Pelvic pain, heavy menstrual flow, frequent urination, may indicate the presence of uterine fibroids. With the expert we see what are the causes and possible treatments in this case.
The presence of uterine fibroids (or myomas) often generates concern and doubts in women. However, these are benign neoplasms that occur frequently, especially during the fertile age.
Although the causes of their development are not yet fully known, uterine fibroids can be treated differently based on various factors such as size, age of the woman, symptoms. For an accurate diagnosis and personalized treatment, the advice of the gynecologist is essential.
So what are the causes, symptoms and possible treatments in case of uterine fibroids? We talked about it with Doctor Valentina Galiano, Surgeon, Specialist in Gynecology and Obstetrics.
- What are
- When do they get dangerous?
«Fibroids (or leiomyomas) are benign solid growths that originate from the muscle tissue of the uterus. They represent one of the most frequent gynecological pathologies. Their prevalence increases with age, being very low before the age of 20 until reaching a peak in the pre-menopausal period, between the ages of 40 and 50. These formations, generally nodular, are made up of muscular and fibrous tissue and can vary greatly in number, position and size (from a few millimeters to several centimeters) », explains the doctor.
It may happen that you are not aware of their presence as the symptoms are not always present. Most of the time they are in fact detected during a routine gynecological examination.
“The causes underlying their development are not yet well known, but it is believed that a role of some importance may be played by genetic predisposition and a subsequent susceptibility to hormonal stimulation (estrogenic and progestin or growth factors such as EGF – Epidermal Growth Factor) ».
«The symptoms depend on the size and in particular on the location of the myomas. In fact, they are often asymptomatic: in these cases their identification does not necessarily imply treatments and periodic monitoring by means of a specialist gynecological examination combined with transvaginal and, if necessary, trans-abdominal ultrasound is sufficient.
When symptomatic, they can also significantly affect a woman’s quality of life as they can cause:
- abundant and / or close menstruation (with consequent possible anemia);
- pelvic pain;
- feeling of heaviness and abdominal bloating;
- frequent urination;
- intestinal disorders.
They can also potentially hinder embryo implantation or pose a risk during pregnancy of miscarriage, abnormal presentation of the fetus, preterm delivery or placental abruption. After childbirth they can also cause post-partum haemorrhage due to the reduction of uterine contractile capacity », specifies the expert.
When do they get dangerous?
«If found, it is always good to perform regular checks (usually every 6-12 months) to check for any increase in volume, the timing of the volume increase and the characteristics of the vascularization. These clinical-ultrasound parameters allow us to estimate the risk of sarcomas (malignant tumors of the uterine body), fortunately much rarer. The increase in size of fibroids, particularly in post-menopause when there is no longer the ovarian estrogen production, must lead to diagnostic investigations », continues Dr. Galiano.
Similarly, it is good to monitor them during pregnancy, as uterine fibroids may grow in volume due to increased estrogenization.
«In the case of symptomatic fibroids, the therapy can be medical or surgical (conservative or destructive). It is the task of the gynecologist to provide the woman with detailed information, illustrating the advantages and disadvantages of all the options, choosing in agreement the treatment that best suits her needs “, concludes the expert.
Each case is therefore independent, so the therapy will be identified by the gynecologist based on the type, number and size of the fibroids detected in the woman’s uterus.
As for prevention, however, since the causes of the onset of uterine fibroids are not well known, there are no specific preventive behaviors to follow to avoid their appearance. However, the advice is to carry out a specialist gynecological examination at least once a year (but even more as needed) to make sure that everything is fine.