Uterine Fibroid: Risk Factors and Therapeutic Interventions

Human infertility is strongly linked to fibroids, a medical disorder that is linked to the growth of uterine tumors. About 20-40% of women in their fertile years are reported to have this condition. When fibroids are present clinically, they can cause symptoms including heavy menstruation and organ pressure. Numerous epidemiologic studies have consistently established a link between parity and a diminished susceptibility to fibroids. Additionally, these studies have consistently revealed that women who have had pregnancies more recently are at a lower risk of developing fibroids compared to those who have had pregnancies in the distant past. Leiomyomas arise as a result of excessive proliferation of smooth muscle and connective tissue within the uterus. The expansion of these growths is perpetuated by the impact of ovarian steroids, namely estrogen and progesterone. A changed molecular environment in leiomyoma as opposed to the normal myometrium has also been demonstrated by several genomic and proteomic investigations. Analysis of global gene expression in uterine leiomyomas (ULMs) has shown that a significant number of genes are dysregulated, with many of them being implicated in essential cellular functions such as cell proliferation, differentiation, and extracellular matrix synthesis. While dysregulated genes can potentially function as effectors or promoters of ULMs growth, their primary role is likely to be secondary induction, indirectly contributing to the development of morbid and symptomatic ULMs. Additionally, when ROS levels are out of harmony with antioxidant levels, they have been linked to the development of serious and incapacitating reproductive issues like endometriosis, uterine fibroids, and infertility. Tranexamic acid and NSAIDs are the two most commonly used non-hormonal medications for bleeding and pain associated with uterine fibroids. This review shows that there is no correlation between the risk of developing uterine fibroids in female individuals and external factors like nutrition or environment, the major treatments for UFs continue to be surgical management by hysterectomy, myomectomy, uterine artery embolization (UAE).