Origin of Uterine Fibroids: Conversion of Myometrial Stem Cells to Tumor-Initiating Cells

Hoda Elkafas, Yang Qiwei, Ayman Al-Hendy

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Uterine fibroids (UFs) are the most frequent gynecologic tumors, affecting 70 to 80% of women over their lifetime, Although these tumors are benign, they can cause significant morbidity and may require invasive treatments such as myomectomy and hysterectomy in premenopausal women at a cost of up to $34 billion per year. Many risk factors for these tumors have been identified, including environmental exposures to endocrine-disrupting chemicals such as genistein and diethylstilbestrol (and other environmental agents) resulting in hyper-responsiveness to hormone in the adult uterus and promotion of hormone-dependent UFs. Although the molecular mechanisms underlying the pathogenesis of UFs is largely unknown, a growing body of evidence implicates unfavorable early-life environmental exposure and multiple biological pathways express as potentially import contributors. In this article, we will review the role of genetic and epigenetics in the conversion of myometrial stem cells to tumor (fibroid) initiating cells, and their role in UF development.

Original languageEnglish (US)
Pages (from-to)481-486
Number of pages6
JournalSeminars in Reproductive Medicine
Issue number6
StatePublished - Nov 1 2017
Externally publishedYes


  • biology of uterine fibroids
  • endocrine-disrupting chemicals
  • epigenetic reprograming
  • myometrial stem cells
  • tumor-initiating cells

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Reproductive Medicine
  • Endocrinology
  • Obstetrics and Gynecology
  • Physiology (medical)


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