Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be talking to you about fibroids.

And you can find written notes on this topic at zero definals.com slash fibroids

or in the gynecology section of the Zero-definals, Obs and Guine book.

So let's get straight into it.

Fibroids are benign tumours of the smooth muscle of the uterus.

They are also called uterine leomyomers.

And they're very common affecting 40 to 60% of women in the later reproductive years

and are more common in black women compared to other ethnic groups.

Fibroids are estrogen sensitive, meaning that they grow in response to estrogen.

Let's talk about the different types of fibroids.

Intramural means within the myometrium, the muscle of the uterus. As these types of fibroids

grow, they change the shape and distort the structure of the uterus. Sub-serosal means just below the outer layer of the uterus.

Sub-serosal means just below the outer layer of the uterus,

and these fibroids grow outwards and can become very large filling the abdominal cavity.

Sub-mucosal means just below the lining of the uterus, below the endometrium. And pedunculated means on a stalk.

So these are the four main types of fibroids, intramural, subsurrosal, subneucosal, and pedunculated fibroids.

Let's talk about the presentation. Fibroids are often asymptomatic. They can also present in several ways. Heavy menstrual bleeding or menorrhager is the most frequent presenting

symptom of fibroids. They can also have prolonged menstruation lasting more than seven days,

abdominal pain worse on menstruation, bloating or feeling full in the abdomen, urinary or bowel

symptoms due to the pelvic pressure or fullness, deep dysparanunia, which is pain during intercourse,

and also reduced fertility. Performing an abdominal and bimannual examination may reveal a palpable

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