Browse By

Uterine fibroids: characteristics, symptoms and treatment options

The size of Uterine Fibroids varies considerably from negligible to large voluminous masses.

What is Uterine Myomatosis?

The Uterine fibroidsalso known as uterine fibroidsis a very common condition in which benign, non-cancerous tumors grow in the uterus, these tumors are made of smooth-fibrous muscle tissue and collagen.

There are many women who can have fibroids at some point in their life and not knowing it because sometimes they do not cause symptoms, 30% of them are asymptomatic. One in five women may have uterine fibroids during reproductive age. The figure reaches 40% in women under 50 years of age, v30% are multiple and are found in 70% of hysterectomized uteruses.

What factors can contribute to suffering from Uterine Myomatosis?

The causes of suffering from this type of tumor are not exactly known, specialists point to genetic changes, hormonal causes and growth factors.

Factors that can increase the risk of uterine fibroids They include family history, age (they are more common in women ages 30 to 40), ethnicity (African American women are at higher risk), obesity, and diet.

Symptoms

Some women with Uterine Myomatosis do not have symptoms, but the most common are:

Menstrual disorders

– Menstruations with heavy, prolonged and painful bleeding

– Intermenstrual bleeding

They are also common compression symptoms which depend on the location and size of the fibroid, difficulty completely emptying the bladder, frequent urination, constipation, pelvic pain and pain during sexual intercourse.

Although they can appear at any age, Uterine Fibroids are more common in women 30 to 40 years old and 20% to 50% of women may have fibroids.

Diagnosis

A good clinical history should be included with a detailed pelvic examination to determine a good diagnosis; if suspected, a Transvaginal Ultrasound and in some cases a pelvic MRI in order to clarify the diagnosis of Uterine Fibroids, their size, number and location for proper management.

What risks exist if Uterine Myomatosis is not treated in time?

If uterine fibroids are not treated in time they can lead to serious complications such as anemia due to significant uterine bleeding, pelvic pain, abortions and adjacent compression.

A very important issue is its relationship with fertility; there is good support regarding the deleterious impact on fertility of submucosal fibroids and the benefit of their removal.

There is good support regarding the non-impact on fertility of subserosal fibroids or their removal. The evidence of the negative impact of intramural fibroids larger than 4 cm has slightly improved, but studies are lacking.

Uterine fibroids have been associated with adverse outcomes pregnancy as spontaneous abortion present in those fibroids with an intracavitary component. Another adverse pregnancy event is malpresentation and increased cesarean delivery due to placental abruption and fetal growth restriction.

In rare cases, fibroids can transform into a type of cancer known as leiomyosarcoma when very accelerated growth of the fibroid and suspicious tissue changes are observed on MRI.

What does the treatment consist of?

In some cases, observation may be all that is needed, especially if the fibroids are not causing significant symptoms.

Treatment may vary depending on the size of the fibroids, their number and location, as well as the patient’s symptoms, age and “plans to have children.”

The gynecologist is the one who decides together with the patient which is the most appropriate treatment in each case.

Treatment alternatives for Uterine Myomatosis

Ulipristal acetate (ESMYA)

It is a medicine that is used for treatment of uterine fibroids symptoms in adult women, acts as a selective progesterone receptor modulator, meaning it has a specific effect on progesterone receptors in the uterus. By binding to these receptors, Ulipristal Acetate blocks the effects of progesterone on the growth of fibroids, which can reduce their size.

In terms of results, clinical studies have shown that Ulipristal Acetate can reduce the size of Submucosal Uterine Fibroids type 1 and 2 and some cases of large volume intramural fibroids and relieve associated symptoms, however, results may vary from person to person. It is important to note that this medication is not a definitive cure for uterine fibroids and the effects may be temporary.

Used preoperatively to reduce the size of the fibroids, it would facilitate the technique of the subsequent myomectomy.

The intrauterine device (Mirena)

It is a contraceptive method that contains Levonorgestrel, a type of synthetic progestin. While Mirena is not used specifically for the treatment of uterine fibroids, can help relieve associated symptoms with fibroids in some cases.

Mirena may be useful in the treatment of submucosal fibroids types 1 and 2, as the Levonorgestrel released by the device can reduce heavy menstrual bleeding associated with these fibroids.

Laparoscopic myomectomy with morcellation can be performed to treat benign and symptomatic uterine fibroids with adequate size and location in selected patients.

Preoperative evaluation: Before laparoscopic myomectomy with morcellation, a thorough evaluation of the patient is recommended, including imaging tests (such as ultrasound and MRI).

Do not use this technique in cases where malignancy is diagnosed or with the slightest suspicion of occult neoplasia.

Can Uterine Myomatosis be prevented?

There is no sure way to prevent uterine fibroids, as their exact cause is unclear. Maintaining a healthy lifestyle, including a balanced diet and regular exercise, can help maintain a healthy weight, which may reduce your risk.

Care and recommendations

Women must do regular gynecological check-ups(including a transvaginal ultrasound), to analyze any changes in your menstrual cycle or new pelvic symptoms or infertility and thus rule out the diagnosis of Uterine Fibroids and also detect other gynecological pathologies in time important and frequent such as pelvic endometriosis, ovarian cysts and endometrial polyps.