Uterine fibroids are one of the most commonly diagnosed benign tumors, which is found in girls aged thirty to forty-five. This pathology is determined in every fourth woman during routine checkups or with targeted examination.
The development of uterine fibroids in the early stages is usually not accompanied by clinical manifestations. Symptoms begin to appear in later stages. One of the characteristic manifestations of uterine tumors is menorhagia - this is a quantitative and qualitative increase in discharge during menstruation.
A secondary symptom that develops as a result of this manifestation is an anemic syndrome, which is accompanied by a woman's weakness, fatigue, and pale skin. As a result of permanent loss of iron, chronic tissue hypoxia develops, which leads to dry skin, wrinkles, brittle nails and hair.
The reason for the development of the above symptoms is the germination of uterine fibroids in the muscle layers of her body, and therefore its contractile function is impaired. It is also possible the development of acyclic bleeding from the genital tract, which arises from the mucous membrane of the uterus, the appearance of this symptom is the reason for the urgent visit to the gynecologist.
Localization of symptoms
One of the most frequently present clinical manifestations in uterine myoma is the presence of pain syndrome, which can be quite diverse. Usually pain is localized in the lower part of the abdominal cavity or in the lumbar region. The appearance of pain may be associated with impaired blood supply to the body of the tumor, which most often develops during exercise.
Perhaps the constant presence of pain, which periodically increases, such a manifestation is usually associated with the presence of uterine fibroids of small size. The later stages of tumor development, in the presence of invasive growth in the submucosal layer of the uterus, are characterized by cramping attacks of pain, as well as the presence of bleeding.
Uterine fibroids are often accompanied by the development of disturbances in the work of closely spaced organocomplexes, which include the rectum and bladder. The feeling of incomplete emptying of the latter after urination or a feeling of constriction is observed with a sufficiently large size of the tumor. Constant urge to urinate or defecate can alternate with pathological ishuria or constipation. To conduct a differential diagnosis with cystitis or rectal tumors, it is necessary to contact a gynecologist.
One of the most frequent symptoms that causes a young girl to seek help from a specialist is the inability to get pregnant. The presence of large fibroids in the uterus can disrupt the patency of the tubes for the egg or interfere with the movement of sperm.
The presence of uterine fibroids often leads to numerous complications during natural childbirth, in connection with this, such patients are more often subjected to operative delivery.
When the tumor is submucous, there is a violation of the normal menstrual cycle of the hyperpolymenorrhea type, and uterine bleeding is also often observed and the secondary development of hypochromic anemia is observed. The presence of pain when located in the submucosal layer is not typical, but when a node falls into the uterus, it is possible to attach high intensity paroxysmal pain sensations. This localization of the tumor is a common cause of the inability of the girl to bear the fetus.
Mixed arrangement of fibroids
The mixed arrangement of myoma node is difficult to diagnose because of what it may not be detected for a long time. With sizes of more than twenty centimeters, a feeling of heaviness in the lower abdomen is possible.
With the increase in the tumor, the phenomena of compression of the internal organs are intensified, the phenomena of chronic intestinal obstruction, alternating constipation with diarrhea appear. Compression of the urethra leads to pathological stagnation of urine, as well as the development of hydronephrosis or pyelonephritis.
Uterine fibroids or ovarian cysts?
Symptoms of the uterus and ovarian cysts are quite similar in their initial stages, which is why their diagnosis is necessary. The methods for determining the true cause of the symptoms include ultrasound diagnosis.
This non-invasive technique gives the maximum amount of information and is considered the gold standard in gynecology. There is also diagnostic laparoscopy, which is used in the development of an acute abdomen when an ovarian cyst is twisted.
Symptoms during pregnancy
Sometimes the detection of uterine fibroids occurs when viewed in the antenatal clinic after the development of pregnancy in the patient. In this regard, it is necessary to know about the management of such women and the clinical manifestations that may accompany such a condition. During the formation of the placenta near the myoma node, there is a decrease in muscle tissue in this area due to the production of biologically active substances.
In this regard, the fetal hypotrophy or the fading of its development may develop. The development of preterm labor is also observed due to the filling of the cavity of the pregnant uterus with numerous tumors. Due to the increase in intrauterine pressure, the rupture of the membranes of the fetus occurs, followed by early delivery. In order to prevent complications during pregnancy or childbirth, women should be examined before pregnancy and operative delivery.
Common manifestations of pathology
Thus, the most common and universal symptoms of uterine fibroids are the following clinical manifestations:
The appearance of long and heavy menstruation, resulting in the development of hypochromic anemia, accompanied by weakness, rapid disability, as well as brittle nails and hair.
Pallor of the skin.
A feeling of discomfort in the lower abdomen, the presence of pain, which is not associated with the phase of the cycle.
Violation of the normal operation of the urinary system and the discharge of intestinal contents.
Joining of cardiac pain to heaviness in the lower abdomen and irregular menstruation.
Inability to get pregnant or bear the fruit.
Increased abdominal volume.
The growth of uterine fibroids is unstable, it can begin its development at a young girl's age, and manifest itself after menopause. In this regard, the symptoms of uterine fibroids with menopause, which include the following:
The development of accelerated growth on the background of hormonal adjustment in a woman's body.
With the initial benign course, malignancy of the process is possible against the background of changes in endocrine regulation.
The development of severe pain and heavy bleeding.
The development of severe forms of the anemic process.
Climax - pathology or norm
Climax is not a pathology. This is the physiological period in the life of any woman, associated with age-related changes in hormonal balance. The average age of a woman in which signs of menopause appear is 50 years. Pathological will be considered the onset of menopause earlier than 45 years.
Every woman has menopause in an individual way. Someone has almost no symptoms, but someone needs a medical correction.
The climacteric period consists of several periods:
- Premenopausal period - a year or two before the cessation of menstruation. At this time, the patient noted violations of the menstrual cycle - menstruation goes irregularly, the amount of menstrual bleeding changes.
- Actually menopause. It usually lasts for a year, and at this time all the characteristic symptoms are observed. Monthly with no.
- Postmenopause. The restructuring of the hormonal balance is completed, and the body comes to the physiological age norm. Menstruation and menopause symptoms do not.
The main signs of menopause, which are found in all women, but in varying degrees of severity:
emotional imbalance, mood lability,
- Blood pressure "jumps"
- feeling of heartbeat,
- very characteristic symptom is hot flashes. This is a sudden sensation of heat throughout the body and redness of the skin of the face and décolleté.
All these manifestations are directly related to hormonal changes. Naturally, the period of menopause implies the disappearance of reproductive function.
During menopause, many gynecological diseases change their course - for better or for worse. Uterine fibroids is a disease that during menopause can either regress or be complicated by more serious processes, for example, neoplasms in the uterine cavity.
Myoma - what you need to know about the disease
Gynecological pathology, which is a benign tumor process (neoplasm), originating from the myometrium (muscle layer of the uterus). The disease has a hormonal nature. That is why menopause has a pronounced effect on the state of the neoplasm.
The essence of the pathological process in uterine myoma consists in the excessive proliferation of myometrium cells. Myocytes can increase in size, and their number can increase.
This process is affected by the hormones estrogen and progesterone. Myoma is the result of an imbalance between them. Tumor growth is due to the fact that its tissue contains more estrogen and progesterone receptors than unchanged myometrium. As a result, hormonal effects on myoma more. Climax also implies a violation of the synthesis of the hormones estrogen and progesterone.
What can cause myoma
Provocative factors for the development of fibroids:
- inflammatory processes in the pelvic organs,
- genital infections
- burdened heredity
- pathology of the menstrual cycle,
- frequent scraping of the organ cavity,
- emotional stress factor.
Myomatous foci are formed in places where there is inflammation or mechanical damage.
Interesting! It is assumed that the cells from which fibroids are formed are laid back in the period of embryonic development. This process is associated with genetic predisposition.
How is fibroids classified
The structure of fibroids may include, in addition to muscle, and more connective tissue. Depending on what type of tissue prevails, the tumor will be called:
- Myoma - more muscle tissue
- fibroma - more connective tissue,
- fibromyoma - the same content of muscle and connective tissue.
If fibroids are prone to rapid growth - it is called proliferating.
A uterine tumor can form in different layers of the organ wall:
Submucous (submucous) - located under the endometrium and grows into the organ cavity, increasing its volume.
- Subserous (subperitoneal) fibroids - located under the outer lining of the uterus, issued into the pelvic cavity.
- Interstitial (intermuscular) - nodes grow inside the muscle layer and deform the organ wall.
Manifestations of fibroids with menopause
Fibroids during menopause can self regress and almost disappear. However, there are also opposing options - when a neoplasm is not only not decreasing, but expanding even more.
The tumor can grow large in size, but the symptoms will be quite scarce. Those manifestations that are usually observed are not considered by most women as a reason to contact a gynecologist.
The patient should pay attention to the following symptoms:
- Before the onset of menopause, hypermenstrual syndrome is observed - a reduction in the time between menstruation, more abundant periods,
- Violation of the regularity of menstruation,
- The appearance of bleeding between menstruation,
- Severe pain before and during menstruation,
Constantly disturbing or nagging pains in the lower abdomen,
- The patient notes an increase in the abdomen of varying degrees, depending on the size of the node,
- Depending on the location of the neoplasm, there may be violations of the adjacent organs - difficulty with urination and the act of defecation,
- With frequent bleeding, a woman will notice the symptoms of anemia - weakness, dizziness, tinnitus, blackening of the eyes, pale skin,
- Women of reproductive age cannot become pregnant.
The presence of at least one of these signs will allow the gynecologist to suspect uterine fibroids and schedule an examination.
Interesting! The size of a benign neoplasm is determined in weeks of pregnancy. The uterus, and accordingly, the abdomen can be enlarged to 15-16 weeks. Such tumors are considered giant and require surgical treatment.
By itself, a benign tumor in menopause does not cause a woman special inconvenience. But the period of menopause is characterized by the fact that hyperplastic processes are prone to rebirth.
Uterine fibroids can malignise and go into a malignant tumor. And uterine cancer is the main cause of gynecological mortality in women older than 50 years.
The precancerous condition of uterine fibroids is called predarsarcoma. It is determined only histologically. Accelerated growth foci containing atypical cells appear in the tumor tissue. Increases the speed of cell division.
How to diagnose myoma
First, the gynecologist collects a detailed history - the patient's complaints, the characteristics of the menstrual cycle. It turns out whether there is a hereditary factor. It also turns out the severity of manifestations of menopause.
- With a gynecological two-handed examination, subserous nodes and nascent submucous can be detected. Interstitial nodes, especially if they are small, can only be detected indirectly - with excessive density of the wall of the organ and its tuberosity.
- The most reliable method that confirms the presence of uterine fibroids remains ultrasound. The ultrasound sensor, especially intracavitary, are available all the walls of the uterus. A node is defined as an education with increased echogenicity. With the help of echography, you can see a tumor with a diameter less than a centimeter.
- Dopplerography is used as an additional research method to assess the ability of fibroids to grow. Proliferative uterine myoma is characterized by a pronounced blood flow both in the center of the node and at the periphery.
- Hysteroscopy can be used to visually assess the surface of a neoplasm. An endoscopic device (hysteroscope) is inserted into the uterine cavity and makes it possible to inspect the node.
- Diagnostic curettage is performed to collect a tumor material for histological examination to prevent malignancy of the fibroids.
Treatment of fibroids with menopause: is surgery necessary?
A tumor of small size, without a tendency to proliferate, does not require treatment. In menopause, such fibroids usually regress and lyse.
The patient in this case regularly undergoes a gynecological examination to monitor the size of the tumor.
If the tumor is proliferating, there is a multiple lesion, the menopause period is accompanied by uterine bleeding, conservative therapy is prescribed.
Objectives of drug treatment:
- Termination of proliferation.
- Maximum reduction of the tumor.
- Correction of menstrual irregularities before menopause.
- Treatment of conditions caused by uterine myoma - more often it is anemia due to uterine bleeding.
Progestogens are prescribed for tumor regression. These include norkolut and medroxyprogesterone. Taking progestogens will reduce the size of tumors to 3 weeks of pregnancy. When menopause, these hormones are taken continuously for six months.
Antagonists of gonadotropic releasing - hormone - buserelin - depot. This drug blocks the activity of the pituitary hormone, under the action of which there is an increase in the production of estrogen. As a result, the neoplasm is reduced in size. The most effective treatment of this drug in women in menopause.
To reduce uterine bleeding in the uterine cavity, Mirena spiral is installed, containing levonorgestrel. Receipt of the drug continues for five years. Climax is not a contraindication for the installation of an intrauterine device.
The question of the surgical treatment of fibroids. A complete cure of uterine fibroids is possible by surgery. There are two types of surgical treatment - radical and organ preserving.
Radical treatment involves removal of the uterus along with the cervix.
Indications for hysterectomy:
- The size of the uterus, as in the 14th week of pregnancy.
- Active proliferation of benign tumors.
- Necrosis of the node in violation of its power.
- The location of the tumor in the cervix.
- Abundant metrorrhagia, leading to severe anemia.
The organ-preserving operations include myomectomy - excision of nodes without removal of the uterus. Climax is not an indication for a radical operation, so women, even in the menopause period, are offered the choice of surgery, if one can be offered.
Существуют также неоперативные способы лечения миомы матки в менопаузе:
- Uterine artery embolization. This type of treatment is more often used before the onset of menopause, in women of reproductive age. In the uterine artery injected substances that block the bloodstream. Power nodes are stopped and they are reduced.
- Clementing. The imposition of ligatures on the uterine artery. The principle of action is the same as for embolization, but the effectiveness of such treatment is lower.
Myoma is the formation of a hormone-dependent tumor of a benign nature, which is mainly localized in various tissues of the uterus itself.
The size of a neoplasm can vary in various degrees: it can be very small, hardly noticeable, but it can also reach impressive sizes when the neoplasm begins to malign. Outside, the fibroid looks like a round knot with a shiny sheath.
With the appearance of small nodes, this pathology usually proceeds without manifestation of characteristic symptoms. With the development of two or more of these tumors, as well as an increase in their growth, a woman may experience signs such as hemorrhages and pain in the lower abdomen.
Depending on the location of the tumor, this pathology may be:
Subserous node This pathological change is localized in the area of the external muscle tissue of the uterus, also called the subperitoneal. This name of the tumor was due to its growth in the direction of the pelvic region.
Intramural tumor, or intermuscular myoma tumor, is localized in the inner layers of muscle tissue, as a result of which an increase in the size of the abdomen is observed.
Submucous node localized under the mucous membranes of the uterus, which provides this process of development of the neoplasm of the second name - submucosal node.
And finally Intraligamentous tumor appears and begins to develop in the area between the ligaments of the uterus.
This pathological process to date has not been fully studied by medical specialists. The reasons for the formation of fibroids can be:
- hormonal disorders in the female body associated with the onset of menopause, therefore, it is often said that fibroids and menopause are two combined processes,
- hereditary predispositions
- postoperative complications,
- infectious pathologies that are transmitted mainly through sexual contact,
- early onset of menstruation (up to 11 years),
- frequent use of alcoholic beverages,
- not suitable ecology.
The presence of a genetic factor contributing to the development of this disease with the onset of menopause is not excluded.
The development of uterine fibroids with menopause, its symptoms and treatment
The initial stage of development of a benign tumor may be asymptomatic if the myomatous nodes are very small, the presence of which can be detected only upon examination by a gynecologist.
If it is necessary to confirm the diagnosis and the exact location of the nodes, the woman will need to have an ultrasound examination, and a hysterosalpingography may be prescribed by a doctor. In rare cases, it may be necessary to undergo additional examinations: such as an MRI or CT scan.
In the more advanced development of uterine fibroids, its symptoms and signs during menopause may manifest as follows:
- the appearance of abundant hemorrhages, continuing for a long period of time,
- the occurrence of aching pain symptoms, localized mainly in the lower third of the abdomen,
- there is a feeling of pressure on the vagina and other organs in the pelvis,
- frequent urination with painful sensations,
- violations of the stool, manifested by the formation of constipation,
- during bowel movements there may be painful sensations in the intestines.
It is worth noting that the symptoms of uterine fibroids with menopause are slightly different from the symptoms of the development of myomatous nodes in the reproductive age. Therefore, when detecting abnormal age violations, it is necessary to urgently contact the specialists to identify the causes and diagnosis.
Moreover, fibroids after menopause also occur, especially in recent times, cases of uterine fibroids after 55 years, when the postmenopausal period has begun, have become very frequent.
Treatment of myomatous nodes can be carried out operatively or conservatively. With the development of fibroids to a fairly large size, there may be a high risk of developing a cancer, therefore, in such cases, as a treatment, only surgery to remove the tumor with the uterus or with preservation of the reproductive organs is necessary.
If the size of a benign tumor is relatively small, then medical methods of treatment can be used to reduce it, in which the smallest myomatous nodules can be completely absorbed.
Types of surgical treatment
Surgical intervention aimed at removing a benign tumor is the most effective treatment. The operation to remove uterine fibroids, in which the genitals are preserved, is called myomectomy, which is divided into three areas:
- abdominal tumor removal: performed with preservation of the uterus, but if there are no more than four myomatous nodes,
- Laparascopic removal: aimed at eliminating subserous and intramural neoplasms.
- and hysteroscopic removal is suitable for the elimination of tumors localized on the mucous surfaces of the uterus.
As mentioned above, the most advanced degree of development of a benign tumor, the dimensions of which are relatively large, will not be cured anymore, and the only solution in this situation will be an operation with 100% removal of the tumor with the uterus, which is called hysterectomy.
This operation can be carried out either by laparamic method through the vaginal path or open. The first and second methods of hysterectomy have a cosmetic effect, that is, after carrying out surgery, there will be no traces or scars on the woman’s body.
Remember: the type of surgery depends entirely on the age of the patient and the degree of fibroid development.
In most cases, doctors prefer to use special minimally invasive substances that are injected into the arteries that feed myomatous nodes. As a result, feeding of myoma nodes ceases, and myoma stops growing.
Conservative treatments for benign education
In the presence of small myoma nodules, the doctors do not prescribe any treatment, but only put the woman under constant control and monitor the progress of the development of the neoplasm. This is more true for women who have uterine fibroids that appear during menopause. With the onset of the menopausal period, a woman will need to be tested for biopsy, to exclude the possibility of developing a cancer.
Treatment of fibroids in menopause should consist of a comprehensive selection of drugs aimed at the treatment of symptoms of menopause and benign neoplasms. At the same time, hormonal preparations should not contain estrogens.
Uterine fibroids with menopause can be treated with medication if:
- sizes of myomatous nodes are relatively small and do not reach 2.5 cm in diameter,
- myomatous nodes intramural or subserous type,
- the uterus is not too enlarged,
- There are no complications of the clinical manifestation of the disease,
- there are no pathological processes in the adjacent organs,
- seals grow at a slow pace
- no allergic reaction to drugs.
If a woman has entered menopause, and myomatous nodes are very small, then special treatment may not be necessary. This is due to the fact that very often this pathology becomes regressive when menopause occurs. But with the use of hormonal drugs for menopausal symptoms, containing natural or synthetic estrogens, fibroids may begin to increase again in size.
Among women who begin the development of menopause with fibroids, very often the question arises: “Can the uterine fibroids dissolve and pass with the onset of menopause, or not?”
Uterine fibroids with menopause may decrease in size due to the natural decrease in estrogen levels in a woman’s body, caused by hormonal changes. With a successful outcome, the tumor itself can pass in the menopausal period without a specific treatment. Cases where uterine fibroids can disappear completely are not fully studied from the point of view of medicine, but the opinions of women who have healed in this way prove the absolute possibility of this fact.
But do not forget that in the overwhelming majority of cases, fibroids with menopause can not regress, but, on the contrary, begin to grow with greater intensity. In this case, the pathology may succumb to the processes of malignancy and develop into a cancerous tumor.
For the purpose of medical treatment of the uterus in menopause, it is worth achieving the following factors:
- stopping tumor growth,
- reduction of its size,
- adjustment of menstrual flow until menopause,
- healing of symptomatic manifestations that myoma forms during menopause.
To reduce tumors in the uterus, progestogenic hormones can be prescribed, among which the most effective are Norkolut and drug Medroxyprogesterone. During menopause, these drugs must be taken at least 6 months.
To block the hormone contained in the pituitary gland, under the influence of which there may be increased production of estrogen, even during menopause, a gonadotropic antagonist is prescribed - Buserelin –Depo. When taking this drug, myoma does not develop further, but begins to regress.
In order to minimize uterine hemorrhages into the uterine cavity, an installation is prescribed. Navy Mirena, which is part of the drug levonorgestrel. IUD can be installed during menopause.
The female body is by nature very enduring and patient, but in order to undergo the development of various gynecological pathologies, especially during menopause, it is necessary to support the body with complex medications. The action of medications will help not only to reduce symptomatic ailments, but also to cure a number of diseases, even such as fibroids, but only with timely treatment to specialists.
Interesting video on the topic:
General characteristics of the pathology
It is a mistake to assume that uterine fibroids occur predominantly in women of menopausal age. Often, tumor formation is found in very young ladies. Therefore, age limits can vary from 25 to 55 years. To know how to deal with this disease, you must have at least a general idea about it.
Myoma is consolidation in the form of one or several nodules. These elements are formed from the muscle tissue of the uterus. Education is usually benign in nature, and extremely rarely does it degenerate into a malignant tumor. Its shape can be different, and the dimensions are in the range from a few millimeters in diameter to tens of centimeters. Doctors fix cases when myoma reaches colossal parameters. So, in one patient, the doctors removed the myoma during the operation, the dimensions of which corresponded to a large melon.
Most often, the appearance of benign growth in the uterine cavity is associated with hormonal changes that occur in women before menopause. But there are much more reasons capable of provoking the development of the disease. Therefore, to judge unequivocally that with the onset of menopause, the risk of fibroids, does not follow. But what is characteristic of fibroids is that the process can be completely asymptomatic.
True, this feature is more characteristic of small formations. But, if the tumor is large or the formation consists of several nodes, then the symptoms of the disease manifest themselves clearly, clearly indicating the presence of education.
Types of neoplasms
The full nature of the pathology has not yet been studied, but the classification and types of fibroids by physicians are clearly defined. Distinguish education by location and structure. The classification by structure has three groups.:
- When a tumor consists of muscle tissue, it is fibroid. For such formations characterized by rapid growth.
- If the node is formed mainly of connective tissue, then we are talking about the presence of uterine fibroma.
- In the case of a mixed structure, doctors diagnose the fibroids of the penis.
But besides this classification, in medical practice there is another criterion by which benign education is characterized. Differentiation of nodes is carried out even at their location.
Subserous myoma usually fixed outside the uterus. With intensive growth, it is able to fill the entire space of the small pelvis.
- Submucous formation develops directly in the uterus. Therefore, this type of tumor is often mistaken for a developing pregnancy.
- Interstitial seal formed from the muscle layer of the uterus, as it grows, it deforms the wall of the organ.
Knowing how fast myoma grows in the uterus and the place of its localization, it is easy to determine which tissues are at the heart of its structure.
What can trigger the development of fibroids
As mentioned above, until a certain time, most medical professionals were inclined to believe that the main cause of the appearance of fibroids is a hormonal failure associated with age-related changes in a woman’s body. Later it was proved that this factor is not the only one. Modern doctors call the following causes of fibroids:
- genetic predisposition
- menstrual irregularities that are pathological in nature,
- frequent abortions and other surgery on the female genital organs,
- late menopause
- sedentary lifestyle,
- impact of stress
- nervous disorders
- violation of metabolic processes, the cause of which is most often malnutrition,
- frequent change of partners
- irregular intimate life also adversely affects women's health, especially during menopause,
- sexually transmitted diseases, as well as inflammatory processes of the sexual sphere,
- poor ecological environment (radioactive contamination, poor quality water),
- hormonal drugs (contraceptives) also contribute to the active growth of myomas.
Separately, it is necessary to dwell on the pernicious habits that many women are subject to today. Alcohol and smoking have a damaging effect on the reproductive sphere of women.
Under the influence of toxins, the production of necessary hormones is disrupted, and as a result of this imbalance, the formation of tumors often occurs.
The truth, which asserts that the disease is easier to cure when it can be recognized by the first manifestations, is applicable to the benign formations of the female genital sphere. The first symptoms and signs of uterine fibroids with menopause can be regarded as an alarm bell. Although each woman has a specific course of the disease, there are a number of common signs. Among them:
- Bleeding Spotting can be observed for several days, as menstruation, or be permanent, often so intense bleeding occurs that a woman’s life is threatened. Severe blood loss usually leads to the development of anemia and a worsening of the woman’s general well-being.
- Pains . This symptom can also manifest itself in different ways: some women complain of nagging pain in the lower abdomen, while others have a pain in the sacrum. Many do not even know why such signs arise.
- Impaired stool . Mostly constipation, and bowel movement is accompanied by severe pain.
- Discomfort during intercourse . Often intimate intimacy is accompanied by pain.
- Waist increase . Often women are interested in whether the stomach can grow during uterine myoma, as during pregnancy. And this phenomenon is observed often. Often, patients refer to a gynecologist about the intended pregnancy. But after inspection, it becomes clear that the cause of the increase in the abdomen is the growth of fibroids.
- Frequent urination or the urge to it is also an obvious sign of the formation of a tumor.
- Temperature rise.
All of these signs clearly indicate the disadvantage of women's health. Therefore, when at least one symptom appears, it is necessary to immediately visit the gynecologist's office. The fact is that not a single woman has yet managed to get rid of the fibroids.
And one more important point that must be taken into account: although the probability of degeneration of a benign tumor into a malignant tumor is minimal, there is still a risk of these changes.
As a rule, doctors do not rush to suspect a fibroid immediately refer the patient to surgical treatment. First, a thorough diagnosis.The patient is assigned an ultrasound scan, conducting hysterosalpingography (x-ray method for the study of the uterus with a contrasting composition).
After receiving the necessary data, the doctor analyzes them. If the tumor is small and doesn’t bother the woman much, they just watch her for a while. But if a large fibroid puts pressure on the bladder, the symptoms are not only unpleasant, but also extremely painful, then the doctors will collectively decide the question of its removal.
This picture can be observed in advanced cases of the disease or with intensive growth of the tumor. The latter is extremely dangerous to health, because the growing tumor gradually increases the pressure on the important great vessels and tissues of the pelvic organs. Of course, such a tumor must be removed.
Small nodes are treated conservatively. A woman is prescribed complex therapy, which includes drugs that affect the structure of the education itself. With successful treatment, small nodules dissolve. If the growth of the formations cannot be blocked, then the issue of the operational treatment option is also discussed.
It should be understood that fibroids are not a pathology of the complexity that can be cured with decoction and infusions. Everything is much more complicated. And if you initially follow this path, you can simply lose precious time and worsen the situation. Therefore, it is not necessary to self-medicate when it comes to health. It is better to turn to professionals in a timely manner, and they will already decide how to treat myoma.
If the experts choose a conservative treatment option, then it is likely that healing herbs will be included in the list of recommended drugs. As an additional treatment, traditional methods are always readily used by traditional medicine. There are many herbal preparations that can stop the growth of benign entities. In the list of these herbs:
- medunitsa medicinal,
- marsh wormwood
This list can be replenished with more than one dozen healing herbs. But basically all plants have a potent and often poisonous component. Therefore, their use is unsafe and also requires medical approval. After all, it is very important to calculate the optimal dosage, especially when it comes to the internal use of toxic herbal preparations.
In principle, all activities of such orientation are reduced to the elimination of factors that can start the pathological process. To prevent the development of fibroids and other formations of the genital organs, it is enough:
- adjust nutrition
- Enrich the diet with fortified foods
- remove from the menu all fried, smoked and fat,
- lead a lively, active life
- sports activities always strengthen the body's resource, and also increase its resistance to disease,
- don't get too involved in sunbathing,
- sexual hygiene must be strictly observed,
- be sure to control the menstrual cycle
- use only safe means of contraception,
- regularly, at least twice a year, visit the gynecologist's office.
Compliance with these basic rules will help to preserve women's health in reproductive age and after menopause.
Causes of uterine fibroids
Myoma is the proliferation of cells in the muscle layer of the uterus. Until now, scientists have not established exactly what leads to the development of uterine fibroids. There are two theories of the origin of progenitor cells of uterine fibroids.
Proponents of the first theory believe that each myoma node grows from a single cell, which becomes defective and begins to divide. Such cells can occur during fetal development. Smooth muscle cells of the uterus develop quite a long time, until the 38th week of pregnancy. At this time, myocytes are unstable, they can be affected by damaging factors. Further, these cells are activated from the onset of menstruation, when the ovaries begin to function, hormonal changes. This can stimulate the onset of myoma growth.
According to the second theory, the cells of the muscular layer of the uterus are damaged by the multitude of menstrual cycles experienced by a modern woman who gives birth no more than one or two times in her life. During the second phase of the cycle, the smooth muscle cells of the uterus begin to divide. They are preparing for pregnancy, during which cell division accelerates. If the pregnancy does not occur, menstruation begins. The newly formed smooth muscle cells die by apoptosis - programmed cell death. Part of the cells can remain and go to the next menstrual cycle in an unchanged state, continuing the division. They form the beginnings of myoma nodes.
The following factors contribute to the growth of uterine fibroids:
- Frequent abortions
- Diagnostic curettage
- Recurrent inflammatory diseases of the uterus,
- Surgical intervention on the uterus,
- Traumatic benefits and complications of childbirth.
The development of uterine fibroids can contribute to early onset of menstruation, late first birth, a small number of births.
Previously, scientists have suggested that uterine fibroids develop as a result of hormonal disorders, increased estrogen levels while progesterone levels decrease. This theory turned out to be incorrect. Numerous studies have shown that women with uterine myoma do not have hormonal imbalance. Uterine myoma is a local pathological process, and our doctors act locally on it, depriving the nodules with the help of uterine artery embolization.
Types of uterine fibroids
Myomas can be of different sizes - from a very small compaction, which is detected by ultrasound of the pelvic organs, to a large tumor, which weighs about a kilogram and is easily determined when the gynecologist probes the abdomen. By location, there are 3 types of myomas: submucous, interstitial and subserous.
In the case of the location of fibroids under the mucous membrane of the uterus, doctors talk about submucous myoma of the uterus. Interstitial fibroids are localized in the wall of the female reproductive organ. Subserous fibroids develop on the surface in the region of the peritoneum, has a broad base or long leg. If a woman has symptoms and signs of fibroids in menopause, the nodes can be located in the body or cervix.
Symptoms of uterine fibroids
When a submucous myoma occurs, the following symptoms are identified:
- prolonged and heavy menstruation with clots
- heavy uterine bleeding,
- bleeding between menstruation,
In the presence of symptoms and signs of submucous fibroids during menopause, the uterus cavity is deformed. Blood loss leads to the development of symptoms of anemia:
- Noise in the ears
- Weakness, weakness,
- Dizziness, fainting,
- Disorders of the heart - heart palpitations, arrhythmias, shortness of breath,
- Pallor and dry skin, brittle nails and hair.
Subserous fibroids develops from the outer muscular layer, located outside. Reaching a certain size, the tumor compresses the organs of the abdominal cavity, located in close proximity to the uterus - the bladder and intestines. Subserous fibroids do not affect the menstrual cycle. Signs of large subserous fibroids are constipation and dysuric disorders.
Intramural myoma grows from the middle muscle layer. As the neoplasia grows, the uterus increases in size. Determined by the following symptoms:
- menstrual disorders
- pain and pressure in the pelvis
- the impossibility of conceiving and carrying pregnancy.
Large myomatous nodes deform the uterine cavity and squeeze the fallopian tubes. This form of fibroids is characterized by intermuscular arrangement of nodes. At the very beginning of the disease, when myoma is very easily and quickly cured, it does not manifest itself. Nodes can be detected only with periodic preventive examination by a gynecologist - the uterus is more dense and enlarged.
As uterine fibroids develop, alarming symptoms and signs appear that a woman should pay attention to and consult with gynecologists of our fibroid treatment clinics:
- increase in the number of menstrual flow and the duration of menstruation (menorrhagia),
- acyclic uterine bleeding (metrorrhagia),
- pain in the lower abdomen and lower back.
When menopause occurs, myoma nodes can continue to grow. The following symptoms and signs of uterine fibroids with menopause occur:
- prolonged pain in the lower abdomen, as during menstruation, giving to the sacrum and lower back,
- painful intimate contact,
- intermittent prolonged uterine bleeding with the development of an anemic condition,
- feeling of pressure on the organs in the pelvis,
- increase in the abdomen and waist,
- frequent urination due to pressure of the node on the bladder,
- painful constipation constipation
- backache and lower back pain.
According to statistics, myoma is reborn into a malignant tumor in only 1% of cases. For this reason, the doctors of our clinics consider the increased oncological vigilance, which many gynecologists show and remove the uterus in case of myoma, to be unjustified. We recommend that women in the event of the appearance of symptoms and signs of fibroids during menopause perform embolization of the uterine arteries. This minimally invasive procedure allows you to get rid of tumors and save the uterus.
Diagnosis of uterine fibroids
If there are signs and symptoms of uterine fibroids with menopause, you can establish the correct diagnosis using a routine gynecological examination. Gynecologists reveal an enlarged uterus of dense consistency, often with a bumpy surface. To clarify the diagnosis, determine the localization and size of education, doctors of our clinics perform transabdominal and transvaginal ultrasound of the pelvic organs. Due to the high resolution of the equipment with which our clinics of treatment of fibroids are equipped, physicians of functional diagnostics are able to identify the smallest myomatous nodes.
If symptoms and signs of uterine fibroids occur in women who are in menopause, an ultrasound scan of the uterus and computed tomography are performed. One of the effective and modern methods of diagnosis of uterine fibroids is hysteroscopy. It allows simultaneously with the detection to remove subserous myomatous nodes.
Conservative treatment of uterine fibroids with menopause
Gynecologists treat uterine fibroids with a therapeutic or surgical method. Conservative treatment of fibroids is to take drugs that are aimed at stopping the symptom of the disease and reducing the size of education. It is based on hormonal drugs, in particular, progesterone derivatives, which inhibit the growth and development of the tumor. In the presence of symptoms and signs of fibroids in women who are in menopause, they are not prescribed.
Gonadoliberin agonists of prolonged action, which suppress the secretion of gonadotropins and thereby cause pseudomenopause (danazol, buserelin, zoladex, diferelin) are also not used for climaxse. The use of GnRH agonists in patients of reproductive age reduces the size of fibroids by 55%, but after treatment, the nodes begin to grow again. Long-term therapy with GnRH agonists is not performed for young women because of the possibility of developing osteoporosis.
The relief of symptoms and signs of uterine fibroids with menopause with drugs is carried out in the following cases:
- if the size of myoma nodes do not exceed 12 weeks of pregnancy,
- with intramural and subserous arrangement of myomatous nodes with a broad base,
- if the patient has contraindications for the use of surgical methods for the treatment of fibroids,
- in the absence of iron deficiency anemia, which is associated with uterine bleeding.
Therapeutic agents are able to restrain myoma in a painless state until menopause, when small tumors usually resolve themselves
Surgical treatment of uterine fibroids
Gynecologists perform surgery for uterine fibroids with the following indications:
- large myomatous nodes (more than 12 weeks of pregnancy),
- rapid growth of myoma formations over a short period of time,
- severe pain syndrome that accompanies uterine myoma and over time can lead to the loss of the woman’s ability to work,
- uterine fibroids in combination with endometriosis or ovarian neoplasm,
- eating disorders or necrosis of the myoma node,
- functional disorders of urination and bowel function,
- submucous site location
- malignant rebirth fibroids.
Gynecologists of our clinics believe that the indications for the implementation of surgery in the presence of symptoms and signs of fibroids during menopause are unreasonably expanded. In most cases, we perform an innovative procedure - embolization of the uterine arteries. After treatment, the patient recovers impaired functions, improves the quality of life, preserves the uterus and restores fertility (fertility).
The nature of surgical intervention in uterine myoma gynecologists determine on the basis of their individual characteristics of the patient. Doctors take into account her age, the general condition of the body and the reproductive system.
There are two ways to perform an operation to treat uterine myoma - myomectomy (removal of myoma node) and hysterectomy (removal of the uterus with or without appendages). Myomectomy refers to organ-sparing operations. It is performed through an incision of the anterior abdominal wall or by laparoscopy. Bleeding is possible during the operation, which forces the surgeon to remove the uterus. After embolization of the uterine arteries in this is not necessary.
In the place of excised myomatous nodes, scars are formed. They can cause miscarriage or rupture of the uterus during labor. After uterine artery embolization, the myoma node is replaced by connective tissue, which does not create problems during pregnancy and childbirth. Radical treatment of fibroids implies the removal of uterus along with the nodes. After the operation, the woman will no longer be able to have children, her sexual function will be disturbed.
A new technique in the surgical treatment of myomas is myomectomy using hysteroscopy. It is used to treat submucous myomatous nodes in women who need to preserve the uterus for further pregnancy. This method gives good results. With it, myoma is excised in a single session using a laser with visual inspection of a physician. The operation can be performed under local anesthesia and does not require prolonged hospitalization. Unlike uterine artery embolization, after surgery there is a risk of disease recurrence.
The effect of estrogen on a woman
Every minute of her life a woman is under the influence of sex hormones. The main ones are the compounds of the estrogen group and progesterone. Estrogens are precisely those substances that form a woman, both outside and inside. Under their influence, such processes occur:
- growth and development of the uterus,
- the formation of secondary sexual characteristics,
- reduction of muscle tissue, respectively, the curves of the body acquire feminine forms,
- decrease in cholesterol in the blood, stopping the development of atherosclerotic plaques in the vessels,
- improving skin condition
- increased sexual desire
- improving mood, intensity and intensity of emotions.
To sum up all of the above, estrogen makes a woman young, attractive, active, alluring, healthy. Their correct balance can only be determined laboratory, but everyone who surrounds a woman and, of course, herself, is able to feel its violation.
Myoma with menopause
The emergence of the disease described women are 25-40 years old. It is not uncommon for myoma to start or increase its growth during pregnancy.
Climax in the representatives of the weaker part of humanity is caused by disorders in the glands that produce sex hormones. In this regard, their balance is violated. When the level of estrogen decreases, uterine myoma during menopause slows its growth or may even decrease in size.
Signs of benign neoplasm during menopause
Benign uncontrolled growth of uterine cells with the formation of nodes in the future is very slow and does not make itself felt for a long time. This process is called leiomyoma. For this reason, there are quite frequent cases when uterine myoma during menopause is detected by chance during a regular check-up at a gynecologist or at a scheduled admission during pregnancy. This is, firstly, the danger of the disease, and secondly, the confirmation of the need for periodic medical examinations.
However, there are symptoms of uterine fibroids with menopause, which can be suspected of the occurrence of something wrong:
- increased bleeding during menstruation, an increase in its duration,
- the appearance of bleeding in the menstrual period,
- uterine bleeding,
- anemia during prolonged illness,
- возникновение болей внизу живота тянущего, ноющего характера, длящихся неделями,
- болезненность и появление неприятных ощущений во время полового акта,
- lower back pain
- an increase in the abdomen
- appearance of frequent urination.
Disturbances in the work of organs located in the neighborhood (intestine, bladder, kidneys) occur when the node reaches large sizes and begins to put pressure on them. Among other things, it is this condition that can cause infertility in a woman. These patients often have miscarriages.
Uterine fibroids after menopause behaves not so aggressively. A woman notices that her manifestations are gradually weakened.