title: Symptoms of uterine myomas: data of an epidemiological study in Germany.
abstract: OBJECTIVE
  Currently, no reliable data are available concerning the type and frequency of symptoms in premenopausal women with uterine myomas.
  
  
  METHODS
  2296 women were examined by means of vaginal ultrasound for the presence of myomas in seven gynaecological outpatient departments in Germany. From this population, 1314 premenopausal women between the ages of 30 and 55 years were evaluated to determine the type and frequency of myoma-related symptoms and their relationship to anamnestic factors, and the number, size, and location of the myomas. Standardised questionnaires were used to record the symptoms.
  
  
  RESULTS
  Prevalence: In almost every second premenopausal woman (n = 639; 48.6%), uterine myomas were diagnosed. The frequency of myomas increased continuously with age and was highest in women between 46 and 50 years (65.2%). Age itself was found to be the main risk factor for the presence of myomas (p < 0.001).
  
  
  METHODS
  54.3% (n = 347) of the women suffered from myoma-related symptoms. The four main symptoms were identified as: Heavy menstrual bleeding (40.7%), dysmenorrhoea (28.2%), lower abdominal pain (14.9%), and intermenstrual bleeding (14.1%). In the majority of cases, the symptoms occurred simultaneously. Determinants for symptoms: Symptoms did not follow a clear age-related trend, whilst the number and size of the myomas did determine the presence of symptoms. The main influencing factor for the presence of intermenstrual bleeding was the location of the myomas.
  
  
  CONCLUSIONS
  The high prevalence of uterine myomas highlights the importance of the diagnosis uterine myomas in standard gynaecological practice: The presence of only one myoma caused symptoms in 46.5% and small myomas of up to 2 cm in diameter resulted in symptoms in 39.5%.
authors.affiliation: MVZ PAN Institut für Endokrinologie und Reproduktionsmedizin, Zeppelinstr. 1, 50667, Cologne, Germany. dfoth@t-online.de.
authors.forename: Dolores
authors.identifier: http://orcid.org/0000-0001-8528-9787
authors.initials: D
authors.lastname: Foth
authors.affiliation: Institut für Biometrie und Medizinische Informatik (IBMI), Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.
authors.forename: Friedrich-Wilhelm
authors.initials: FW
authors.lastname: Röhl
authors.affiliation: Frauenarztpraxis, Schalaunische Straße 6-7, 06366, Köthen (Anhalt), Germany.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Friedrich
authors.affiliation: Praxis für Gynäkologie und Geburtshilfe, Leipziger Straße 45B, 39120, Magdeburg, Germany.
authors.forename: Heike
authors.initials: H
authors.lastname: Tylkoski
authors.affiliation: Universitäts-Frauenklinik, Voßstr. 9, 69115, Heidelberg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Rabe
authors.affiliation: Klinik für Gynäkologie und Geburtshilfe, EVK Köln-Weyertal, Weyertal 76, 50931, Cologne, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Römer
authors.affiliation: Institut für Biometrie und Medizinische Informatik (IBMI), Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.
authors.forename: Ann
authors.initials: A
authors.lastname: Kitay
authors.affiliation: Praxis für Frauenheilkunde und Klinische Forschung, Halberstädter Str. 122, 39112, Magdeburg, Germany.
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Ahrendt
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016021:Epidemiologic Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007889:Leiomyoma / Q000453:epidemiology*; D008875:Middle Aged; D017697:Premenopause; D015995:Prevalence; D011795:Surveys and Questionnaires; D014594:Uterine Neoplasms / Q000453:epidemiology*
keywords: Heavy menstrual bleeding, dysmenorrhoea, lower abdominal pain; Prevalence of myomas; Uterine myomas