Between 40% and 70% of women will suffer at some point in their lives “the benignity” of uterine fibroids, an abnormal growth of smooth muscle tissue that can cause, in some cases, infertility and sterility if it is localized in the endometrial wall, even more so at 30 and 40 years of age.
Active surveillance against the “perversity” of uterine fibroids
“They are more frequent in women who have not given birth, in those who have had very early menstruation or due to factors, let’s say, hereditary, possibly related to the hormonal system,” says Dr. Carmen Sala, an obstetrician and gynecologist and expert in quality of life of the woman of the Clinic Gine-3 of Barcelona.
If a woman bleeds between periods or her period is very heavy, sometimes with clots, or lasts longer than usual, or she has frequent urination or cramps or pain during periods or pressure in the lower abdomen, surely you will have developed one or multiple uterine fibroids in different pelvic locations.
“You have a uterine myoma -I inform the patient after carrying out the relevant diagnostic tests-… Of course! My mother had an operation for a fibroid… Oops! And you’ve seen my sister too -she comments-… Surely it is not genetic, but it is a kind of family physiological characteristic».
And it should be noted that approximately half of women will have a uterine fibroid around the age of fifty.
The determining location of uterine fibroids
Broadly speaking, uterine fibroids -fibromas- can be of an inappreciable size at a gynecological view or of a size that is frightening, giving very notorious cases of tumor masses greater than the weight of a newborn baby; but even so, the important thing is its pelvic location: in the intrauterine area –submucosos e intramurales– or in the ectopic area –subserosos-.
“Women with submucosal fibroids will have much more abundant periods and last for many more days. So much so that even the family doctor can detect anemia after seeing the hemoglobin data in an analysis of the patient, “says Dr. Sala.
“Submucous fibroids -intrauterine- can cause implantation failure during infertility treatments. As for sterility, as these fibroids occupy a space within the uterus, they can cause abortions, premature births or delays in fetal growth, ”he indicates.
“If the placenta inserts right into the pared endometrial where this type of fibroid has developed, the tumor can cause serious pathologies, such as placental abruption”, highlights the gynecologist.
Subserosal fibroids can reach very large sizes.
“They took one of four kilos from my mother”… a woman in the consultation told me. These fibroids frequently generate compression problems by resting on the bladder, making you want to pee more often, or on the rectal area, causing constipation”, he describes.
About the treatments, will depend on the woman’s age, location, size and symptoms (around 30% cause symptoms), but each fibroid will be treated specifically and individually.
“If the fibroid is a casual finding in a gynecological examination and does not produce symptoms, no treatment will be necessary, since they do not degenerate into malignancy,” he explains.
“If the woman is in the process of pregnancy and a submucosal fibroid is detected, selective surgical treatment will have to be applied to avoid serious problems, such as failure of the placenta to implant.”
Depending on the case, radiofrequency ablation of fibroids may also be used, which is performed vaginally through a suitable needle that applies heat inside the fibroid and necroses its tissue. Myoma reduces its volume and its symptoms.