Uterine fibroids represent one of the leading causes of gynecological morbidity across the globe. They impact women’s health by causing abnormal uterine bleeding, pelvic pain, infertility, and sometimes complications during pregnancy. Globally, uterine fibroids affect up to 70–80% of women by the age of 50, making them the most common benign tumors in women of reproductive age¹. In India, the burden is increasingly recognized, with fibroids accounting for a significant number of gynecological admissions and surgeries². The financial burden due to loss of productivity and treatment costs is considerable, warranting more focused clinical attention³.

Fibroids are benign tumors composed of smooth muscle and connective tissue and originate from the myometrium. Their etiology is multifactorial, with genetic, hormonal, and environmental factors playing a role⁴. Types of fibroids include intramural, submucous, subserous, and pedunculated. The clinical presentation varies depending on the size, number, and location of fibroids, ranging from asymptomatic to severe symptoms such as AUB, bulk-related discomfort, and fertility issues⁵.

In the Indian context, although fibroids are frequently encountered, regional epidemiological and clinical data remain sparse. Cultural and socioeconomic barriers often delay diagnosis and treatment⁶. This study was therefore undertaken to examine the demographic pattern, clinical features, types and degeneration of fibroids, and therapeutic approaches in women presenting to a tertiary care hospital in India. The aim is to provide data that can contribute to evidence-based fibroid management strategies tailored to the Indian population.

Type of Study

This was an observational, cross-sectional study conducted in the Department of Obstetrics and Gynecology at a tertiary care hospital. The study aimed to investigate the demographic distribution, clinical features, types and degeneration of fibroids, and their management strategies among women presenting with uterine fibroids.

Setting

The study was conducted in a tertiary care teaching hospital with a high volume of outpatient and inpatient gynecology services.

Sample Size

A total of 50 women who were clinically and radiologically diagnosed with uterine fibroids were included in the study.

Inclusion Criteria

Women aged 20 years and above with a confirmed diagnosis of uterine fibroids on clinical examination and ultrasound were included. All participants provided informed consent to participate.

Exclusion Criteria

Patients with a history or clinical evidence of malignancy, those diagnosed with endometriosis or pelvic inflammatory disease, and pregnant women were excluded.

METHODOLOGY

All selected patients underwent a thorough clinical history, physical examination, and ultrasound scanning to determine the size, number, location, and degeneration of fibroids. Based on clinical findings and patient preference, management strategies included expectant, medical, or surgical treatment.

Statistical Analysis

Descriptive statistical methods were used to summarize the data. Frequencies and percentages were calculated for categorical variables such as age group, parity, type of fibroid, and treatment modality.

Table 1: Age Group

More than half of the patients (58%) belonged to the age group 41–60 years. 32% were aged 20–40 years, and only 10% were over 60.

Table 2: Parity

The majority of the patients (72%) were multiparous, followed by 22% primiparous and 8% nulliparous.

Table 3: Clinical Features

AUB was the most common symptom (72%), with 38% experiencing pressure symptoms and 10% reporting infertility.

Table 4: Type of Fibroid

Intramural fibroids were the most prevalent (72%), followed by submucous (14%), subserous (10%), and pedunculated (4%).

Table 5: Degeneration

Degenerative changes were observed in 42% of patients, while 58% showed no signs of degeneration.

Table 6: Management

Surgical management was the predominant approach (60%), followed by medical (28%) and expectant management (12%).

This study corroborates findings from previous literature indicating that fibroids are most common in women between 41–60 years of age. Baird et al. reported that up to 70% of women develop fibroids by age 50, with increased prevalence during perimenopausal years⁷. Our observation of high incidence among multiparous women reflects cumulative hormonal exposure and uterine remodeling post-pregnancy⁸.

Abnormal uterine bleeding was the most common clinical presentation in this study (72%), in agreement with Gupta et al., who found AUB in approximately 74% of fibroid cases⁹. Similarly, Laughlin-Tommaso et al. emphasized AUB as the predominant symptom influencing women’s quality of life and decision to seek treatment¹⁰.

Intramural fibroids were the most prevalent type (72%) in our study. This is consistent with global data, such as that from Buttram and Reiter, who identified intramural fibroids as the most common variant seen on histopathology and imaging¹¹. Submucous and subserous fibroids, though less common, are clinically significant due to their roles in abnormal bleeding and fertility issues¹².

Degeneration was noted in 42% of cases—higher than some international figures. This may reflect later presentation or missed opportunities for early intervention in our population. Degenerative changes are known to result in atypical symptoms and complicate surgical management¹³.

In terms of treatment, surgical management (60%) was the dominant approach, similar to what is reported in the ACOG Practice Bulletin, which cites surgery as the standard for moderate to severe symptomatic fibroids¹⁴. However, the significant proportion of women (28%) managed medically in our study reflects the growing role of pharmacological options like GnRH analogues, progestins, and antifibrinolytics¹⁵.

Despite being a single-center study with a limited sample size, these results contribute important insights into the clinical landscape of fibroid management in India and support the need for broader multi-center data collection.

This study highlights that uterine fibroids primarily affect women in their late reproductive to perimenopausal years, with AUB as the most common presenting feature. Intramural fibroids are most prevalent, and a significant portion show degenerative changes. Surgical management is still the most utilized treatment, though medical management is gaining traction. Further large-scale, multicentric studies are recommended to establish broader clinical guidelines and management protocols in the Indian context.

Limitations

This study was limited by a small sample size and its single-center nature, which may affect the generalizability of findings. Diagnostic confirmation was based primarily on imaging and intraoperative findings, without long-term follow-up.

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