Fibroids are the most common uterine tumors in women. However, do not be frightened when you hear the word tumor. Because they are not cancer. Although half of women have fibroids, most of them do not know about it. Your doctor may discover them by chance during a gynecological examination or ultrasound. Half to one third of women with fibroids have symptoms. These women are usually between 30 and 40 years old.
Most fibroids do not cause you any problems. They only require regular gynecological examination and follow-up with ultrasound imaging. Especially if you are close to menopause, follow-up is more appropriate. Because the hormones estrogen and progesterone during the fertile period can increase the growth of fibroids. During menopause, the ovaries will stop producing hormones and fibroids will no longer grow.
If there are symptoms such as excessive bleeding, abdominal pain or compression of neighboring organs, the fibroid must be removed. In addition, other problems that may occur are as follows;
– You may develop anemia because you bleed a lot.
– Your belly may grow.
– You can go to the toilet often.
– There may be back pain.
– Constipation may occur.
– There may be pain during sexual intercourse.
Rarely, fibroids can prevent you from conceiving by pressing on the ovarian ducts and blocking the passage of the fertilized egg into the uterus. In this case, the fibroid may need to be removed. In the past, fibroids were treated by removing the entire uterus. But this is a very serious operation and you cannot have children afterwards. And if the ovaries are also removed, you will need to take hormone therapy to deal with the symptoms of menopause. But now, for most women, other treatments are possible without this. This is because they are not cancerous and usually grow slowly. You have plenty of time before making such a serious decision.
How do they develop?
Fibroids develop from the muscle layer of the uterus. From a simple cell, it multiplies continuously to form a pale, rubbery, separate mass that can be of different shapes. There may be a single one or many. It can enlarge the uterus and distort its shape, sometimes so much so that it can even reach the rib cage.
They can take different forms;
-In the muscle layer of the uterus
-On the outer surface of the uterus
-In the lining of the uterus
-They can develop attached to a stalk on the inner or outer surface of the uterus.
Causes
It is not known exactly why fibroids form, but many factors are thought to be involved.
Genetic causes. In 40% of fibroids, there is a gene change in the uterine muscle cell.
Heredity. If your mother or sister has fibroids, you are at high risk of developing fibroids.
Race. It is more common in the black race.
Hormone dysregulation. Estrogen and progesterone appear to initiate fibroid formation. The cells in fibroid tissue contain more estrogen and estrogen receptors than normal uterine muscle cells.
Obesity Obese people are at higher risk of developing fibroids.
Symptoms and Signs
– Excessive menstrual bleeding
– Prolonged menstruation
– Clot fragments in menstrual blood
– Pain or pressure in the groin
– Pain during sexual intercourse
– Urinary incontinence, frequent urination
– Constipation
– Pain in the lower back or legs
– Fatigue due to anemia caused by excessive blood loss
– An enlarged uterus as if there is a pregnancy
– Infertility, miscarriage or premature birth
Diagnosis
With a gynecological examination, your doctor can estimate the size of the fibroid by feeling your uterus. He or she may even compare it to a pregnancy and express it as the size of a 10-week or 12-week pregnancy. If necessary, your doctor may also order blood tests for bleeding disorders and hormone levels.
In order not to miss other causes of abnormal bleeding, such as cancer, cell samples (biopsy) can be taken from the inside of the uterus and sent for analysis. Abnormal bleeding, especially in older women, is also important. Fibroids are easily seen with ultrasound. Images of the uterus are obtained with sound waves and its size is measured. Depending on the location of the fibroid, it can be performed through the abdomen and/or vagina. To get a better image with abdominal ultrasound, the bladder must be full of urine. Therefore, it is useful to drink plenty of water. However, no such preparation is necessary for vaginal ultrasound. Other imaging methods (tomography or magnetic resonance imaging (MRI)) may also be performed if your doctor deems it necessary.
Treatment
The most appropriate treatment for fibroids is surgical removal of the uterus. But there are also other treatment options.
-Medication treatment. Some synthetic hormones can relatively reduce or stop fibroid growth.
-Myolysis. This involves the destruction of the fibroid by applying an electric current to the fibroid. Destruction can also be done in another way by freezing with liquid nitrogen.
-Removal of the fibroid. Only the fibroid is removed and the uterus is left in place.
-Laser burning. Fibroids on the inside of the uterus can be burned with a laser.
-Follow-up If the fibroid is not causing you any problems, you do not need treatment. It is enough to go for regular check-ups. However, if there is a problem, then treatment options will be evaluated. In fact, there is no single approach to fibroids treatment. Your choice will depend on many factors together with your doctor.
– Your existing symptoms
– Severity of symptoms
– Your childbearing status
– Approaching menopause
– Your thoughts about surgery will be the determining factor in your treatment options.