Fibroids: Causes, symptoms, Diagnosis, types, treatments, and prevention
A fibroid is a benign growth that slowly grows in the muscular wall of the uterus. Fibroids do not metastasize and can grow or bulge in the wall of the uterus.
A smaller fibroid is about the size of a pea. The size of
an orange is also not uncommon. In extreme cases, the size of a fibroid
can mimic pregnancy. A fibroid develops from muscle fibers and enlarges
under the influence of hormones.
Fibroids affect more than 20% of all women. It most
commonly affects women between the ages of 35 and 55. In less than one
percent of all cases, a fibroid can be malignant.
Why a fibroid develops
cannot be clearly defined. It has been proven that fibroids can be
partially inherited. It is also considered certain that the sex hormone
estradiol plays a role in the development of fibroids.
Fibroids do not appear in girls before puberty. They
only grow when the body has increased estrogen levels. This is the case,
for example, with pregnancy or when taking hormone preparations.
During menopause, estrogen levels drop and
the fibroids shrink. Fibroids no longer appear in women after menopause.
Fibroids cause different symptoms depending on their size and
location. If they are still small, they often do not cause any problems
and are therefore only discovered by chance. The most common symptom is
pain, which can increase to extremely strong, labor-like cramps,
usually during the menstrual phase.
Depending on their location, fibroids can put pressure on
nerves, which can cause pain that radiates down the legs or back. During
physical exertion or during sexual intercourse, an unpleasant painful
pressure can be felt. Large fibroids can constrict the bladder or
bowel and cause increased urination or constipation.
It rarely happens that the urethra is completely squeezed and
urination is no longer possible. This would require immediate medical
attention. Extremely large fibroids can increase abdominal
girth. Bleeding disorders also occur. The period can be unusually
heavy because the bleeding vessels are prevented from closing up quickly enough
by the tumors.
Menstruation often lasts longer than usual. The amount of
blood excreted is significantly increased; sometimes it comes off like a
gush. Due to the increased blood loss, the blood iron level drops
and iron deficiency develops. Typical signs of this are tiredness,
listlessness, tachycardia, pale skin, brittle nails, and hair loss.
What Are The Diagnosis & History Of
Fibroid?
A smaller fibroid often goes unnoticed and is
only discovered by chance during routine examinations. If you
experience menstrual cramps or spotting or continuous
bleeding, you should see a doctor.
This will first carry out a gynecological examination. A
fibroid can often be felt by touch. Ultrasound or a cell examination,
in which a smear is taken, will bring certainty. If a hysteroscopy is
performed, a special endoscope is inserted through the vagina into the
uterus. The uterus is filled with gas and illuminated.
A smaller fibroid causes no symptoms. If the fibroid is
larger, it can cause pain or complications with menstrual bleeding. Larger
fibroids change the shape of the uterus. In pregnant women, the fetus is
pushed into unusual positions. It can lead to miscarriage. A
fibroid can also put pressure on the rectum and bladder.
A uterine tumor can cause a variety of
symptoms. First and foremost, women suffer from menstrual disorders and
thus also from relatively severe menstrual pain. These can also lead to
mood swings and thus significantly reduce the quality of life of those
affected. Dizziness and pallor also occur.
Those affected appear exhausted and weak and also suffer from
circulatory problems. It is not uncommon for a loss of consciousness to
occur. In pregnant women, in particular, a uterine tumor can be a serious
complication and, in the worst case, lead to a miscarriage. In most cases,
no specific treatment is necessary for a uterine tumor. However, those
affected are dependent on regular visits and checks by a gynecologist.
In some cases, the uterine tumor must also be surgically
removed. However, there are no complications and the patient's life
expectancy is not reduced. Even after the treatment, a uterine tumor can
reoccur. In many cases, a fibroid can also be treated with medication.
Disorders and irregularities in menstrual bleeding in a sexually
mature woman should be clarified by a doctor. If bleeding or spotting
occurs outside of the normal menstrual period, you should see a doctor for a
check-up. If there is discomfort during intercourse, there is cause for
concern. Pain, a feeling of pressure, or a pulling sensation in the abdomen
must be examined and treated. Disorders of the digestive tract, diarrhea, or constipation are signs of health problems. A doctor's visit is
necessary as soon as the symptoms persist for a long time or if they increase
in scope and intensity.
In the case of swelling in the abdomen, palpable lumps, or
changes in the appearance of the skin, the symptoms should be presented to a
doctor. If there is a decrease in general performance, fatigue, or inner
weakness, a doctor is needed. Heart palpitations or irregular heart
rhythms should be discussed with a doctor. Feelings of anxiety, inner
insecurity, sleep disorders, or changes in urination are indications that should
be monitored further.
If they occur constantly, it is advisable to consult a
doctor. A pale appearance, sudden hair loss, or irregularities in the
fingernails or toenails should be checked by a doctor. The cause is
determined in various tests so that treatment can be initiated to alleviate the
symptoms.
A small fibroid does not necessarily have to be
treated. Regular check-ups by the gynecologist are
sufficient. A smaller fibroid can be removed during a
hysteroscopy. For this rather unpleasant procedure, the patient receives
local anesthesia or anesthesia.
Larger fibroids require surgical removal through an incision in
the abdomen. If several fibroids have formed, the entire uterus often has
to be removed. A larger fibroid can be made to shrink by
administering hormones. After that, surgical removal is possible,
whereby the uterus can be preserved.
A new method is causing a sensation in special
clinics. This involves shrinking the fibroid by blocking the surrounding
blood vessels. This is done by injection. The type of therapy can
depend on various factors. These include the size and location of the
growth, the symptoms caused or the age of the patient, and the associated status
of family planning.
Therapy usually aims to preserve the uterus. However, if
the myoma is proliferating and causing a lot of pain, a hysterectomy is often
unavoidable.
The hormone treatment with GnRH analogs, which has been tried
and tested for many years, is now being supplemented by the new therapy against
symptomatic uterine fibroids with the active ingredient ulipristal
acetate. It is taken in tablet form. The indication is the pre-operative
treatment of moderate and severe symptoms - such as lower abdominal pain,
exhaustion, or pain - as well as a long-term treatment. One tablet is taken
daily for a period of up to twelve weeks. If necessary, the treatment can
be repeated, there is no time limit for this.
The active ingredient ulipristal acetate reduces the volume of
the fibroids and at the same time the associated symptoms. This means that
surgery can often be avoided. The long-term therapy mentioned is ideal for
women who are still approaching menopause and who want to
get through menopause without surgery. Once menopause is
over, the risk of fibroids also disappears. These stop growing due to the
reduction in the hormones progesterone and estrogen. Long-term
therapy is also suitable for women who complain of severe symptoms, who want to
control them effectively and permanently, and who have not yet completed their
family planning.
Ulipristal acetate is one of the selective progesterone receptor
modulators, so the active ingredient is used for casual drug therapy. This
has a direct influence on the cause of the disease. Not only are the
symptoms alleviated, it is also about bringing about healing. The activity
of progesterone, a hormone that occurs naturally in the body, is inhibited by
ulipristal acetate. However, the preparation itself is not a hormone,
which means that it is well tolerated and leads to permanent and rapid relief
of symptoms. The bleeding is reduced or stopped completely, the fibroids
become smaller and the pain subsides.
The course of the disease depends on the size and location of
the tumor. Affected patients should go to the gynecologist for regular
check-ups in order to avoid complications. This also applies if fibroids
show no symptoms. Urinary tract infections and pain during urination can
occur if the tumor presses on the bladder.
Functional disorders of the bladder, intestines, and kidneys can
also occur if the tumor presses on the organs. Heavy or prolonged menstrual
bleeding often leads to anemia as a result of iron deficiency. There are
also problems with fertility and during pregnancy. In principle, however,
the myoma does not represent an obstacle to pregnancy. Infertility only occurs
in a few cases, for example, if the tumor is in front of a fallopian tube.
During pregnancy, the fibroid can cause various
problems. As an estrogen-dependent tumor, a fibroid grows faster during
pregnancy because the body then produces more sex hormones. Due to the
increasing size and position, the fibroid can cause pain. Anomalies in the
position of the unborn child can also occur or even block the birth
canal. Preterm labor can also occur. A fibroid has been shown to
increase premature birth and miscarriage rates. If the tumor grows in the
uterine cavity or under the lining of the uterus, miscarriage and ectopic
pregnancy can occur.
There are no known preventive measures against a fibroid. Women
between the ages of 35 and 55 should have check-ups with their gynecologist every
six months. A fibroid can be detected at an early stage by palpation and
ultrasound.
In this way, complications can be eliminated that can arise if
the fibroid is detected too late. If a fibroid has been removed, the
patient is not immune to this growth. A fibroid can recur at any
time. Women who have already had problems with a fibroid and consider
their family planning to be over should consider having the uterus
removed. A fibroid only grows in the muscles of the uterus and can therefore
no longer occur in patients who have undergone surgery.
A fibroid is usually not treated because it is small and does
not cause any acute symptoms. Instead, doctors choose to monitor the
benign tumor as part of follow-up care. This happens for two reasons: On
the one hand, the fibroid can grow and thereby disrupt the function of other
organs. On the other hand, scientists assume that myoma degenerates in
a fraction of the cases and then tends to form metastases.
Follow-up care, therefore, serves to avoid complications. The doctor and patient agree on a quarterly or semi-annual rhythm. In addition to a
palpation examination, an ultrasound examination is also carried
out. Doctors believe that diagnosing a change early has the best chance of
a cure. Therefore, the scheduled examinations must be followed
conscientiously.
If the doctor and patient decide to remove a fibroid, follow-up
care is also indicated afterward. This aims to eliminate any symptoms
that may follow from the procedure and prevent the tumor from
recurring. Because the uterine tumor can form again under certain
circumstances.
The extent of the progress control corresponds to the
descriptions above. Participation in a rehabilitation measure immediately
after an operation may be necessary. In addition, patients should of
course see their doctor immediately if acute problems arise.
Since fibroids usually do not pose a health risk, symptoms can
be alleviated by self-treatment. Depending on the severity and duration of
the symptoms, a prompt medical consultation is advisable. In the case of
existing fibroids, a regular gynecological examination should be
carried out.
Fibroids usually cause more severe symptoms around the time of
menstrual bleeding and a few days before. In order to counteract spasmodic
pain, it is recommended to avoid alcohol and salty foods - as they
remove water from the body - and to compensate for increased fluid intake
beforehand. This also counteracts frequently occurring circulatory
problems. Coffee and dairy products also put a strain on the body and
should be reduced. Some women are iron deficient due to
fibroids. Eating green leafy vegetables (chard, kale, nettle,
herbs) or taking a ready-made preparation like the ones available in pharmacies
can help here is available. It was also possible to determine that the
symptoms were alleviated by taking magnesium. Nuts, avocados, algae, and
legumes provide important vitamin B, which also works against muscle cramps.
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