Uterine fibroids (benign tumor) is one of the most studied and common gynecological pathologies. It grows from connective or muscle tissue and is located in the cavity or on the walls of the uterus. It is most often diagnosed in women of childbearing age (30 to 35 years). After menopause, uterine fibroids are rarely diagnosed. Most often, it consists of multiple nodes of smooth muscle fibers, less often represents single formations and does not degenerate into a cancerous tumor, that is, it is always benign. This article will look at the causes, symptoms and treatment of uterine fibroids.
Disease classification
Symptoms and signs of uterine fibroids (a photo of its different types is presented below) depend on various criteria. Specialists adhere to a certain systematization of the disease.
According to the location of the tumor:
- Intramural - located in the muscle tissue of the uterus, often changes the contour of the organ, reducing its internal volume. It is this type of tumor that occurs more often than others.
- Submucosal - located in the inner partuterus under its mucous layer, is rare.
- Subserous - located under the peritoneum. It is located outside the uterus and, as it grows, presses on the peritoneum.
By knot size:
- small - up to 2 cm;
- medium - 4 to 6 cm;
- large - more than 6 cm. In some cases, tumors reach very large sizes.
Shape:
- Nodular - a smooth, rounded neoplasm. May contain one or many nodes of different sizes.
- Diffuse - there is no formed node, it is a vaguely enlarged muscle tissue. Appears as a result of a chronic inflammatory process.
Subserous and submucosal uterine fibroids have several stages of development:
- 0 - nodes do not grow into the submucosal layer. The subserous node is located on the leg in the abdominal cavity, and the submucosal node is in the uterine cavity;
- I - fibroids are half in the tissues of the organ;
- II - most of the nodes are located in the body of the uterus;
- III - there is no muscle tissue between the neoplasm and the mucous membrane.
A large variety of uterine fibroids suggests the need for an individual approach to each patient. Diagnosis of the disease is complicated by the absence of symptoms of uterine fibroids in the early stages of the development of the disease, therefore, an already advanced or complicated form is often found.
Causes of disease
In medical practice, the exact prerequisites for the development of this benign tumor have not been found. However, the dependence of its formationfrom hormonal consistency in the body. Failure of the function of the ovaries, which produce excess estrogens (female hormones), leads to the growth of muscle fibers. It is the dependence of uterine fibroids on the amount of sex hormones that often causes a hormonal imbalance. This happens in the following situations:
- termination of pregnancy - spontaneous and induced abortions;
- failure of the menstrual cycle - heavy and prolonged bleeding, pain;
- menopause - the restructuring of the body provokes the frequent appearance of a tumor in the late reproductive period or during menopause;
- stress conditions are the cause of ovarian dysfunction.
In addition, the lack of regular sex and relationships without orgasm entail a greater likelihood of developing fibroids. The late onset of the menstrual cycle in girls, the inability to become pregnant and bear a child also indicate hormonal disruptions. As you can see, the symptoms and causes of uterine fibroids are inextricably linked to each other. Although it is known that fibroids appear in women with normal hormonal levels. In addition, there are other factors that provoke the disease. These include:
- inflammatory diseases of the reproductive system, endometritis;
- injuries of the uterine cavity - during sampling for diagnosis, surgery, abortion;
- endometriosis - proliferation of cells of the inner layer of the uterine wall;
- use for IUD protection;
- various diseases –diabetes mellitus, lack of thyroid hormones, hypertension;
- hereditary predisposition;
- late delivery;
- lack of movement and obesity;
- decreased immunity.
Nutrition plays an important role in the formation of fibroids. Eating a lot of meat fatty foods and carbohydrates, as well as a lack of fiber, increase the level of female hormones. Reception of vegetables, fruits, cereals, grains and dairy products reduces the risk of developing a tumor. In addition, there are studies that neoplasms can appear during a late first pregnancy, and women who have given birth are less susceptible to the disease.
What to look out for
Uterine fibroids in the early stages have no symptoms. In the future, the following signs are possible:
- Profuse menstruation. This is due to the fact that the tumor that has appeared interferes with the contraction of the muscles of the uterus. In addition, uterine bleeding in the intermenstrual period is possible. Heavy bleeding leads to anemia, so in these cases, medical attention is needed.
- Pain syndrome. This symptom of uterine fibroids can be of any intensity. Most often, pain occurs in the lower abdomen and lower back. In violation of blood circulation in the myomatous node, they occur suddenly. A large tumor that grows slowly during menstrual bleeding causes a symptom of uterine fibroids in the form of pulling pain. Growing in the mucosa, it leads to cramping cuts. In any case, the appearance of pain signals that since the onsetpathology has passed a certain time.
- Violation of the work of other organs. First of all, the rectum and bladder suffer. With the pressure of the tumor on them, chronic constipation and polyuria occur. Turning to the clinic with such problems, you should also visit a gynecologist.
- Infertility. The location of fibroids in the submucosal layer of the uterus leads to a violation of the patency of the fallopian tubes, the passage of sperm is difficult.
- Headache, weakness and dizziness. These symptoms of uterine fibroids may result from a decrease in hemoglobin and red blood cells due to heavy bleeding.
- Pain in the region of the heart. The development of the tumor leads to the tone of the heart muscle, therefore, an increase in venous pressure is possible.
Most women with multiple fibroids have complicated labor. There are statistics that the tumor decreases with the onset of menopause and even disappears completely, which means that the symptoms also go away.
Disease Clinic
Depending on the location and size of the uterine fibroids, the symptoms may be as follows:
- Submucosal location. The tumor node is located in the submucosa. In this case, various disorders are possible: heavy and prolonged menstruation, uterine bleeding, accompanied by anemia. Intense and cramping pains may appear when a myomatous node prolapses into the uterine cavity. In other cases, pain is not observed. Often such a fibroid provokes infertility and makes it impossible to carry the child to the end of pregnancy.
- Subserous finding. The disease proceeds for a long time without any symptoms. With an increase in the node in the lower abdomen, a symptom of uterine fibroids occurs - a pulling pain. In case of malnutrition of large fibroids, severe pain appears. In this case, the patient is often erroneously admitted to the surgical department with a diagnosis of "acute abdomen". Bleeding does not occur with this location of the tumor.
- Mixed myomatous nodes. They are very difficult to diagnose. When the knot reaches a size of about 30 cm, inexplicable discomfort appears in the lower abdomen. Increasing, the tumor begins to put pressure on the rectum, ureters, bladder, inferior vena cava. As a result, there are problems with defecation, urination, abdominal pain and shortness of breath.
Uterine fibroids have the following specific features:
- this is the most common gynecological disease of late childbearing age and pre-menopausal period;
- never becomes malignant;
- may shrink, grow or disappear without treatment during menopause;
- capable of developing rapidly or, conversely, very slowly;
- has various symptoms or progresses without any symptoms.
Diagnosis of uterine fibroids
To make a diagnosis, the doctor conducts an examination and instrumental examination of the patient using the following methods:
- Examination, palpation and bimanual examination on a gynecological chair.
- Ultrasound - makes it possibledetermine the location of the tumor and its size.
- MRI and CT provide information about the location and size of fibroids. However, they are rarely performed due to the high cost of research.
- Tests: blood - shows the general condition of the patient, urine - taken to exclude diseases associated with the urinary system, smear - excludes sexually transmitted infections.
- Hysteroscopy. It is performed using a special device equipped with a camera that allows you to examine the uterine cavity from the inside. In addition, with the help of a hysteroscope, you can take a biopsy and perform curettage.
Based on the data obtained, the final diagnosis is established and appropriate therapy is prescribed.
Conservative treatment of uterine fibroids
It is carried out with the help of drugs that stop the growth of the tumor, avoid consequences and reduce the size of the nodes. For conservative therapy, there are the following indications:
- intramural and subserous uterine tumors;
- Fibroids up to 12 weeks;
- no acute manifestations;
- premenopausal period;
- contraindications for surgery.
With small tumors and the course of the disease without symptoms and signs, the treatment of uterine fibroids involves the appointment of hormones and progestins.
What medications are prescribed
The doctor selects hormonal medications that are most suitable for a particular patient, after a complete examination.
Most oftenuse the following drugs:
- Combined oral contraceptives. With minor uterine fibroids, the preparations "Yarina" and "Zhanin" stop the growth of nodes and reduce their size. The course of treatment lasts up to three months.
- Gestagens. They normalize the endometrium, but have little effect on the tumor. They are often used for mild symptoms of uterine fibroids and the treatment of submucosal tumors. These are the drugs "Duphaston", "Norkolut", "Utrozhestan". Treatment continues for approximately two months.
- Intrauterine device (IUD) "Mirena". It contains levonorgestrel, which is secreted daily into the uterus and stops the growth of the neoplasm, but does not affect the general condition of the body. The spiral is placed for five years and protects against unplanned pregnancy.
- Antigonadotropins. They suppress the production of female hormones, thereby preventing tumor growth. They are rarely used, as they have many side effects and little effect. These include Gestrinone, Danazol.
- Analogues of the hormone gonadotropin-releasing. They are used to reduce the production of estrogen, which causes uterine fibroids to grow. The course of treatment is from three months to six months. They use Zoladex, Buserelin and Diferelin.
Fuzz ablation of uterine fibroids
This is the impact of ultrasonic rays on the tumor. The procedure is a modern method of treating an ailment, performed in a medical facility within three to six hours. Ultrasound destroys the tissues of the node, disrupting blood flow and nutrition in them. As a result, the tumorstops growing and disappears. For the effectiveness of the procedure, it is necessary to accurately determine the symptoms and signs of uterine fibroids: the size, structure and position of the node. The advantages of the method are as follows:
- no blood loss or injury;
- no anesthesia required;
- carried out in an outpatient setting;
- preserves reproductive functions;
- used for large and multiple knots;
- has no complications or side effects;
- does not relapse;
- quick recovery.
Uterine artery embolization for uterine myoma
This method (EMA) is recognized as one of the most modern in the treatment of tumors, it has a good effect and does not require long-term recovery. In UAE, doctors use an X-ray camera to insert a special catheter through a small incision at the inguinal fold. Through the femoral artery, the doctor inserts a catheter into the vessels of the uterus and introduces special microcapsules that can block the vessels of the tumor, thereby depriving it of nutrition. After the procedure, the uterus is completely restored, the fibroids die off. Before surgery, the patient is examined to clarify the symptoms and signs of uterine fibroids, the size, number and location of nodes are evaluated. The procedure is performed in an operating room x-ray surgery. Staying in the hospital is no more than three days.
Surgical treatment
Surgical intervention for a benign tumor of the uterus is practiced in the following cases:
- large fibroids;
- fittingtumors to the inner wall of the uterus (submucosal or intramural type);
- appearance of comorbidities;
- a sharp increase in the tumor;
- pregnancy obstruction;
- with necrosis of nodes, circulatory disorders;
- with pronounced symptoms and signs of uterine fibroids, manifested by bleeding and severe pain.
Doctors use several methods of surgical treatment of the disease, choosing the most appropriate in each case:
- Laparoscopy - uterine fibroids are removed through holes in the abdominal wall. A device with a video camera is inserted into one, instruments into the others.
- Hysteroscopy - performed through the vagina. The doctor uses a high-frequency alternating current resectoscope or a laser beam to cut through tissue. Destroyed fibroids are washed out of the uterus with a glucose solution.
- Abdominal operation - a horizontal incision is made about ten centimeters long just above the pubic joint. Subsequently, the incision line is invisible, as it is done in the fold of the skin. Surgical intervention of such a plan is carried out when the symptoms of uterine fibroids are quite clearly expressed (photo of the operation is given above). Although doctors primarily try to preserve the organ, especially if the woman is of reproductive age.
- Robotic operation. It is carried out with the help of a robot controlled by a surgeon. Such operations are rarely done due to expensive equipment.
Surgeons give preference in the treatment of uterine fibroidslaparoscopy and hysteroscopy. Removal of the genital organ in a woman is performed only as a last resort, when the symptoms and signs of uterine fibroids are pronounced. After such an operation, a woman will not be able to have children. The postoperative period includes limiting physical activity and abstinence from sexual activity for a month and a half, observation by a doctor in order to notice possible complications in time.
Uterine fibroids: symptoms and treatment with folk remedies
To help conservative treatment, you can use various herbal remedies to reduce or prevent the growth of uterine fibroids. Before starting the use of folk remedies, you should find out the type of localization of the nodes and consult with your doctor about the use of medicinal herbs. With subserous nodes, tamponing with decoctions and oils is more often used, and the submucosal location of the tumor involves the use of decoctions inside. Herbs are often used to strengthen the immune system, have an antibacterial effect and help regulate the production of the female hormone. For treatment use:
- Celandine. Indicated for small neoplasms of a benign nature. Flowers, leaves and roots are used. Alkaloids and essential oils contained in the plant inhibit fibroids, which leads to its reduction. In addition, celandine has an analgesic and hemostatic effect. Drug treatment of symptoms of uterine fibroids and folk remedies help to stop the development of the disease. A decoction of celandine is taken once a day before meals for half a glass, diluting it with the samevolume of water. The course of treatment can be continued for several months. Fresh juice is squeezed out of the plant and diluted with water in a ratio of 1:10. Used for douching or tamponing, which is carried out at night. Helps with pain and bleeding.
- Burdock. To prepare a decoction, take a teaspoon of chopped dried burdock root and pour 0.5 liters of water. Drink several times a day for up to four weeks.
- Calendula. Brew a tablespoon of flowers in a glass of boiling water overnight. Drink on an empty stomach in the morning. With the initial signs and symptoms of uterine fibroids, calendula infusion can stop the development of the tumor.
- Red brush. It has an anti-inflammatory effect and reduces the production of female hormones. Used as a decoction: one and a half tablespoons of dried raw materials are poured into 300 ml of water. Take half a glass once a day.
Herbal treatment sometimes gives good results, but don't expect miracles. With vivid clinical symptoms, you should consult a doctor to correct therapy.
Uterine fibroids: symptoms and signs of menopause
The main reason for the appearance of benign tumor nodes in menopause is hormonal failure. The most prone to this are women who have:
- frequent injuries of the uterine cavity (complicated childbirth, curettage, abortion);
- inflammatory gynecological diseases;
- obesity;
- diabetes mellitus;
- infection of the reproductive system;
- hypertension;
- hereditary factors;
- disharmony in sexual life.
With a small size of uterine fibroids, the symptoms of menopause do not appear in any way. The tumor is usually found only during physical examinations. As nodes grow, the following symptoms appear:
- intermittent light bleeding lasting several days;
- dull and aching pain in the lower abdomen, they radiate to the lower back or sacrum;
- constipation, pain during bowel movements;
- frequent urination.
Small fibroids in women during menopause, which do not increase and do not give discomfort, do not require treatment. Such uterine fibroids, the symptoms and signs of which will disappear after the normalization of the hormonal background, will pass by itself. If necessary, the doctor will prescribe the appropriate therapy.
Prevention of uterine fibroids
To prevent disease, the following measures should be taken:
- keep calm;
- eat well;
- showing constant physical activity;
- should give up bad habits;
- go for preventive check-ups every year;
- have regular sexual relations;
- plan pregnancy, childbearing and breastfeeding;
- timely treat inflammatory gynecological diseases.
In addition, in order to prevent the appearance of uterine fibroids, it is necessary to regularly consume dairy products. Scientists, after conducting research, came to the conclusion that by eating more than four servings of various dairy dishes per day, the risktumor development is reduced by 30%. It is also recommended to take trace elements and vitamins that have an antioxidant effect. If all recommendations are followed, the symptoms of uterine fibroids in women will never appear.
