Definition

Small lumps, generally in the inner lining of the uterus, although they can be anywhere - even on the eye! Probably...

Epidemiology

Mostly in the 40-50 age range. About 10% of women suffer from them, although they are found in 25% of women with abnormal bleeding.

Pathophysiology

No-one knows, but there seems to be a link with oestrogen levels; they tend to grow in women with high oestrogen levels. They are prone to bleeding, perhaps because they are often made of endometrium. They can occur anywhere, mostly in the uterus, but can be vaginal or cervical too.

Risk Factors

• Being on HRT, or anything that increases oestrogen levels
• Obesity
• High blood pressure
• Cervical polyps

Clinical Features

Usually none. If they have bleeding problems, it's worth checking for these

Investigations

• Transvaginal ultrasound
• Hysteroscopy
• Curettage

Management

• Surgical removal
• Diathermy (burn them off)
• If there are any cancerous cells, hysterectomy.

Prognosis

1. In the vast majority of cases, a long and happy life.
2. To those with extra bleeding, after diathermy, there will often be recurrence.
3. To those with cancer and hysterectomy, see the pages on endometrial cancer and cervical cancer.