EA, Cookson CL, Gandolfo RA, et al. Epidemiology of uterine fibroids: a systematic review. BJOG. 2017 Sep;124(10):1501-12.Full text  Abstract

Marshall LM, Spiegelman D, Barbieri RL, et al. Variation in the incidence of uterine leiomyoma among premenopausal women by age and race. Obstet Gynecol. 1997 Dec;90(6):967-73. Abstract

American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 228: management of symptomatic uterine leiomyomas. Jun 2021 [internet publication].Full text

Wise LA, Laughlin-Tommaso SK. Epidemiology of uterine fibroids: from menarche to menopause. Clin Obstet Gynecol. 2016 Mar;59(1):2-24.Full text  Abstract

American College of Radiology. ACR Appropriateness Criteria®. Fibroids. 2022 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Uterine fibroids images
  • Differentials

    • Adenomyosis
    • Endometrial polyp
    • Endometrial hyperplasia
    More Differentials
  • Guidelines

    • ACR appropriateness criteria: clinically suspected adnexal mass
    • ACR appropriateness criteria: fibroids
    More Guidelines
  • Patient information

    Fibroids

    Fibroids: questions to ask your doctor

    More Patient information
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