Uterine fibroids are among the most common female problems. Uterine fibroids are often asymptomatic, making diagnosis difficult and delayed and the therapeutic possibilities limited. It is therefore important to know the signs that may announce such problems and know how to relieve suffering without exposing you to later dangerous complications. Often discovered by chance during a routine gynecological exam, fibroids are most often benign tumors that do not turn into cancer but in very rare cases. In general, fibroids have the appearance of a ball and size as a nut, as a grapefruit or larger. Fobroids develop on the surface of the uterus, muscular layer of this organ (myometrium), and may be the origin of very severe symptoms that require specific treatment.
It is estimated that between 20% and 40% of women aged between 30 and 45 have been or are diagnosed with such tumors. Only 25% of them need therapy, in most cases the treatment consists of hysterectomy (surgical ablation of the uterus).
Formations develop independently of each other, and half of them are based on genetic aberrations.
There are several types of fibroids:
- Subserous fibroids located near the external surface of the uterus, develop in the abdominal cavity and can compress neighboring organs especially leading to a painful bladder and digestive tract.
- Interstitial fibroids that develop in the uterine wall depth.
- Submucous fibroids that develop in the uterine submucous layer.
Despite the high frequency, up to now the causes of appearance of uterine fibroids are unknown, thus different assumptions have been issued. Some researchers support the genetic origin of fibroids.
- Women whose close relatives are suffering or have suffered from such disorders have an increased risk of becoming victims of fibrosis also.
- Hormonal factors. Fibroids development is favored directly or indirectly by the estrogen in the blood and, to a lesser extent that of progesterone. This explains why some tumors disappear after menopause, when natural hormone production ceases.
- Obesity, age at first menstruation occurred – more than 12 years, infertility, lack of birth or ethnicity (black women are more likely to develop large fibroids and at younger ages) are also contributing factors.
In most cases, this is asymptomatic fibroids, they do not cause any disorder. There are sometimes a series of changes that may signal the presence of fibroids.
- Heavy menstrual bleeding, frequent and
- Pelvic pain
- Abdominal cramps
- Urinary disorders
- Bowel disorders
- Fertility problems
Diagnosis is established based on gynecological examination and an ultrasound or MRI. Around 30% of patients with appropriate age for procreation, present one or more fibroids and one third of these cases requiring treatment for stabilizing menstruation, relieveing pain, improving fertility and reducing obstetrical risks.
Currently there are a variety of therapeutic options to treat fibroids that are causing severe symptoms. Hormonal treatment, surgery and arterial embolization are just some of the many options available.
Drug treatment aims to reduce the production of progesterone, leading to fibroid atrophy. It generally uses derivatives of progesterone and antigonadotropic agents used as synthesis contraceptives, dosed particullary for each person. Hemostatics and NSAIDs (to limit bleeding) can complement the treatment. Unfortunately, using this type of therapy is transient and involves numerous side effects similar to those that accompany menopause, also it does not prevent reconstruction of fibroid a few months after the treatment ends.
Adverse effects during fibroids treatment:
- Hot flashes
- Vaginal dryness
- Bone decalcification
Surgery can be performed both classically (with the scalpel) and laparoscopically through the abdomen or vagina, depending on location and size of the fibroid. Thanks to medical advances in this field the number of days of hospitalization and complexity of the surgical act have reduced significantly. Myomectomy, myolysis, arterial embolization are the latest achievements in the field. These techniques allow the destruction of fibroids using an electric current or by limiting the fibroids blood perfusion, without affecting the uterus and hormonal cycles.
Complications of fibroids are rare, but when they exist they can be very serious:
- Anemia. Fibroids can be the origin of large amounts of blood loss, that can be the cause of an anemia.
- Aseptic necrosis. Stopping localized blood flow to fibroid tissue can cause brutal pelvic pain, fever and intense brown bleeding.
- Fibroid Torsion
- Compression of neighboring organs. Large fibroids may press on other organs: bladder, veins (edema, varicose veins, hemorrhoids), nerves (neuralgia), rectum and sigmoid.