Uterine Fibroids

What are fibroids in the uterus?

Myomas or fibroids are benign growths emerging from the smooth muscle of the uterus (the uterus).

Fibroids are also called fibroids, or leiomyomas.

Fibroids are very common, and there may be one or many. Small fibroids usually gives no symptoms, and many women have fibroids in the uterus without knowing it. Sometimes muscle knots discovered by chance by a gynecological examination or a scan of the abdomen.

If the muscle knots becomes large or poor location, they can be a nuisance.

How common are fibroids in the uterus?

In an ultrasound study found myomas in 4% of women aged 20-30 years, 11-18% were aged 30-40 years and 33% aged 40-60 years.

In other statements varies the frequency of fibroids from 5% to 77% depending on the women studied, the method used to detect the muscle knots, and the very small knots are counted or not.

What causes fibroids in the uterus?

The reason is unclear, but the tumor growth rate is affected by the hormones estrogen, growth hormone and progesterone. Estrogen and growth hormone stimulates the growth of myomas, whereas progesterone inhibits growth.

Myomas grow as long as the woman is clever fertilization, and they tend to increase in size during pregnancy. Myomas shrink after menopause. Women who have not been pregnant, you often myomas.

Use of oral contraceptives and hormone replacement therapy during menopause may get myomas grow.

Fibroids are more common in some breeds than others, and there seems to be a certain heredity for myomas.

What are the symptoms of fibroids in the uterus?

Myomas leads in most cases no discomfort.

Symptoms often attributed myomas, are heavy menstrual bleeding (Menorrhagia in approximately 30%), irregular vaginal bleeding and menstrual pain(Dysmenorrhea). The risk of bleeding disorders the greatest if the muscle knots are centered inside the womb and bulge into the uterine cavity and affects the lining of the uterus.

Large fibroids can cause abdominal pressure and heaviness. You can press on the bladder, causing frequent urination or incontinence. You can press against the gut and cause difficulty with bowel movements. In rare cases, very large fibroids pinch off the urethra.

Fibroids usually gives no pain and are rarely malignant. Fibroids can cause pain if it grows very quickly, and vascular supply can not keep up.

What symptoms should you pay particular attention to?

If you as part of symptoms related to myomas experience signs of anemia or other conditions that require effort.

Pregnancy and myomas

It is unclear whether trouble getting pregnant (infertility) and repeated miscarriages are associated with myomas.

Most women who have fibroids can become pregnant. Approximately every fifth fibroids to grow in the first half of pregnancy. Large fibroids that grow rapidly, can cause pain due to insufficient blood supply to the muscle knot, where parts of the muscle knot perish (infarction in myomet). In most cases the pain decreases gradually. In rare cases triggered premature labor.

Large fibroids may increase the risk that the fetus turns in positions other than head position at birth.

It is rare for fibroids grow so large that a normal birth can not be implemented.

If myomas suspected to be the cause of complications in pregnancy, they should be removed before the next pregnancy.

How is it diagnosed?

The diagnosis may be suspected by a gynecological examination. Ultrasound often provide a definite diagnosis. Smaller fibroids which sits inside the womb, best through a keyhole through the vagina (hysteroscopy).

What treatment is there?

In most cases it is not necessary treatment.

If there is bleeding disorders, believed triggered by muscle knots, you can initially try medical treatment of bleeding problem. In other situations, a surgery may be the right treatment.

The most commonly used medical treatment is the insertion of IUS. The spiral leads in most gradually to the cessation of menstruation, and also entails that myomas reduces in size. There are often spotting in the first 3-6 months after placement of an IUS and these bleeding can be more powerful if there are fibroids in the uterus. If there are fibroids inside the uterine cavity, is a hormone spiral is rarely a good idea.

It launched a new product Esmyra that can reduce the size of fibroids. It is recommended to use it prior to surgery and the preparation may be used in three possibly six months. Another alternative is the drug tranexamic acid, which inhibit the loss of blood by menstruation. The pill may also be attempted.

Surgery may be current. You will either choose to remove the whole uterus or just myomas – depending on where muscle knots sitting, their size and age of the woman.

Less muscle knots which is housed inside the uterine cavity, may optionally be removed by a telescope operation through the vagina (hysteroscopic surgery). In some cases, more than one intervention to.

Larger fibroids require an open operation through the abdominal wall. In young women who have a desire to become pregnant, it is often possible to remove muscle knots and preserve the uterus. In women who have had the children they will have, the best solution is often to remove the entire uterus. This prevents, that new fibroids and needed several operations. Before menopause will preserve ovaries and hormone production does not change, but there will be no more bleeding.

A newer method is embolization (occlusion) of the arteries (arteries) that provide blood supply to the muscle knot. Conducted a catheter into the artery in the groin and into the artery (artery), which supplies the uterus. Small microparticles is injected into and block the artery. The procedure is performed only a few places in South Africa.

Embolization may be painful for the first time after the procedure, but reduces the presence of heavy bleeding, and 75-80% of women may prevent the uterus to be removed. So far, this method is not for women who have a desire for pregnancy, as there may be an increased risk of miscarriage and pregnancy complications after this treatment.

How is long-term prospects?

Myomas are benign. They grow usually very slowly, but they can be very large, especially in pregnancy. Myomas will decrease in size after menopause, but will not disappear completely.

In women using estrogens in tablet form after menopause, muscle knots continue to grow.

One can experience certain complications of myomas:

• If all or part of a myoma suddenly dies (an infarction in the uterus), you can have pain and fever
• Infertility can occur as a result of changes in the womb
• In pregnant can cause myomas abortionSeat position and cross bearing, preterm labor, pain, difficult labor and bleeding after childbirth
• Women with myomas have a slightly increased risk of cancer of the endometrium, but the risk is still very small. uterine cancerarises only after menopause and is manifested by bleeding after the regular menstruation has ceased. This is a symptom that should always be considered whether there is myomas or not

How do I avoid or aggravate fibroids in the uterus?

There are shown association between high intake of meat and other animal products, while fruit and vegetables reduces the risk of fibroids.

Similarly, a high BMI have a correlation with fibroids.