UTERINE MYOMA, IS IT ONLY CAUSED BY ESTROGEN?

Introduction: Uterine myomas are the most common benign neoplasms of the female reproductive tract and a major public health concern in reproductive age women. Uterine myomas are made of abnormal smooth uterine muscle cells and fibroblasts surrounded by extensive amount of extracellular matrix (ECM). However, other very important pathways exist, which are not only hormone-dependent. So we would like to make a systematic review to know what the causes of uterine myoma are. Methods: We performed a Google scholar search of papers published from 2017 until 2021, using the Medical Subject Heading terms “uterine myoma” or “leiomyoma” combined with “hormone" or "estrogen" or "factor" or "risk factors" and free search terms “hormone” or “estrogen” in combination with “fibroids” or “uterine fibroids” or “myoma” or “uterine myoma” or “leiomyoma” or “uterine leiomyoma”. Result and Discussion: We identified 146 potentially relevant citations. Based on the title and abstracts, full texts of 23 articles were selected for detailed evaluation. Of these articles, 12 articles were excluded. The remaining 11 articles met our criteria and were therefore included in the analysis. Conclusion: Uterine myoma is cause by multifactorial. Besides of Estrogenic, there are many factors that can increase of uterine myoma percentages. The other factors are age between 30-50 years old, the inflammatory process in uterus, vitamin D deficiency, air pollution, alcohol consumption, body mass index > 25, the concentration of MCM protein and CYP1A1 gene.