El Uterine myoma It is a benign tumor of the body of the uterus or womb of the woman. It is a tumor because it presents growth, although frequently it is slow.
This does not imply malignancy. There are very few cases of fibroids that can become sarcomas or malignant tumors of the uterus.
Uterine fibroids are also called leiomyomas or fibroids.
The medical services of the Dra. Gómez Roig Institute include the Gynecology and the pathology of the sexual reproductive organs such as myomatosis or uterine fibroids.
What is a uterine fibroid
Uterine fibroid is a tumor, or uterine nodule, which grows on the wall of the body of the uterus independently of the rest of the muscle that composes it.
The uterus is made up of muscle and myomas or fibroids grow from it.
Fibroids can grow from the muscular wall of the uterus in or out. These growths are not cancerous and do not usually become cancerous. However, sometimes it is necessary to make the differential diagnosis with a malignant tumor that grows very quickly, although these are very rare.
This benign uterine pathology It is very prevalent, since approximately 80 percent of women will have fibroids throughout their lives.
Not all are diagnosed, since many times they do not give symptoms.
Fibroids are treated in women who have fibroid-related problems, such as heavy menstrual bleeding, pain or pressure in the pelvis, or infertility and sterility.
What are the causes of fibroids?
causes of fibroids or fibroids is unknown.
These benign uterine masses They seem to respond to the female hormones: estrogen and progesterone. That is, they are dependent on hormones and with them they can grow.
On the other hand, some women have specific genes that may predispose them and their families to developing fibroids.
Lifestyle and reproductive factors can also play a role.
Some fibroids grow over time and others shrink.
In menopause, when the hormones disappear, they usually stop growth or even reduce their size somewhat. They don't usually go away completely.
What types of fibroids are there
The types of fibroids They can be classified according to their location.
In addition, fibroids can be located in:
- La innermost part of the muscular wall of the uterus, touching or pushing the endometrium, the inner layer that gives the rule: subsmucosal fibroids.
- Middle part of the musculature without bulging neither in nor out: intramural.
- La most superficial part from the wall pushing outward: subserous fibroids.
Gynecologists follow somewhat more complex classifications within this same classification. To help standardize the criteria for conduct and treatment at a professional level.
What symptoms do uterine fibroids give
The symptoms of uterine fibroids They can vary according to their size and location.
Some fibroids can be microscopic in size up to the size of an orange or even larger. In addition, the largest are usually the ones that give the most symptoms.
The submucous fibroids, those that press the endometrium, the inner layer of the uterus that gives the rule, also give more symptoms.
Most of these benign growths are small and do not cause any symptoms. However, some women have very heavy and long periods. Other women report pelvic pressure or pain that interferes with their quality of life.
Fibroid symptoms tend to improve when a woman no longer has menstrual periods and is in menopause.
Most frequent reasons for consultation
The most frequent reasons for consultation are:
- Increase and duration of menstrual bleeding.
- Pelvic pressure and pain.
- If it is pressing on the bladder, the woman may feel like she needs to go to the bathroom more often.
- A fibroid pressing on the rectum can cause constipation.
- Sterility, in a low percentage, and more related to age. The older you are, the greater the risk of having uterine fibroids.
Most women who have a pregnancy with uterine fibroids small or isolated, the course of pregnancy is usually normal and without complications.
However, women with large fibroids, or with the presence of multiple fibroids, may be at increased risk of complications such as increased risk of miscarriage and prematurity.
How are they diagnosed?
The diagnosis is made by gynecological examination: abdominal palpation and vaginal examination.
La gynecological ultrasound identifies uterine fibroids, as well as defines their size and location.
Uterine fibroid treatment
El uterine fibroid treatment it is decided based on the presence of symptoms, size and location of the tumor.
Women who do not have symptoms usually do not need any treatment.
En women with symptoms that affect their quality of life, they can try medical treatment. And if this does not work, go to a surgical one.
The best treatment depends on which symptom bothers you the most. The size, number, and location of fibroids, as well as whether or not you want a future pregnancy also influence treatment decisions.
The treatment will be classified into:
- Medical treatment
- Surgical treatment
Medical treatment
Most medical treatments are aimed at reducing symptoms such as Menstrual disorders: heavy menstrual bleeding, pain, or correct anemia.
The Medical treatmentsThey are often recommended before surgical treatments.
In addition, treatments of this type include:
- iron and vitamins: for women with anemia.
- Nonsteroidal anti-inflammatory drugs, NSAIDs, such as ibuprofen and naproxen. These medications help reduce associated pain.
- Hormonal contraceptives: These methods include the pill, skin patch, vaginal ring, hormonal shot, hormonal IUD, and subcutaneous implant. These treatments reduce bleeding, pain during the menstrual period, and can correct anemia.
- Antifibrinolytic drugs: These medicines do not contain hormones and work by helping the blood to clot sooner, decreasing bleeding. Tranexamic acid is used worldwide as an antifibrinolytic.
- Progesterone receptor modulators: Medications that change the way the progesterone hormone works are being used more and more. This treatment quickly stops heavy menstrual bleeding and causes some contraction of the fibroids.
- Gonadotropin-releasing hormone agonists: is a medication given by injection once a month or every three months, used to temporarily shrink uterine fibroids and stop menstrual bleeding. It simulates an artificial menopause, and is accompanied by menopausal symptoms as a side effect.
Surgical treatment
The surgical treatment of uterine myoma may be indicated if:
- The woman has heavy menstrual bleeding, pain, or pressure that does not improve with medical treatments.
- You are trying to get pregnant.
- The size or location of the fibroid is giving symptoms that worsen the woman's quality of life.
El Surgical treatment Consider different possibilities:
- Myomectomy: Myomectomy is a surgery performed to remove uterine fibroids and reduce related symptoms. Preserving the uterus allows having children later.
- endometrial ablation: This technique destroys, or partially removes, the inner lining or endometrium of the uterus. Treatment does not reduce fibroids, but it does decrease menstrual bleeding.
- Uterine artery embolization, uterine fibroid embolization, also called UFE: This treatment blocks the blood supply to the fibroids, reducing their size and bleeding.
- focused ultrasound guided by magnetic resonance or MRgFUS: it is a recent option. It is carried out in an MRI machine that guides the treatment. Multiple waves of ultrasound energy pass through the abdominal wall and converge on a small volume of tissue, leading to thermal destruction of the fibroid.
- Laparoscopic Radiofrequency Ablation Ultrasound-guided: This is also a novel treatment that uses several small incisions in the abdomen to place a camera, a thin ultrasound, and the ablation device. Causes tissue destruction.
- Hysterectomy: Hysterectomy is a surgery that removes the uterus that includes fibroids. This technique implies the non-possibility of having a pregnancy later.
Possible complications
La uterine myomatosis, a condition characterized by the presence of fibroids (benign tumors) in the uterus, can trigger various complications in some women. Although fibroids are usually rare in terms of causing serious problems, it is important to be aware of symptoms that could affect quality of life and reproductive health.
One of the main problems associated with myomatosis is abnormal uterine bleeding, which can be heavy and prolonged, causing anemia in many patients.
This bleeding may occur unexpectedly or be related to the menstrual cycle, complicating the management of uterine myomatosis.
In some cases, they can distort the uterine cavity, interfering with a woman's ability to become pregnant or carry a pregnancy to term. Some women who do conceive, depending on the location of the fibroid, may face additional difficulties when trying to give birth, as some may increase the risk of premature birth or the need for a cesarean section.
Although The most serious complications are rare, it is essential to have the guidance of a medical professional to assess the size, location and impact of the fibroids. Adequate monitoring will allow the best treatment to be decided, which may include active surveillance to surgical interventions, such as myomectomy or, in severe cases, hysterectomy.
While most fibroids do not pose a serious threat, they should not be ignored. Early medical attention can make a big difference in reproductive health and in preventing long-term complications.
When to worry
Uterine fibroids can cause a number of complications. Although fibroids do not usually cause serious problems, and many of them are asymptomatic, there are situations in which they should be a cause for concern.
El heavy and prolonged uterine bleeding It is one of the main warning symptoms, as it can lead to anemia and affect quality of life.
Occasionally, infrequently and depending on the location, it can appear in the vagina after an attempt to give birth to the fibroid, or what the medical professional calls a delivery of myomaThese situations are also accompanied by heavy bleeding.
In addition, fibroids can cause abdominal pain. This occurs in the case of rapid growth of uterine fibroids. Before experiencing abdominal pain, it is always advisable to consult a doctor and check the condition of the fibroid.
Although serious complications are rare, it is crucial to have an evaluation by a gynecologist specialist to assess the impact of these benign tumors.
Depending on the case, interventions such as surgery or other procedures may be required to preserve the patient's health and well-being.
We take care of women's health
On Dra. Gómez Roig Institute we take care of women's health. Within our medical services, gynecology includes the diagnosis and treatment of uterine fibroids.
If you want to know more, do not hesitate to contact us.
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- About the Author
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Head of the Obstetrics and Gynecology Service at the Sant Joan de Déu Hospital in Barcelona. Associate Professor of Obstetrics and Gynecology and Coordinator of the Sixth Course of Medicine at the University of Barcelona, UB. Director of the Dra. Gómez Roig Institute and Coordinator of Obstetric and Gynecological Processes at the Corachan Clinic in Barcelona.