Myomas – causes and symptoms. Treatment of uterine fibroids

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Myomas are benign tumors that originate in smooth muscle fibers, so why care for them? First of all, because they occur frequently and are the most numerous group of cancers in women (10-20% for the entire population). They especially affect women between 35 and 55 years of age. If we add to this many concomitant bothersome symptoms, it becomes clear how important the topic is the topic of fibroids – benign tumors of the uterus.

Myomas – classification and types of myomas

In order to better understand the symptoms and possible treatments for fibroids, we need to know exactly where uterine muscle tumors may appear. They can affect both the uterine body and, although much less frequently, the cervix.

According to another division, based on the direction of growth, the following are distinguished:

1. intramural fibroidsgiving rise to other forms of fibroids;
2. subserial fibroidswhich, growing initially intramuscularly, continue towards the outer surface of the uterine muscle and may even extend beyond it, remaining in communication with the uterus only through the peduncle;
3. submucosal fibroids – Their growth out of the muscle membranes drives them further into the uterine cavity, remaining beneath the surface that lines the lining of the mucosa (endometrium). The growth may be so great that the myoma fills the entire uterine cavity. The part is pedunculated and, in the event of significant elongation of the peduncle, the myoma may appear in the cervical canal. We are talking then about the myoma that is being born. It is also possible for a tumor to grow between the broad ligament of the uterus, which is then called inter-ligamentous myoma.

Of the above-mentioned types of uterine fibroids, the most common are the intramural forms, and the least often the submucosal ones.

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Also check: Vitamin D reduces the risk of uterine fibroids

Myomas – causes

The exact causes of uterine fibroids are unknown. However, it should be remembered that uterine fibroids are benign tumors of the uterus and only a small percentage (1 percent) of them malignantly transform into leiomyosarcoma.

The most common causes of the formation of uterine fibroids is excessively high levels of estrogens and cell hypersensitivity to estrogens. Importantly, not all women with too high estrogen levels suffer from uterine fibroids. Previously, attempts were made to treat fibroids by administering progestogens, but this had the opposite effect, i.e. the growth of the fibroids. Therefore, progesterone is now considered to be a factor in the formation of uterine fibroids.

Sometimes, however, the occurrence of fibroids, e.g. after curettage of the uterus, has a different background. It has been speculated that this may be related to the cell’s response to trauma, similar to that of the skin on which keloids are formed.

Some specialists are convinced that the reasons for the tendency to the appearance of these fibroids should be found in abnormalities in the development of the reproductive organs. still in the fetal period of girls. Genetic factors certainly have an influence here, as uterine fibroids sometimes run in families.

A similar situation occurs with many other gynecological diseases that are hereditary. To be able to determine whether a woman is in the so-called risk of developing a given disease, it is necessary to know the history of diseases in the family of this woman. There are several risk factors that could make a woman more likely to have this condition.

However, it should be remembered that if any of the factors are present, there is uncertainty about the occurrence of fibroids. However, it can be concluded that obesity and overweight promote uterine fibroids.

According to specialists, excess body fat may lead to increased estrogen production, which may result in the development of fibroids. According to data every 10 pounds over the normal weight increases the risk of developing the disease by as much as 20 percent. Unfortunately, the loss of unnecessary kilograms does not inhibit the production of estrogen, because the fatty tissue has developed. Therefore, it is extremely important to take care of your weight and prevent girls from becoming overweight.

Also, women who are in the group of women struggling with a longer period of menstruation are much more likely to develop uterine fibroids. It is also worth knowing that the appearance of the first period before the age of 10 is a risk factor, although this does not apply to every woman.

Also read: Cervical polyp

Myomas – complications

Uterine muscle tumors can grow considerably in size and are often found in large numbers. There are cases where the pelvic myomatous uterus extends to the costal arches.

A potato uterus is when the uterus with numerous myomas takes on the image of a bag filled with irregularly shaped potatoes. These tumors, due to their large size, may soften and, as a result of e.g. necrosis, create fluid-filled cavities of various sizes.

If bacteria, such as those from the uterine cavity, intestines or blood, enter the tumor, inflammation, suppuration or putrefaction may occur in the myoma, which causes an increase in body temperature and fetid vaginal discharge. The reverse of softening is hardening of fibroids, which can occur either through connective tissue changes, i.e. fibrosis, or through calcification.

The torsion of the peduncle in pedunculated myomas is serious for the health and life of a woman, leading to symptoms of irritation of the peritoneum. It should also be emphasized that there is a risk of malignant benign fibroids. Sarcomas develop from fibroids in approximately 0,2-0,5% of cases. Moreover, fibroids are observed more often in patients with endometrial cancer than in healthy women.

Myomas also affect a woman’s fertility and difficulties in carrying on a pregnancy, leading to more frequent miscarriages or premature births. Very large fibroids in the lower uterus may be a barrier to labor or contribute to fetal malposition, requiring a caesarean section.

Find out more: How is cervical cancer diagnosed?

Myomas – symptoms of uterine fibroids

Nearly 20% of women with fibroids have no symptomsTherefore, in this group, they are detected completely accidentally when examined for other reasons, e.g. during pregnancy.

If ailments appear, the most common are abnormal uterine bleeding and concern about 45% of cases. Very heavy and prolonged periods are characteristic, and there may be intermenstrual bleeding. This is especially true of fibroids located submucosa or intramammary and most often results from impaired contractility of the uterine muscle or an increased surface of the uterine mucosa.

Although the severity of the bleeding is related to the location, it is not related to the size of the myoma. Depending on the location and type of the myoma, there is a feeling of pressure and pressure. The pressure of the growing cervical fibroids on the bladder can lead to a number of symptoms: residual urine in the bladder, urinary tract infections, paroxysmal incontinence or urinary retention. Pressure on the rectum can be constipation. Uncharacteristic foreign body sensation in the abdominal cavity may be reported by the patient in the case of large fibroids.

Pains or even systemic symptoms such as anemia appear much less frequently.

Myomas – treatment of uterine fibroids

The diagnosis of fibroids is made by a gynecologist based on a gynecological examination and an ultrasound examination, and finally only on a histopathological examination after surgical removal.

It was mentioned above that about 1/5 of the fibroids are asymptomatic and such tumors are only subject to gynecological observation, usually every six months. They require treatment only when they cause ailments. There are of course some exceptions to each rule, and this is also the case here. Among the mentioned exceptions, where the therapy should be started without present symptoms, one can mention the rapid growth of the myoma, in which the malignant process should be excluded, or the very large size of the tumor, with the risk of additional complications.

The choice of the treatment method depends on the patient’s age, size, number and location of the fibroids, but also, which is very important, the patient’s desire to preserve fertility, or the indications or contraindications for a given method.

There are many treatments available for uterine fibroids. One of the most effective is surgerywhich is also the method of choice. And here the choice is wide, depending on the route and scope of the operation.

The following should be mentioned here:

1. performing a hysterectomy, i.e. excision of the myomatous uterus with or without appendages, both by laparotomy and laparoscopy;
2. carrying out a myomectomy, i.e. excision (enucleation) of fibroids while maintaining possible reproductive functions.

Some procedures can be performed through the vagina, e.g. hysteroscopic myomectomy.

Drug treatment is a conservative method, selected especially in the need to delay or, less frequently, abandon the operation. Hormonal treatments include oral contraception, GnRH agonists, progestins / antiprogestagens, and selective progesterone receptor modulators.

New methods of treatment include induction of ischemic changes in the uterus and myoma by embolization of the uterine arteries, laparoscopic coagulation of the uterine arteries or transvaginal, non-incision, Doppler-controlled closure of the uterine arteries. Among the methods of treating fibroids we also find radiological treatments such as high intensity ultrasound beam (MRgFUS).

Myomas are the most common cancers of the uterus and, although they are benign, they are an important problem for women of childbearing age. The causes of their formation are still unknown, and estrogens are of great importance. The intensive development of various methods of treatment shows the scale of this phenomenon. Therefore, a further increase in the diagnosis of fibroids in women is to be expected.

Prophylactically and supportively during the treatment period, it is worth using Uterine fibroids – a mixture of irrigation herbs with anti-inflammatory properties.

we recommend: Benign neoplasms of the uterus – symptoms and treatment

Prevention of uterine fibroids

Reducing the chances of fibroids may be related to early pregnancy and a large number of babies born, because the pregnancy and the number of pregnancies experienced affect the structure of the uterus.

Another factor that may also reduce the risk of this disease is the lactation period. This is related to the level of hormones which is then close to the levels in the late postmenopausal period, which in turn translates into the formation and growth of fibroids. According to specialists, during the lactation period, low levels of hormones can contribute to the reduction of the size of fibroids or even their disappearance.

As a prophylaxis and treatment support, we recommend For uterine fibroids – a herbal mixture of Father Klimuszko, from which you will prepare a special infusion soothing unpleasant ailments related to fibroids.

Read more: Uterus – structure, role and the most common diseases

Muscles and pregnancy

Sometimes there is a situation in which fibroids are detected in pregnant women, which is a big problem because uterine fibroids are a threat to pregnancy and the use of pharmacological treatment during this time becomes limited.

You should know that fibroids are the cause of three times more miscarriages and postpartum hemorrhagesalthough it is not uncommon for women to carry the pregnancy without complications despite the presence of these tumors. Therefore, it is extremely important that a woman planning a pregnancy knows all the necessary information, such as the type of fibroids.

The size and location of the tumors are important here. Specialists recommend that women have their fibroids surgically removed or undergo drug therapy with ulipristal acetate before becoming pregnant. This is due to the fact that their diagnosis, when a woman is already pregnant, forces the patient to stay under the close care of a gynecologist, as hormonal changes that occur may lead to faster growth of tumors.

Impaired blood supply to the uterine mucosa in the area of ​​the forming placenta causes recurrent and often profuse bleeding, and even miscarriage. It also leads to premature contractions, as well as preventing self-delivery, which in turn makes doctors recommend caesarean section.

Remember that fibroids are not removed during pregnancy. According to gynecologists, the procedure should be performed after the end of the puerperium (more precisely, almost six weeks after giving birth). The removal of the fibroids itself may also, but does not have to, affect the course of the next pregnancy. However, it is worth remembering that this significantly increases the frequency of cesarean sections. Unfortunately, there is no guarantee that uterine fibroids will not come back in the future.

Check it out: What tests should be done before pregnancy?

Myomas and fertility

According to specialists, uterine fibroids may be one of the causes of reduced fertility or pregnancy complications, up to its loss. The effect of fibroids on fertility varies from case to case. According to doctors, the majority of miscarriages and difficulties associated with getting pregnant are closely related to the inability to implant the embryo.

If the volume of the myoma is reduced, even by half, the chance of getting pregnant increases significantly with no complications at the same time. If, however, there is a situation in which the myoma is reduced, but the pregnancy is not, surgery will probably be needed.

See also: How much do women’s fertility tests cost and where to do them?

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