Approximately 50 to 70 percent of all women of childbearing age will suffer from a uterine myoma at some point in their lives. Fibroids are also the most common cause of hysterectomies at this age.
What is a uterine fibroid?
The term uterine fibroid, also known as uterine tumor, refers to a benign growth in the muscle layer of the uterus. Fibroids consist partly of connective tissue and can grow up to several centimeters in size. As growth progresses, they can even fill the entire uterus, as in pregnancy. For lassa fever 101, please visit photionary.com.
A uterine myoma is a hormone-dependent tumor and its growth is stimulated by estrogen. Therefore, growth depends on the intact function of the ovaries, in which the sex hormones are produced. This is why uterine fibroids only appear when a woman is of childbearing age and usually slowly regress during the menopause.
Causes
How a uterine fibroid develops has not yet been sufficiently researched scientifically, but it is considered certain that there is a connection between the estrogen balance and the occurrence of hormones. The benign tumor develops from muscle cells in the uterus. It is not unlikely that they arise from an energy rush that the body normally intended for pregnancy.
There also seems to be a genetic predisposition, because uterine fibroids occur more frequently in families in which the mother already suffered from fibroids. It is also known that high estrogen levels promote the growth of fibroids and that they mainly occur during the fertile period. Fibroids do not appear before puberty and they go away again during menopause.
Symptoms, Ailments & Signs
The symptoms and symptoms that a fibroid causes are highly dependent on its size and whether one or more fibroids are present. Prolonged menstrual bleeding can occur, with the intensity of the bleeding mostly depending on the size and location of the fibroid. Some women can develop anemia from the increased bleeding.
Other symptoms can include feelings of pressure and discomfort in the abdomen because the fibroid can press on other organs. In the bladder, this can lead to a stronger urge to urinate or problems with emptying the bladder. If the fibroid presses on the rectum, constipation is encouraged. Discomfort during sexual intercourse is also common.
Women with fibroids who wish to have children often do not become pregnant because the fibroid can prevent the fertilized egg cell from implanting in the uterus. When fibroids grow during pregnancy, they can cause miscarriage, pregnancy discomfort, and premature labor.
Diagnosis & course of disease
In most cases, uterine fibroids are detected during a pelvic exam. Sometimes the anamnesis interview gives rise to a suspicion. The conversation is followed by a physical examination, and if a fibroid is suspected, an ultrasound examination, in which fibroids can be easily identified. The size and position can also be precisely determined in this way.
Other examinations such as magnetic resonance imaging (MRI) or computed tomography (CT) can sometimes be carried out in addition, especially if fibroids have to be surgically removed. With a hysteroscopy, fibroids that protrude into the uterus can be examined more closely.
If they grow into the abdomen, a laparoscopy can provide information. In most cases, however, this is not necessary. It is not easy to distinguish benign uterine tumors from malignant ones. In most cases, a tissue examination is necessary.
Complications
A uterine fibroid is usually harmless and does not result in any further symptoms. Complications can occur when a so-called uterus myomatosus occurs, i.e. the uterine wall is interspersed with numerous fibroids. This increases the risk of malignant degeneration, which is rare in classic uterine fibroids (in less than one percent of all those affected).
Furthermore, a uterine fibroid promotes urinary tract infections and occasionally causes pain when urinating. If the fibroid presses on the bladder or ureters, functional disorders can occur. An infestation of the intestines and kidneys also carries the risk of a sensitive disruption of organ function. A pedunculated suberous fibroid can suddenly twist the pedicle, causing severe pain and serious complications that require prompt surgery.
In the long term, a uterine fibroid can cause fertility problems. If the growth occurs during pregnancy, there is a risk of preterm labor. Above a certain size, fibroids can also cause anomalies in the position of the child. If the uterine fibroid is just under the lining of the uterus, it can cause an ectopic pregnancy or a miscarriage.
There are typical risks associated with surgical or medical removal. Infections and injuries can always occur during surgery. Drug therapy is associated with the risk of side effects and interactions.
When should you go to the doctor?
In the case of a uterine myoma, the person affected is usually always dependent on medical treatment by a doctor. Since this disease cannot heal on its own, a doctor must be contacted at the first signs and symptoms to prevent further complications. Early diagnosis usually has a positive effect on the further course. A doctor should be consulted for uterine fibroids if the woman suffers from significantly prolonged menstrual bleeding. This can also come very irregularly, which can have a negative effect on the psyche.
Many women also suffer from anemia as a result of the disease. In many cases, severe abdominal pain or pain during sexual intercourse can also indicate this disease and should also be examined by a doctor. Some women continue to experience pain when urinating. A uterine myoma can be treated by a general practitioner or by a gynaecologist. As a rule, this disease can be treated well so that there are no further complications and no reduced life expectancy for those affected.
Treatment & Therapy
If there are no symptoms, fibroid treatment is not absolutely necessary, but a check-up should be carried out approximately every six to twelve months. In the case of complaints, the therapy depends on various factors such as the age of the woman or whether she still wants to have children or has completed family planning. The size and location of the uterine myoma is also crucial.
In principle, fibroids can be treated with various methods: surgically, with medication or newer methods such as embolization or focused ultrasound. In younger women, uterine preservation measures are preferred, in older women who have completed family planning, the usual therapy is usually removal of the uterus ( hysterectomy ).
In the case of drug treatment, progestins are usually used for treatment, which reduce the body’s own estrogen production and inhibit fibroid growth so that the symptoms decrease. If a fibroid is very small and you still want to have children, there is also the option of removing individual fibroids, either through a small abdominal incision, vaginal or laparoscopic surgery.
During an embolization, the blood vessels are blocked, which ideally leads to a regression of the fibroid. With focused ultrasound, beams are aimed at the spot where the fibroid is located. The fibroid should die off due to the resulting heat. However, this procedure is still new, very expensive and is often not reimbursed by health insurance companies.
Prevention
A meaningful prevention is not possible with a uterine myoma. Women of childbearing age should attend regular check-ups so that fibroids can be detected at an early stage. Early treatment can prevent worse symptoms from undetected fibroids. Even if an operation has been carried out, this does not mean that fibroids can no longer appear. They can grow again and again because they are located in the uterine muscles. Only an operation can prevent a new formation.
Aftercare
As a rule, a uterine fibroid is not treated because it is usually small and does not cause any symptoms. However, it is observed regularly and consistently in the course of follow-up care. Usually, the affected women should go to the gynecologist for check-ups at intervals of about three to six months. The attending doctor decides on the exact time intervals.
In exceptional cases, shorter or longer intervals between the follow-up examinations are necessary. This mainly depends on any gynecological pre-existing conditions. As part of these checks, it is examined whether the uterine myoma is growing and possibly affecting other organs. On the other hand, the potential development of a malignant tumor should be detected in good time.
However, this only happens in extremely rare cases. Usually, the gynecologist performs both a palpation examination and an ultrasound examination. Other measures such as blood tests are rare. Strict follow-up examinations are also necessary after surgical removal of a uterine fibroid.
In the first few weeks after the operation, these are used to eliminate any possible symptoms that may follow from the operation. In addition, quarterly or half-yearly check-ups with the gynecologist check whether new uterine fibroids may form. The procedure is similar to that already described.
You can do that yourself
Uterine fibroids do not necessarily have to be treated. If clinical complaints appear, the gynecologist should be consulted. The individual therapy options can be supported by those affected by self-help measures.
In the case of drug therapy, the intake of the medication should be adhered to in the first place. Any hormonal problems should be reported to the doctor. Affected women should also take it easy and pay careful attention to possible side effects and interactions. Drug treatment usually takes place in preparation for an operation. Rest is important after an operation. If the pain persists, natural preparations from herbal medicine, such as pain-relieving teas with valerian or cooling and warming pads that are placed on the lower abdomen, help.
If the fibroids are treated using focused ultrasound, no further self-help measures are necessary. The most important measure is to observe the physical symptoms. After one to two weeks, the gynecologist must be consulted again. If the fibroid has shrunk as desired, the treatment can be repeated.
Accompanying general relaxation measures help to reduce the stress of the treatments and to improve well-being beyond the therapy. In the event of persistent intermenstrual bleeding or pain, the doctor must be informed.
