myomen

Myomen are benign tumors composed of smooth muscle cells and fibrous tissue that most commonly develop in the uterus. The term is used in some medical languages as the plural form of myoma; in English, uterine fibroids is the more typical name for fibroids located in the uterus. Myomas can also occur in other smooth muscle–containing organs, but uterine fibroids are by far the most common form.

Epidemiology and pathology: Fibroids are noncancerous growths that commonly arise during reproductive years and often shrink after menopause. They are estimated to affect up to about 70% of people by age 50, with higher rates among certain populations. Fibroids vary in size, number, and location, and are classified by position relative to the uterine wall: submucosal (protruding into the uterine cavity), intramural (within the muscular wall), subserosal (on the outer surface), and pedunculated (attached by a stalk).

Clinical presentation: Many fibroids cause no symptoms. When present, symptoms may include heavy or prolonged menstrual bleeding, pelvic pressure or pain, frequent urination or constipation, and swelling of the abdomen. Fibroids can contribute to infertility or complications during pregnancy in some cases.

Diagnosis and management: Initial assessment uses pelvic examination and imaging, most often transvaginal ultrasound; MRI may be used for detailed mapping. Treatment depends on symptoms, size, number, location, age, and fertility goals. Options range from observation to medical therapies (for symptom relief and shrinkage), to uterus-preserving surgery such as myomectomy, or definitive procedures such as hysterectomy. Other interventions include uterine artery embolization and, in selected cases, MR-guided focused ultrasound.

Prognosis: Fibroids may recur after treatment, especially in individuals with a predisposition. Symptoms often improve after menopause as fibroids tend to shrink.