Symptoms of uterine fibroids and methods of treating benign tumors

A benign neoplasm that occurs in women of childbearing age is uterine fibroids.

Having heard such a diagnosis, many fall into despair, immediately starting to look for unconventional methods of treatment and take risky measures.

The gynecologist will tell you what the symptoms and signs of uterine fibroids are and choose an effective treatment method. The peculiarity of the tumor is that its growth depends on the level of female sex hormones. The pathology is the most common in gynecology; effective methods of therapy and rehabilitation have been developed.

Myoma concept

In women, due to hormonal imbalance, uterine fibroids develop - a benign tumor formed from uncontrollably growing muscle tissue that transforms into nodes. Localization of nodes is individual.

Hormonal imbalances often lead to the development of pathology. The cause of the disease may lie in various factors. This is determined individually by the gynecologist. Depending on where the nodes are located, the types of pathology differ:

• subserous;
• intramuscular;
• submucosa;
• cervical;
• on a leg;
• fibroids in the interligamentous space.

Knowing the diagnosis, you should undergo treatment; regular examinations by a specialist are recommended for patients. The consequences of the disease lead to infertility, anemia, and other disorders of the reproductive system. In rare cases, a benign formation degenerates into a malignant one.

How to recognize fibroids

The danger of the pathology lies in its asymptomatic course in the first two stages. Myoma can be detected during microscopic examination; it is not visually visualized. A woman who neglects regular gynecological examinations may find out about the problem 5-8 years after it appeared. At the third stage, the gynecologist sees the formation during the examination.

Ultrasound provides a detailed description of the detected node. Gynecologists have identified echographic signs of fibroids:

• the presence of formations of medium, low echogenicity in the myometrium;
• observed changes in the contours of the uterine cavity, endometrium, characteristic of interstitial, sumbucous nodes;
• the lumen of the rectum, bladder, formed as a result of dense formations;
• the level of echogenicity depends on the amount of connective tissue in the nodes. The more it is, the higher the echogenicity of the node;
• if there are calcium deposits in the nodes, small hyperechoic inclusions will be visible, with acoustic shadows behind them.

An ultrasound examination using a Doppler sensor allows you to make an accurate diagnosis and obtain complete information about the condition of the organs of the reproductive system.

Self-examination

A woman cannot determine at home that she is developing fibroids. The pathology cannot be visualized or determined by touch. In this case, unpleasant symptoms will appear, which the fair sex confuses with other gynecological ailments. In this case, it is important to consult a doctor and not self-medicate, aggravating the situation.

The first signs of pathology have been identified:

1. Feeling tired, general weakness for no apparent reason.
2. Reduced hemoglobin level.
3. Frequent urge to urinate.
4. Headaches resembling migraine attacks.
5. Irregular bowel movements, periodic constipation.
6. Appearing tides.
7. Feeling of heaviness, pain localized in the lower abdomen.
8. Heavy menstrual flow, accompanied by severe pain.
9. Bloody discharge in the middle of the menstrual cycle.

Not a single woman will understand that such symptoms indicate a developing disease, so the ailments that appear are attributed to fatigue and external factors. It is imperative to consult a doctor, undergo an examination, and undergo tests to find out the true cause of the condition.

General manifestations

In the first stages of development, symptoms of uterine fibroids do not appear. When a tumor dependent on the female hormone estrogen grows, its size increases, the woman faces multiple problems, and the condition of the whole body worsens.

Characteristic signs of pathology:

• the menstrual cycle is disrupted. There is an increase in the duration of the cycle, menstruation becomes heavy and painful. Bloody discharge appears in the middle of the cycle due to the fact that the neoplasm develops, leading to bleeding of the walls of the uterus;
• secondary signs of pathology are pain in the lower abdomen, in the sacral area. First, the pain increases during menstruation, when the tumor develops, the woman suffers from cramping attacks;
• a neoplasm growing in the area of ​​the bladder and rectum leads to problems with their functioning. In the early stages, a woman experiences frequent urination or problems with bowel movements. In the future, the situation worsens. In this case, an examination by a urologist or gastroenterologist is required;
• heavy menstrual flow leads to the development of anemia, headaches become more frequent, the skin becomes pale, dizziness occurs, and frequent weakness occurs;
• with a myomatous tumor developing in the submucosa, obstruction of the fallopian tubes may occur. As a result, sperm do not gain access to the egg and the woman faces infertility;
• tumor growth causes a decrease in the tone of the heart muscle, and pain in the heart occurs. In advanced forms of the disease, an increase in venous pressure is possible. The woman should be examined by a cardiologist;
• active growth of the formation causes the abdomen to grow , but the weight remains virtually unchanged.

A woman should know the main signs of the disease, if at the same time she observes an elevated body temperature, weakening of the body, we can talk about intoxication due to necrotic processes occurring in the tissues of the formation.

Symptoms and signs by form

Myoma can be recognized by the characteristic signs for each form of pathology.

1. Under the membrane separating the uterus from the peritoneal cavity, a subserous tumor develops on the outside of the organ. A woman faces problems with defecation and urination. There is constant discomfort in the lower abdomen. Hemorrhoids may appear, accompanied by cramping pain.
2. Intramuscular fibroids develop in the thickness of the uterine wall. Menstruation becomes painful and profuse. Constipation occurs and there is a risk of bleeding. Women of childbearing age are more likely to experience this form of the disease.
3. A submucosal tumor emerges into the lumen of the uterus, affecting the internal part of the organ. It causes infertility, heavy and prolonged menstrual bleeding, and pain in the lumbar region.
4. In rare cases, a cervical mass develops on the cervix. The tumor leads to infertility, does not affect the course of menstruation, but increases pain during this period.
5. The formation can develop in the interligamentous space, leading to problems with defecation and frequent urination. The pathology has no other symptoms.

A separate subspecies is pedunculated fibroids; formations can develop on wide, narrow bases in the cavity of the organ, and beyond.

As soon as alarming symptoms appear, you should undergo an examination prescribed by your doctor. Self-medication or ignoring the situation will aggravate the condition, as a result of which you will need to spend more time on treatment and rehabilitation.

Symptoms during pregnancy

It is necessary to identify fibroids at an early stage, reducing the risk of spontaneous abortion and premature birth.

Pathology is a consequence of hormonal imbalance in the expectant mother. Having discovered a problem, the doctor will monitor it and monitor the growth of the tumor.

A formation located far from the placenta does not have a negative effect on the gestation of the fetus.

An increase in tumor size can provoke:

• inflammatory process;
• increased uterine tone;
• miscarriage;
• premature birth;
• placental abruption;
• oxygen starvation of the fetus.

Signs of menopause

If uterine fibroids are detected, the symptoms of which did not appear before the onset of menopause, then there is a chance that it will gradually resolve without additional medical intervention.

The emerging range of unpleasant symptoms characteristic of the disease will gradually disappear.

Education dependent on hormones will resolve, because it will not receive estrogen, the main sex hormone in women, necessary for the growth.

A woman who is aware of the pathology should monitor her condition and undergo regular gynecological examinations. A disease left to its own devices can turn into a malignant formation.

If menopause passed without problems, then the fibroid will most likely disappear without a trace without additional intervention.

Uterine fibroids and pregnancy

A tumor diagnosed in a woman carrying a child may not harm the fetus or cause premature birth or early miscarriage. The condition of the expectant mother is monitored by a gynecologist, as is the size of the formation.

Being far from the placenta, the pathology does not pose a threat. In another case, the situation is resolved individually. The doctor does everything to preserve the reproductive function of the woman and the fetus.

Diagnostic methods

The first diagnostic method is an examination by a gynecologist. A specialist can determine the presence of a tumor by seeing that the uterus is enlarged, the walls are thickened or deformed. The diagnosis requires confirmation, for this purpose the following is prescribed:

1. Ultrasound of the pelvic organs.
2. Blood test for tumor markers CA125, ESR.
3. Hysteroscopy. During the procedure, the doctor determines the condition of the fallopian tubes and the condition of the internal layer of the organ. Takes a tissue biopsy of myoma nodes for cytological and histological analysis.
4. MRI – allows you to see a three-dimensional image of the uterus, confirms or refutes the diagnosis.
5. Laparoscopy - the procedure is carried out strictly as prescribed by the gynecologist, it allows you to remove small nodes.

What treatments can be used

Therapy is selected individually in each case, depending on the size of the formation and location.

1. Tumors up to 2 cm can be successfully eliminated with medication. If there is no discomfort, pain or other complaints from the woman, the gynecologist gives nutritional recommendations and recommends regular examinations and ultrasounds. Medicines are selected individually. These can be COCs, antiprogestogens, antigonadotropins. All medications are aimed at alleviating the condition, relieving pain, and normalizing the cycle. However, they have side effects, so self-treatment is strictly prohibited.
2. Rapidly developing large fibroids are eliminated during surgical operation.

   In extreme cases, the doctor recommends removal of the uterus, more often for women past reproductive age.

3. Myomectomy is prescribed for women who want to preserve reproductive function. The procedure can be performed through the femoral artery (embolization), through a puncture in the abdomen (laparoscopy), or through the vagina (hysteroscopy). These methods are the least traumatic, the woman recovers quickly and in the future has the opportunity to become pregnant, carry, and give birth to a child.

In this case, it is prohibited to use folk remedies. It is necessary to supplement conservative treatment with proper nutrition and light exercise (if allowed).

A hormone-dependent tumor can develop in a woman’s body for many years and not cause problems or become an obstacle to a happy life and motherhood. It is impossible to recognize the formation on your own, so you should remember the importance of preventive examinations and careful attention to your health.

Source: https://ginekologius.ru/simptomy-i-priznaki-miomy

Signs and symptoms of uterine fibroids

Uterine fibroids are one of the most commonly diagnosed benign neoplasms, which is found in girls aged thirty to forty-five years. This pathology is determined in every fourth woman during preventive examinations or during targeted examinations.

The development of uterine fibroids in the early stages is usually not accompanied by clinical manifestations. Symptoms begin to appear in later stages. One of the characteristic manifestations of a uterine tumor is menorrhagia - this is a quantitative and qualitative increase in discharge during menstruation.

A secondary symptom that develops as a result of this manifestation is anemic syndrome, which is accompanied by the woman’s weakness, fatigue, and pale skin. As a result of constant loss of iron, chronic tissue hypoxia develops, which leads to dry skin, the appearance of wrinkles, brittle nails and hair.

The reason for the development of the above symptoms is the growth of uterine fibroids into the muscular layers of its body, and therefore its contractile function is impaired. It is also possible to develop acyclic bleeding from the genital tract, which arises from the mucous membrane of the uterus; the appearance of this symptom is a reason for an urgent visit to the gynecologist.

One of the most frequently present clinical manifestations of uterine fibroids is the presence of pain, which can be quite varied. Typically the pain is localized in the lower abdomen or lumbar region. The appearance of pain may be associated with impaired blood supply to the tumor body, which most often develops during physical exertion.

There may be a constant presence of pain, which periodically intensifies; this manifestation is usually associated with the presence of small uterine fibroids. Later stages of tumor development, in the presence of invasive growth into the submucosal layer of the uterus, are characterized by cramping attacks of pain, as well as the presence of bloody discharge.

Uterine fibroids are often accompanied by the development of disturbances in the functioning of nearby organ complexes, which include the rectum and bladder.

A feeling of incomplete emptying of the latter after urination or a feeling of constriction is observed with a sufficiently large size of the neoplasm. A constant urge to urinate or defecate may alternate with pathological ischuria or constipation.

To carry out differential diagnosis with cystitis or rectal tumors, you need to contact a gynecologist.

One of the most common symptoms that forces a young girl to seek help from a specialist is the inability to become pregnant. The presence of large fibroids in the uterus can lead to obstruction of the tubes for the egg or interfere with the movement of sperm.

Different localizations of the myomatous node are accompanied by their own specific symptoms.

As the tumor increases, the compression of internal organs intensifies, the phenomena of chronic intestinal obstruction and alternation of constipation with diarrhea appear. Compression of the urethra leads to pathological stagnation of urine, as well as the development of hydronephrosis or pyelonephritis.

The symptoms of the uterus and ovarian cyst are quite similar in their initial stages, which is why their differential diagnosis is necessary. Methods to determine the true cause of symptoms include ultrasound diagnostics.

This non-invasive technique provides the maximum amount of information and is considered the gold standard in gynecology. There is also diagnostic laparoscopy, which is used in the development of an acute abdomen due to torsion of an ovarian cyst.

Sometimes uterine fibroids are detected during an examination at a antenatal clinic after the patient has developed a pregnancy.

In this regard, it is necessary to be aware of the management of such women and the clinical manifestations that may accompany this condition.

When the placenta forms near the myomatous node, a reduction in muscle tissue in this area is observed due to the production of biologically active substances.

In this regard, fetal malnutrition or fading of its development may develop. The development of premature birth is also observed due to the filling of the cavity of the pregnant uterus with numerous tumors.

Due to increased intrauterine pressure, rupture of the membranes occurs, followed by early delivery.

To prevent complications during pregnancy or childbirth, women should be examined before pregnancy and undergo operative delivery.

Thus, the most common and universal symptoms of uterine fibroids are the following clinical manifestations:

• The appearance of prolonged and heavy menstruation, resulting in the development of hypochromic anemia, accompanied by weakness, rapid loss of ability to work, as well as brittle nails and hair.
• Paleness of the skin.
• A feeling of discomfort in the lower abdomen, the presence of pain that is not associated with the phase of the cycle.
• Disruption of the normal functioning of the urinary system and the discharge of intestinal contents.
• The addition of heart pain to heaviness in the lower abdomen and menstrual irregularities.
• Inability to become pregnant or carry a child to term.
• Increase in abdominal volume.

The growth of uterine fibroids is not constant; it can begin its development at a young age and manifest itself after menopause. In this regard, the symptoms of uterine fibroids during menopause are highlighted, which include the following:

• Development of accelerated growth against the background of hormonal changes in a woman’s body.
• With an initial benign course, the process may become malignant due to changes in endocrine regulation.
• Development of severe pain and heavy bleeding.
• Development of severe forms of anemic process.

In ultrasound diagnostics, echo signs of uterine fibroids are as follows:

• An enlarged uterus is detected.
• The presence of a foreign body in its cavity.
• Thickening of the myometrium and signs of inflammation.

In the photo: Ultrasound of the uterus

Uterine fibroids in pregnant women often develop primarily against the background of radical hormonal changes in the body. Often such tumors do not affect the course of pregnancy and childbirth, and also remain undiagnosed until more pronounced clinical symptoms develop at an older age. The presence of uterine fibroids during pregnancy can lead to the following complications:

• Development of inflammatory processes in the uterine cavity.
• An increase in the muscle tone of the internal layers that form the body of the uterus, which can cause miscarriage.
• Detachment of a normally located placenta.

Uterine fibroids are a fairly common disease and require close attention from both the patient and the attending physician. Treatment and diagnosis should only be carried out by a specialist; this tactic will reduce the development of possible complications to a minimum and protect the woman’s health.

Source: https://ProtivRaka.su/dobrokachestvennye-opuholi/mioma-matki.html

Myoma is a benign tumor of the uterus: causes, symptoms and signs, diagnosis and treatment of uterine fibroids in Moscow

04 February 2018 4978 0

Myoma is a common pathology of the muscular wall of the uterus. Myoma is often called “benign fibroid” or “benign uterine tumor.”

Please note that this text was prepared without the support of our Expert Council.

The true cause of the formation of nodes in the muscular wall of the reproductive organ is still unknown, but factors are known that can stimulate the development of fibroids.

1

What is benign uterine fibroid?

Myoma or leiomyoma, fibromyoma are the names of benign formations depending on the predominance of connective or muscle tissue in the tumor; they develop in the myometrium, the muscular layer of the uterus. A benign formation consists of intertwined smooth muscle fibers.

Because of their round shape, fibroids are called nodular formations or nodes. Myoma nodes range from a few millimeters in diameter to enormous sizes, when the weight of fibroids reaches several kilograms. Research into the causes of the tumor and the factors influencing its growth continues.

For a long time it was believed that the cause of the development of a benign tumor was a hormonal imbalance in a woman’s body, but fibroids began to be discovered in women with normal hormone levels.

It was believed that they develop in women of late reproductive age, in the premenopausal period, but fibroids have become increasingly diagnosed in young girls and women.

Benign tumor-like nodes are more often found in women of childbearing age, often in very young girls. Benign nodes are diagnosed in the premenopausal period, after 40 years, there are cases of growth after menopause.

Such cases are associated with hormonal changes in the body, imbalance of hormones - this has a negative effect on the reproductive organ and accelerates the growth of tumor-like nodes.

Women who have not given birth and women with one or two children are forced to cope with hormonal surges (menstruation) throughout their lives - this becomes the cause of the development of fibroids.

In most countries, the main treatment in the past was hysterectomy. A tumor-like node that reached a certain size was removed along with the uterus, which became the cause of the development of severe complications in women who underwent hysterectomy.

Modern doctors are developing new organ-preserving methods for treating the disease, preserving the reproductive organ and women's health. Doctors often call fibroids a benign tumor, but at the same time this statement is not entirely accurate.

Myoma is a benign formation of muscle tissue, which very rarely turns into a malignant state, may not manifest itself with symptoms and is discovered by chance during an examination by a doctor, and may be accompanied by painful menstruation, bleeding, rapid growth of a benign formation, fatigue, anemia, and infertility. If you experience such symptoms, an email consultation will help you get timely medical help.

2

Benign fibroids and pregnancy

The disease rarely causes a woman to become infertile. The chance of conception and pregnancy is reduced if a benign node interferes with the advancement of sperm, compresses the fallopian tubes, and interferes with the attachment of the fertilized egg.

A large number of women become pregnant without realizing that the uterus is affected by nodes. Small tumors rarely affect the fetus during pregnancy, with the exception of multiple organ damage.

The ability to carry a pregnancy to term will depend on the location of the fibroids and the site of attachment of the fertilized egg, while at the same time the risk of premature termination of pregnancy increases.

Changes in hormonal levels during pregnancy in some cases lead to a reduction in the tumor; in most cases, under the influence of hormones, muscle tissue grows. Doctors recommend undergoing treatment before planning a pregnancy.

Uterine fibroids not only create a risk of complications during pregnancy (placental abruption, abnormal presentation and position of the fetus, other complications), it can cause prolonged labor, in many cases causing cesarean section and postpartum complications.

3

Can uterine fibroids be malignant?

Myoma rarely degenerates into a malignant tumor, but such cases do occur. Very rarely, a benign uterine tumor degenerates into a uterine sarcoma. Most often, a sarcoma tumor develops during the postmenopausal period, accompanied by bleeding and pain, and the rapid growth of a malignant tumor. Factors contributing to the development of uterine cancer include:

• Stress. Chronic stress often causes the development of cancer, as it leads to a decrease in immunity.
• Organ injuries.
• Obesity. Obesity is accompanied by metabolic and hormonal imbalances.
• Bad habits.
• Poor nutrition. A lack of vitamins and microelements leads to disruption of the functioning of many organs and systems, and a decrease in the body's defenses.
• Great physical activity.
• Women with uterine tumors are not recommended to visit the sauna, steam bath, or take a hot bath.

To avoid the degeneration of a benign node into a malignant tumor, you should regularly visit a gynecologist and undergo treatment for diseases of the genital area and fibroids.

4

Treatment of benign formation - fibroids

Treatment of benign fibroids consists of several methods. Each method is used in certain cases:

• Conservative method: drug treatment with GnRH agonists.
• Surgical methods: hysteroresectoscopy, laparoscopic removal of nodes, uterine amputation.
• Minimally invasive procedures: uterine artery embolization.

Treatment of the disease is preceded by an examination, which helps to establish the type, location, size of fibroids, the condition of the uterine cavity, and the presence of concomitant diseases.

The disease is diagnosed using ultrasound with a transvaginal sensor, MRI, CT, hysteroscopy, the patient is sent for research - blood tests for hormone levels and others.

Using hysteroscopy, the localization of a tumor-like formation, its size, and quantity are determined with great accuracy. During the procedure, the doctor may take a biopsy of tumor tissue. Hysteroscopy allows you to determine the deformation of the organ cavity and the condition of the uterine mucosa.

5

Conservative treatment of fibroids

The choice of treatment method depends on many factors: the patient’s age, health status, size, location, growth rate of fibroids, and the presence of children.

Conservative therapy may include treatment with one hormonal drug or a complex of hormones; one of the treatment methods is an intrauterine device with hormonal content.

This treatment is carried out for small myomatous nodes and helps stop the growth of benign formations. It is not recommended to use the drug Duphaston, which is one of the factors influencing the increase in fibroids.

6

Surgical treatment of myomatous node

Surgical treatment is carried out using organ-preserving methods and radical methods. Organ-preserving methods include removal of nodes using laparoscopic and hysteroscopic approaches.

Hysteroscopic myomectomy is considered the most optimal method for removing submucous fibroids.

Organ-preserving techniques can reduce the time of rehabilitation after surgery, but have certain indications for their implementation.

Radical surgery to remove the reproductive organ with large tumor-like nodes is performed using an abdominal approach, during which the anterior abdominal wall is injured. After such an operation, various complications often arise, and the rehabilitation period is long.

7

Uterine artery embolization

Uterine artery embolization is an innovative, organ-preserving, minimally invasive treatment method. During the procedure, emboli made of medical polymer are used. The procedure does not require general anesthesia or lengthy preparation of the patient. UAE preserves a woman’s reproductive organ, improves the quality of life, and has virtually no complications.

During the procedure, emboli are injected into the blood vessels of the uterus using a special catheter through the femoral artery. Emboli accumulate in the blood vessels of tumors and stop blood circulation. Tumors begin to degrade, decrease in size, and over time degenerate into connective tissue.

The endovascular surgeon observes the procedure on the monitor; embolization of the uterine arteries takes place under the control of modern X-ray equipment. After UAE, the patient is under the supervision of a doctor for some time, then goes home.

A small puncture remains at the site where the catheter was inserted, which heals quickly.

After the procedure, there are no scars left on the uterus, the emboli are fused with connective tissue, lose the ability to move, and do not have a negative effect on the woman’s body. Relapses occur very rarely after UAE.

They are determined by ultrasound during the first six months after the procedure, when the restoration of blood supply to the tumor is detected. Additionally, embolization of the uterine arteries is carried out, and the fibroid dies.

The embolization drug and the experience of the endovascular surgeon play a major role in the effectiveness of UAE. When deciding on a procedure, be responsible when choosing a clinic and surgeon. Here you can choose highly professional services and doctors, choose a fibroid treatment clinic.

Bibliography

• Savitsky G. A., Ivanova R. D., Svechnikova F. A. The role of local hyperhormonemia in the pathogenesis of the growth rate of tumor nodes in uterine fibroids // Obstetrics and Gynecology. – 1983. – T. 4. – P. 13-16.
• Sidorova I.S. Uterine fibroids (modern aspects of etiology, pathogenesis, classification and prevention). In the book: Uterine fibroids. Ed. I.S. Sidorova. M: MIA 2003; 5-66.
• Meriakri A.V. Epidemiology and pathogenesis of uterine fibroids. Sib Med Journal 1998; 2: 8-13.

Source: https://www.mioma.ru/mioma-i-opuhol.html

Uterine fibroids: types, causes, symptoms. How and with what are uterine fibroids treated?

Uterine fibroids are a disease that, according to the Ministry of Health of the Russian Federation, affects approximately one third of women. With this pathology, nodules of smooth muscle tissue form in the wall of the organ. Fibroids do not contain malignant cells, they are not life-threatening, but they can cause some symptoms and problems with pregnancy.

“An ultrasound showed that you have fibroids in your uterus,” these words often make women very worried. It's actually not that scary.

Causes of uterine fibroids

It was previously believed that uterine fibroids are a benign tumor that grows due to an imbalance between female sex hormones - estrogen and progesterone. Modern science knows that this is not so. Scientists and doctors are forced to admit: at the moment it is impossible to name the exact causes of the development of uterine fibroids. There are two theories:

The embryonic theory states that disorders occur even before the girl is born.

The fact is that smooth muscle cells in the wall of the fetal uterus mature relatively late - by the 38th week of pregnancy. In the intestines and bladder, these processes are completed by the 16th week.

Due to late maturation, the smooth muscle tissue of the uterus remains in an unstable state longer, so there is a higher risk of disorders leading to fibroids.

The traumatic theory states that damage to the myometrium occurs throughout life. It can be caused by multiple periods, previous curettages and abortions, inflammatory diseases, and inaccurate actions of obstetricians during childbirth.

Uterine fibroids do not develop due to hormones, but they do affect its growth. Myomatous nodes almost never appear in girls before their first menstruation and decrease after menopause.

Several factors increase the risk of developing uterine fibroids:

• Age. The disease affects 40–60% of women aged 35 years and 70–80% by 50 years.
• First menstruation at an early age.
• Heredity. The risks are increased if uterine fibroids have been diagnosed in close relatives.
• Overweight.

Fibroids occur more often in women who have never given birth. The risks decrease with the number of pregnancies and births.

Types of uterine fibroids

The wall of the uterus is like a sandwich, the “filling” of which is precisely the muscle layer. The inside of the organ cavity is lined with a mucous membrane (endometrium), and the outside is covered with a serous membrane (perimetry). Myomatous nodes can grow inward or outward, depending on this they are divided into three types:

Subserous fibroids grow on the outer surface of the organ, on a broad base (like a mound) or on a stalk (like a mushroom). They most often do not cause symptoms.

Submucous fibroids protrude into the organ cavity. They are the most problematic, as they most often cause bleeding and problems with pregnancy. Submucous fibroids are divided into three types:

1. Zero type - completely located in the uterine cavity.
2. The first type - protrude half into the organ cavity.
3. The second type - less than a third protrude.

Intramural fibroids are located inside the muscle layer and can grow more toward the uterine cavity, outward, or located in the middle.

Cervical fibroids are distinguished separately.

Symptoms of uterine fibroids

Most women experience no symptoms and are not even aware that they have uterine fibroids. Often the diagnosis is made accidentally, during an ultrasound for another reason. There are situations when a woman has a blood test, anemia (low hemoglobin level) is detected, and further examination shows that the cause is heavy periods due to uterine fibroids.

The three most common symptoms are:

1. Heavy, prolonged (more than a week), painful periods.
2. If the fibroid is large, it puts pressure on the bladder and rectum. There are problems with bowel movements and urination. A woman may complain that she has constant constipation and often has the urge to urinate.
3. Abdominal enlargement also occurs with large uterine fibroids. Women often do not attach much importance to this symptom and believe that they have simply gained weight.

Pain in the lower abdomen, legs and lower back, pain during sexual intercourse and other symptoms are less common and are usually caused by other concomitant diseases.

Uterine fibroids are NOT a malignant tumor. But oncological diseases can manifest similar symptoms, so you need to visit a gynecologist and undergo an examination.

Why are uterine fibroids dangerous?

There are many myths about this. Even some gynecologists continue to believe in them, although serious scientific research has long been carried out and all the i’s have been dotted.

The main misconception is that “over time, fibroids will definitely turn into cancer.” And from here the conclusion follows: “the terrible tumor must be removed as quickly as possible.”

In fact, uterine fibroids have nothing to do with cancer. Malignant tumors of the myometrium are called leiomyosarcoma.

Myomatous nodes degenerate into malignant tumors no more often than normal myometrium.

The second common myth is that a woman with uterine fibroids will not be able to get pregnant. In fact, this is not always the case. And even if fibroids cause infertility or miscarriage, in most cases this can be corrected with treatment.

Some gynecologists of the “old school” intimidate women, saying that they are no longer allowed to visit bathhouses, solariums, vacation in warm countries, work out in the gym, do massages and physiotherapy, or have sex. This has been proven not to be the case. A woman with uterine fibroids can lead a full, active life if there is no heavy bleeding.

None of these factors will cause the nodes to begin to grow rapidly. In general, the growth of uterine fibroids is an unpredictable thing. In each specific case, it is impossible to say how the disease will behave over time, no matter what lifestyle the woman adheres to, and no matter what restrictions she observes. Therefore, it is important to regularly undergo ultrasound and monitor the condition of the nodes.

For example, in one study, women with uterine fibroids were followed for a year. The results were very different. During this time, some nodes decreased by 25%, while others increased by 138%.

Why are uterine fibroids actually dangerous? Some women develop complications:

• Anemia is a decrease in the level of hemoglobin in the blood due to severe bleeding. Manifests itself in the form of pallor, increased fatigue, weakness, headaches and dizziness.
• Some uterine fibroids lead to infertility and miscarriage.
• Women with uterine fibroids have a 2–2.5 times increased risk of menopausal syndrome, a set of symptoms that occur shortly before, during and after menopause.

How do modern gynecologists treat uterine fibroids?

In modern gynecology, not only the understanding of the mechanism of development of uterine fibroids has changed, but also approaches to its treatment. Different methods are used, each of them has its own advantages and indications. First of all, you need to figure out whether the woman needs treatment. If uterine fibroids are small, do not grow and do not cause symptoms, monitoring over time is sufficient.

So, a woman with uterine fibroids needs to be treated if:

1. There is one of the three symptoms that we talked about above.
2. The last two or three ultrasounds, performed at intervals of 4-6 months, showed that the fibroids were constantly growing.
3. A woman wants to have a child, and fibroids can interfere with pregnancy.

Surgery

Since uterine fibroids were previously considered a tumor (even benign), they fought it radically. Often, doctors immediately suggested that women have their uterus removed. “Are you planning on getting pregnant again? Then why do you need this bag of knots?”

Previously, you could often hear this from doctors. And if a modern gynecologist says so, it’s better to stay away from him.

The operation of surgical removal of the uterus (hysterectomy) is a last resort; it is permissible when there is absolutely no other way.

Another surgical option is myomectomy. During the operation, the surgeon removes only the fibroids, the uterus remains in place, and the woman can become pregnant in the future. Surgical intervention can be performed in different ways: through an incision, a puncture (laparoscopically), using robotic installations, without an incision through the vagina.

Consequences of removal of uterine fibroids and pregnancy

After myomectomy, the symptoms of uterine fibroids disappear, and the woman can become pregnant and give birth to a child. But the main disadvantage of surgical treatment is the high risk of relapse. After 4–5 years, fibroids will be detected again in approximately half of the women operated on. Therefore, the operation is indicated in cases where a woman is planning a pregnancy in the near future, and not sometime later.

Other conditions under which fibroid removal may be performed:

• If the doctor is sure that during the operation the uterine cavity will not be opened and the organ will not have to be removed.
• If there are not many large scars left on the uterus.

However, even one scar can create problems during pregnancy and become an indication for a caesarean section. Another possible complication is adhesions, which can lead to infertility.

Not to mention that any surgical procedure involves certain risks.

In recent years, the list of indications for myomectomy has been greatly reduced because new, minimally invasive techniques have appeared.

A modern method of treating uterine fibroids is UAE.

A procedure called uterine artery embolization—UAE for short—has been around for decades, but it has only recently become widely used to treat uterine fibroids.

Because of this, even some gynecologists treat her with distrust.

But scientific research has conclusively proven that it is an effective and safe method, and it is suitable for most women with uterine fibroids who are eligible for treatment.

The essence of the procedure is that, under X-ray control, a catheter is inserted into the vessel feeding the uterine fibroids, and through it a special embolic drug is inserted.

This drug consists of microscopic particles that clog the lumen of small vessels. The myomatous node ceases to receive oxygen and nutrients, dies and is replaced by connective tissue.

If the fibroid is located inside the organ cavity on a pedicle, it separates and comes out.

Uterine artery embolization has some advantages over surgical methods for treating fibroids:

• This is a non-invasive procedure. No anesthesia needed. There is no incision - the catheter is inserted into the femoral artery through a small puncture in the upper thigh.
• There is no risk of complications associated with surgery.
• After UAE, recovery occurs quickly. On the second or third day after the procedure, the woman is discharged home.
• The rehabilitation period is much shorter than after myomectomy.

And the most important thing is the result. Studies show that 98% of women after UAE do not need any additional types of treatment. At the same time, after myomectomy, due to the high probability of fibroid recurrence, women are prescribed hormonal drugs.

The risk of recurrence after UAE is less than 1%. If the myomatous node is detected again, the procedure can be repeated.

Uterine artery embolization is the preferred method of treating fibroids if a woman plans to become pregnant in the long term, if many nodes are found in the uterus.

Secondly, not all doctors are proficient in the UAE technique, and not all clinics have the equipment to perform it. Gynecologists work the old fashioned way and are reluctant to refer “their” patients to other specialists.

What should a woman who has been diagnosed with uterine fibroids do? Become a well-informed patient. You can find a lot of information on the Internet about uterine artery embolization.

If there is no specialist in your city who practices this type of treatment, you can come to the European clinic or get a consultation with our doctor remotely - to do this, send the results of your research to our email.

Do medications help?

Drug treatment of uterine fibroids is possible, but indications for its use are limited. It is advisable to use only one drug - ulipristal acetate.

It blocks receptors for the hormone progesterone and stops the growth of fibroids. Nodes shrink in 60% of cases.

It is recommended to carry out two or three cycles of treatment at intervals of 2 months, while regularly performing ultrasound and monitoring the growth of nodes.

This therapy is indicated only for young women with uterine fibroids up to 3 cm. Its disadvantage is that it has only a temporary effect. It is impossible to predict when fibroids will begin to grow again after treatment.

Are there effective measures to prevent uterine fibroids?

Since the exact causes of the disease are unknown, there are no effective methods of prevention.

The risks are reduced in women who have multiple children. But, of course, protection from uterine fibroids is not the first on the list of reasons why women plan pregnancy, and this is not the determining factor.

The most important measure is regular visits to the gynecologist and ultrasound. They help to diagnose uterine fibroids in a timely manner, assess its size over time and find out when treatment is required.

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Source: https://www.embolization.ru/mioma-matki

Myoma is a benign tumor of the uterus

Almost 30% of the entire adult female population around the world asks the question: what is fibroid? This disease creeps up unnoticed, and recognizing it at the very initial stage is very difficult. She is like a black cat in a dark room: she is and is not visible. So what kind of disease is this?

Myoma is a benign tumor of the uterus that develops from muscle fibers and connective tissue elements.

Depending on the ratio of muscles and connective tissue in the structure of the tumor, in recent times it had a variety of names: myoma, fibroma, fibromyoma.

But since fibroid nodes often develop from muscle cells, most doctors today consider the correct term “fibroids” or “leiomyoma”.

Most often, fibroids are a slow-growing tumor, and a tumor capable of relapse and degeneration into a malignant neoplasm. Every woman should know about this!

When does it occur?

The development of uterine fibroids is a benign, hormone-controlled increase in the thickness of the muscular layer of the uterus - the myometrium. And there can be many reasons that contribute to the beginning of this process.

Hormones only control the growth of fibroids, and it occurs spontaneously - after abortion, improper contraception, chronic inflammatory processes in the female organs, hormonal disorders, stress, due to excessive love of tanning, obesity or hereditary predisposition. In short, fibroids form after anything that can provoke tumor growth in our body.

If we had the opportunity to look inside the muscular layer of the uterus at the very beginning of the development of fibroids, we would see an extremely interesting picture. The cells of the uterus spontaneously begin to actively divide.

This is confirmed by the fact that fibroids increase in size during pregnancy and decrease in size during the postmenopausal period.

At the same time, the normal balance of estrogen and progesterone in the blood does not at all guarantee the absence of fibroids: it can arise with minor fluctuations in hormonal levels.

How is fibroid diagnosed?

Fibroids are most often detected during a medical examination by a gynecologist. In this case, the doctor can only state the fact of the presence of uterine fibroids.

In other situations, the first signs of fibroids may be pain in the lower abdomen or lumbar region, bleeding, changes in the menstrual cycle, dysfunction of neighboring organs, for example, frequent urination.

The classic manifestations of uterine fibroids are protracted regular menstruation, against the background of which there are often irregular uterine bleeding - metrorrhagia. If such symptoms appear, you should go to an appointment with a gynecologist.

Diagnosing fibroids is not difficult if there is an increase in the size of the uterus, uterine bleeding, or deformation of the uterus by fibroid nodes. It can be detected by palpating the uterus through the anterior abdominal wall.

Final confirmation of the diagnosis is provided by ultrasound, hysteroscopy or hysterography. The last two methods are contraindicated for pregnant women.

Sometimes doctors may prescribe computed tomography or nuclear magnetic resonance to clarify the diagnosis.

Should she be treated?

Myoma can “resolve” on its own if the body’s hormonal levels change. Conditions contributing to this: small size of fibroids, absence of symptoms and progression over a fairly long period of time. For example, during or after menopause.

However, fibroids are often still operated on. The presence of fibroids in itself is not always an indication for surgery. It all depends on the patient’s condition, the severity of symptoms and the size of the tumor.

Indications for surgery to remove fibroids are pain, rapid growth in the size of the node, suspicion of degeneration into a malignant tumor, impaired blood supply to the fibroid nodes and inflammatory changes in them, failure of the functions of neighboring organs - the bladder, intestines; infertility – when all other causes have already been excluded. If an experienced gynecologist believes that surgery is necessary, then the sooner it is done, the better.

There is also a conservative solution to the problem. Uterine fibroids should be monitored regularly using ultrasound with a vaginal probe.

In many cases, this is quite enough, and no treatment - neither conservative nor even surgical - is required.

If a woman periodically experiences discomfort or pain in the pelvic area, taking non-steroidal anti-inflammatory drugs is effective. But prescribing hormonal drugs in order to reduce the size of the node is completely unjustified.

Today, another treatment method has been developed - transcatheter embolization of myomatous nodes, in which the node is deprived of blood supply and undergoes regression without the slightest harm to the uterus as a whole, but this method still remains experimental and is not widely used.

The most modern method of treating fibroids is immunocorrection using a special vaccine, which promotes the formation of a specific immune response against this disease. This treatment is used in young patients with tiny fibroids and at the very beginning, at the start of the disease. The goal of treatment is to preserve the uterus and enable the patient to give birth at the right time.

What about prevention?

We have already talked about it.
These are: – regular visits to the gynecologist for early diagnosis of the disease;
– prevention of abortions;

– reasonable use of hormonal contraceptives under the supervision of a physician.

Source: https://zoj.kz/populiarnie/women/1627-mioma-dobrokachestvennaya-opuhol-matki.html