Uterine fibroids. Causes, symptoms, and treatment.
Uterine fibroids are benign tumors that develop from muscle cells. The term "fibroids" is often used as a synonym for uterine fibroids. Uterine fibroids are the most common benign tumors in women. While they are not inherently dangerous, they can cause discomfort and serious complications in some cases. Depending on their size, fibroids can cause various symptoms.
Changes caused by fibroids are not life-threatening, but they can affect a woman's quality of life and her ability to conceive. Fibroids are spherical tumors, usually of compact consistency. Their size can vary from a pea to a mass several centimeters in diameter, potentially exceeding the size of the uterus itself. They do not spread to nearby tissues and do not metastasize. Fibroids can spontaneously increase or decrease in size throughout a woman's life at different rates. The type of therapy depends on the symptoms, size, and location of the fibroids, as well as the age of the affected women.
Diagnosis of fibroids
Uterine fibroids are often discovered incidentally during gynecological examinations, as they frequently do not cause any symptoms. Ultrasound is conducted to precisely locate the fibroids and determine their size.
This is why it is important for women to undergo pelvic ultrasound at least once a year.
Diagnostics in Switzerland includes a women's health check program, encompassing a full range of analyses and ultrasounds necessary for preventing asymptomatic conditions like uterine fibroids.
Causes
The causes of uterine fibroids are unknown. It is known that some fibroids grow under the influence of female sex hormones, particularly estrogen. Unmodifiable risk factors for their development include black race, genetic factors, early onset of first menstruation, late onset of menopause, and the presence of fibroids in close relatives (e.g., mother). Modifiable risk factors (those that can be influenced throughout life) include obesity, especially uncontrolled arterial hypertension, high consumption of red meat, and the abuse of substances such as alcohol and caffeine. It has been proven that pregnancy before the age of 25, multiple pregnancies, and the use of hormonal contraception have a protective effect against fibroid formation. About one in five women suffer from them. In most affected individuals, fibroids do not cause any symptoms and usually appear between the ages of 35 and 50.
Symptoms of fibroids
Fibroids can be entirely asymptomatic, but if they grow rapidly, symptoms such as menstrual pain, non-menstrual bleeding, abdominal pain, and pain during sexual intercourse may occur. Increased menstrual bleeding can lead to iron deficiency.
If the fibroid is large, the abdomen may also enlarge. Another symptom of fibroids can be difficulty conceiving. If they are located in the cervix, they may increase the risk of miscarriage or complications during childbirth.
What to do if you have uterine fibroids?
In the presence of symptoms that may indicate uterine fibroids, it is necessary to visit gynecologists for diagnosis, ruling out other causes of discomfort, and initiating treatment. In the case of asymptomatic changes, regular monitoring is recommended. Symptoms of anemia, which may result from heavy vaginal bleeding, should not be underestimated, and patients should seek a general practitioner while waiting for a specialist appointment.
What are the methods of treating uterine fibroids?
Only fibroids causing symptoms that affect a woman's quality of life require treatment Treatment in Switzerland involves choosing a method depending on the patient's age, the need to preserve fertility, and the patient's preference regarding the preservation of the uterus. Asymptomatic changes are subject to regular monitoring only.
In each case, pharmacological treatment aimed at relieving symptoms without causing fibroid disappearance should be considered. These are usually chosen as a preparatory step before surgery, as they can reduce the size of the fibroids. It should be noted that some of these drugs have time limitations, and their effects are not long-lasting.
Surgical methods are the most popular and effective approaches, especially when pharmacological treatment does not provide the desired relief of symptoms. For women of reproductive age planning to conceive, the most common procedure is fibroid enucleation (myomectomy). The procedure can be performed laparoscopically through small openings in the abdominal wall, and for small (up to 3 cm) submucosal fibroids, the tumor can be removed by hysteroscopy.
In postmenopausal women or those younger and not planning pregnancy, the uterus is usually removed (hysterectomy). The fallopian tubes are also usually removed with the uterus, sometimes with the cervix. Ovaries are typically left until the age of 60–65, as it positively impacts a woman's health and well-being. In later years, due to the lack of benefits and the risk of cancer development in this area, the ovaries are removed along with the entire reproductive organ.