General Practice 2022

Uterine fibroid: what é, causes, symptoms and treatment

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Uterine fibroid: what é, causes, symptoms and treatment
Uterine fibroid: what é, causes, symptoms and treatment

The fibroid is a type of benign tumor that forms in the muscular tissue of the uterus and that can also be called fibroma or uterine leiomyoma. The location of the fibroid in the uterus can vary, as well as its size, which can be microscopic or several centimeters.

Fibroids are relatively common and, in most cases, do not cause symptoms, however some women may report cramping, bleeding or difficulty conceiving. In these cases, the start of treatment may be indicated according to the gynecologist's guidance and characteristics of the myoma, and the use of medication to relieve symptoms or surgery to remove the myoma or uterus, in more severe cases, may be recommended.

What causes fibroids

The fibroid does not have a very well-established cause, however it arises when the muscle tissue cells that form the uterus multiply in a disorderly way, leading to the appearance of the tumor. It is possible that this disordered proliferation is also related to hormonal changes in women, because the symptoms usually appear in adult women and regress after menopause.

Furthermore, fibroid symptoms may also appear more frequently in women taking hormone replacement therapy.

Women who are more likely to have fibroids are those who do not have children, who have a diet rich in red meat and low in vegetables, obese women and those with a family history of this disease.

Types of fibroids

Fibroids can be classified into different types according to where they develop in the uterus, the main ones being:

  • Subserous, in which the fibroid develops in the outermost part of the uterus;
  • Intramural, when it arises within the walls of the uterus;
  • Submucosal, when it develops internally, inside the cavity of the uterus.

Knowing the type of fibroid is important to assess the severity of the fibroid and the need to start treatment right away. Learn more about the types of fibroids.

Main symptoms

In most cases, uterine fibroids do not lead to the appearance of signs or symptoms, however when the fibroid is large or when several fibroids are found in the uterus, it is possible for the woman to present some symptoms such as intense cramps, pain during intercourse, symptoms of constipation and a longer menstrual period. See other uterine fibroids symptoms.

The presence of myoma is verified by the gynecologist through imaging tests such as ultrasound, hysteroscopy and hysterosalpingography, which evaluate the cavity of the uterus.In addition, women with uterine fibroids who wish to become pregnant, even if they do not have symptoms, should have a follow-up with the gynecologist, as the presence of this tumor can cause some complications in pregnancy, such as miscarriages.

How the treatment is done

Treatment is indicated when the woman has severe symptoms, such as a lot of pain or heavy menstruation, or when she is trying to conceive without success. The type of treatment depends on the symptoms, size and type of myoma of each woman, and must be guided by the gynecologist, and may be recommended:

  • Use of anti-inflammatories, such as Ibuprofen or Naproxen: improve severe menstrual cramps and reduce excess bleeding caused by fibroids;
  • Use of hormonal drugs, such as the pill: help relieve the intensity of menstruation and reduce the size of the fibroid;
  • Iron supplements: prevent and treat cases of anemia caused by excessive bleeding;
  • Surgery, known as myomectomy: it is used to remove the fibroid without having to remove the uterus. It is used especially when the fibroid presses on other organs or causes very severe symptoms;

In addition, when the fibroid is very large, it may need to be reduced in size before surgery, and for this a technique known as embolization is used. In it, the doctor, through a surgical procedure, makes several injections with an embolizing agent diluted in iodinated contrast through the femoral artery, until a reduction in blood flow is observed in the artery that nourishes the myoma, causing its death.

When a woman has a fibroid and no longer plans to become pregnant, the doctor may recommend removing the uterus to eliminate the fibroid and prevent the tumor from forming again.

Fibroids make pregnancy difficult?

Some women who have fibroids may have difficulty getting pregnant, because fibroids can cause some deformities in the inner part of the uterus, in addition to changes in circulation and increased inflammation. In these cases, it is possible to carry out treatments with hormone-based drugs, such as estrogens and androgens, or surgeries, such as myomectomy or fibroid embolization to increase the chances of getting pregnant. See more about treating fibroids in pregnancy.

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