What is uterine fibroids? What you need to know about uterine fibroids [Doctor-supervised]

Introduction

Uterine fibroids are benign tumors that develop in the uterus, and it is said that one in four women has uterine fibroids.

Because they are not malignant tumors (cancer), there is no need for emergency treatment if they are small, but if fibroids grow larger they can cause severe menstrual pain, anemia, and sometimes infertility, so it is necessary to monitor the progress and undergo treatment if necessary.

This time I would like to explain about uterine fibroids.

What are uterine fibroids?

It is a benign tumor originating from muscle tissue that develops in the uterus and is seen in women of all ages, from young people to postmenopausal women.

Fibroids grow due to hormones secreted from the ovaries, so they shrink after menopause. While fibroids are small, they often have no symptoms, and there are many cases where they are discovered by chance during cancer screening or pregnancy.

If uterine fibroids grow large, the stomach will look like that of a pregnant woman, and when you touch the stomach you may feel a hard, lumpy mass.

Types of uterine fibroids

Depending on the location where they occur, uterine fibroids are divided into subserosal fibroids, intramural fibroids, and submucosal fibroids.

Subserosal tendon swelling

They develop outside the uterus and typically do not cause symptoms until they increase in number.

As fibroids grow larger, they can put pressure on the surrounding organs, causing symptoms such as constipation and frequent urination.

In addition, twisting of the stalk can cause severe pain (pedunculated subserosal myoma) and, in severe cases, can lead to shock.

Intramural myoma

Fibroids that develop within the muscles of the uterus.

Nearly 70% of uterine fibroids occur within the muscle layer.

Small ones do not cause many symptoms, but as they grow larger they can cause deformation of the uterus, which can lead to irregular bleeding, infertility, miscarriage, and premature birth.

Submucosal myoma

Compared to fibroids in other locations, they are more likely to cause symptoms such as menorrhagia, excessive menstruation, and menstrual pain even when they are still small, and are also more likely to cause anemia.

As fibroids grow larger, the uterine lining becomes thin and stretched, making it more susceptible to bleeding, which can lead to irregular bleeding, heavy menstrual periods, and infertility.

Causes of uterine fibroids

The cause of fibroids has not been fully elucidated, but it is said that genetic mutations and female hormones released from the ovaries are related to their growth.

They may begin to appear in young people around high school age, rapidly increase in their 30s and 40s, and then continue to grow until menopause, at which point the number of fibroids may increase.

The increase in size and number varies from person to person, with some people experiencing no change for a long period of time and others experiencing a sudden increase.

Fibroids tend to get smaller before and after menopause, due to the involvement of female hormones released from the ovaries.

Endometriosis is thought to be related to later marriage and fewer births, but uterine fibroids are said to be unrelated.

Symptoms of uterine fibroids

The main symptoms are listed below. If the fibroid is small, some people may not experience any symptoms.

• Menorrhagia (heavy menstrual flow)
• Menorrhagia (prolonged periods)
• Dysmenorrhea (severe period pain)
• Feeling a lump in the abdomen
• Anemia
• Frequent urination
• Difficulty urinating (difficulty urinating)
• constipate
• lower back pain
• infertility
• Miscarriage or premature birth

Diagnosis of uterine fibroids

Diagnosis is by internal examination and ultrasound examination.
In cases where the fibroid is large or surgery is required, an MRI examination may be performed as necessary.

Large fibroids may rarely be uterine sarcomas, so MRI scans are important.

Pelvic examination and ultrasound examination cannot distinguish between uterine fibroids and sarcoma.

Treatment of uterine fibroids

In the case of small fibroids, asymptomatic fibroids, or non-large fibroids (fibroids with a diameter of 6 cm or less, or the entire uterus smaller than the size of a fist), no treatment is necessary and you will simply need to undergo regular checkups for observation.

Uterine fibroids do not turn into malignant tumors.

Treatment is indicated when the fibroid is large (fibroids 6cm or larger in diameter, or the entire uterus is larger than a clenched fist), or when symptoms are so severe that they interfere with daily life.

Treatment methods mainly consist of surgery and drug therapy.

Surgical treatments mainly include removal of the uterus (total hysterectomy) and removal of only the fibroids (myomectomy).

For those who wish to become pregnant in the future or have a strong desire to keep their uterus, surgery to remove only the fibroids is chosen.

Small fibroids may be left behind, and uterine fibroids may recur.

The surgical procedure is usually open surgery, but recently laparoscopic surgery has become more common.

Drug therapies include pseudo-menopause therapy (stopping menstruation with medication), low-dose oral contraceptive pills, intrauterine progesterone releasing system, iron supplements, and symptomatic treatment with oral painkillers.

Medical menopause treatments include nasal sprays, injections, and oral medications.

This method suppresses the secretion of female hormones and prevents menstruation, so the medication cannot be used for more than six months, as it may cause symptoms similar to those of menopause and increase the risk of osteoporosis in the future.

Also, uterine fibroids shrink during treatment, but return to their original size when the medication is stopped.

It is used to shrink fibroids before surgery or as a temporary treatment before menopause.

Taking low-dose birth control pills and an intrauterine progesterone-releasing system are methods of suppressing the growth of the endometrium and relieving menorrhagia and dysmenorrhea.

This treatment does not shrink uterine fibroids.

The same goes for iron supplements and painkillers; they are used not to shrink uterine fibroids, but to relieve symptoms of anemia and dysmenorrhea.

Another procedure is called uterine artery embolization, which involves blocking the blood vessels leading to the uterus.

What should you be careful about in your diet and lifestyle if you have uterine fibroids?

Many diseases are related to lifestyle, but it is said that there is no lifestyle change that can prevent uterine fibroids or stop their growth.

There seems to be information circulating that fibroids can be reduced in size by extreme dieting or smoking, but we cannot recommend these as a means of prevention or treatment.

Also, as a folk remedy, there are rumors on blogs that taking purple ipê can shrink or eliminate uterine fibroids, but unfortunately, there seems to be no medical evidence to support this at present.

Uterine fibroids and infertility, pregnancy, and childbirth

When looking at the symptoms of uterine fibroids, you will often see the words infertility, miscarriage, and premature birth.

This information may be worrying for women who wish to become pregnant and have uterine fibroids.

Submucosal fibroids can cause deformation of the endometrium, leading to infertility due to implantation problems, but not all uterine fibroids affect infertility, miscarriage, or premature birth.

However, in rare cases, uterine fibroids may grow during pregnancy.

In such cases, the pregnant woman may experience pain or develop thrombosis.

If uterine fibroids affect the baby’s development or the birth canal, a cesarean section may be chosen.

Recently, there have been many women who have successfully conceived while undergoing both infertility treatment and treatment for uterine fibroids.

Even if you have uterine fibroids, there is no need to worry that the baby will have a higher chance of abnormalities, but I think there are many pregnant women who are concerned about the condition of their baby.

Recently, the number of facilities performing highly accurate NIPT (non-invasive prenatal testing) has been increasing.

NIPT (non-invasive prenatal testing) is a test that checks for chromosomal abnormalities such as trisomy 21 (Down syndrome), trisomy 18, and trisomy 13 in the fetus using blood drawn from the mother .

World-class NIPT

Experience unparalleled excellence in Non-Invasive Prenatal Testing (NIPT) at Hiro Clinic. Our world-class services blen...

Treatment of uterine fibroids during pregnancy

Uterine fibroids are often first discovered during pregnancy.

Although many women with uterine fibroids can have a pregnancy without any problems, there is a risk of miscarriage, premature birth, problems during birth, and bleeding after birth.

Treatment for uterine fibroids during pregnancy is generally conservative treatment and follow-up observation.

In cases where fibroids are interfering with the pregnancy and making it difficult to continue, surgical treatment may be chosen.

Conclusion

Uterine fibroids can affect many women.

If you are experiencing symptoms such as heavy menstrual bleeding, severe menstrual pain, or a feeling of heaviness in the lower abdomen or lower back, or if you are suffering from infertility, it is a good idea to visit a gynecologist.