Most women will develop a fibroid at some point. While generally harmless, such benign tumors can become troublesome and need attention as they have the potential to cause serious illness. Fibroids affect women worldwide. A new American study indicates that this type of benign tumor affects 20% to 77% of them, although more precise numbers are lacking. This is due to the fact that they are usually only identified later – when they are not identified at all. In general, they are usually only diagnosed and during routine exams, or when they appear from the first symptoms. The number of unreported cases is therefore high. Furthermore, fibroids occur 59% more frequently in black women, something still unexplained. Also for unknown reasons, most fibroids are detected in women of childbearing age, between 25 and 50 years. The researchers believe that among the factors may be both genetic predisposition and female sex hormones, since the probability of developing any form of myoma after menopause is almost zero. There are different types of fibroids: submucous, which form under the lining of the uterus; intramural, in the muscle layer; and subserous, which grow on the outside of the uterus. Tumors can usually be detected during a gynecological exam by touch or ultrasound. By themselves, they are not usually a cause for concern, but they can cause several diseases. The most common symptoms of fibroids Symptoms can vary greatly, depending, for example, on the size and location of the fibroid. The first signs of a fibroid can be pain in the abdomen or pelvic area. There may also be heavy, long-lasting menstrual bleeding, as well as off-period bleeding. At worst, this results in anemia and subsequent episodes of dizziness. In the case of very strong symptoms, the advice is to consult a doctor in order to clarify whether it is a myoma or a malignant tumor. The evaluation of an expert is therefore essential. There are rare cases of benign fibroids that transform into malignant tumors. If the fibroid is small, it is advisable to have examinations at regular intervals. Most are less than five centimeters, but there are those that weigh several kilograms. In such cases, they can put pressure on adjacent organs and thus trigger other symptoms. If the bladder is affected, for example, it causes a strong and unpleasant urge to urinate, which becomes uncontrollable. Other symptoms are back or kidney pain, or a dull ache in the legs. But for such symptoms to be associated with a myoma, the doctor needs to have experience in the subject and know how to indicate the best treatment for each individual case. Non-Invasive Treatment Options Fibroids can be surgically removed. In these cases, the tumor is removed during a minimally invasive hysteroscopy or laparoscopy. Another option is the embolization method, in which plastic particles are inserted into the arteries that irrigate the myomas, and end up interrupting the blood flow and the transport of other substances. The tumor is then “smothered” and withers away. Another relatively new form of therapy is transcervical radiofrequency ablation: electrodes are inserted into the cervical canal, from where they emit heat directed at the fibroid, also causing it to shrink. The situation is more complicated when the myoma is very large. The solution is often a hysterectomy, in which the entire uterus is removed. Such a procedure, however, is only indicated if all other therapies have failed and non-invasive removal is not possible. The method chosen also depends on the patient’s desire to have children or not and, ultimately, on good professional advice. Women should be informed about all the advantages and disadvantages of each method, so that they can participate in choosing the most appropriate therapy. Author: Gudrun Heise
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