Uteri Myoma or Uterine Fibroids: Symptoms, Causes, and Treatment Methods

Uterine myomas or uterine fibroids are benign tumors that are not cancerous and can grow inside or outside the uterus. This condition occurs due to muscle and connective tissue growth from the uterine wall.

The size, number, and location of myomas can vary. Myomas were found to grow only one or more to form clusters. Its size can reach the size of a watermelon. The growths may occur within the uterine wall. They may protrude into the endometrial space or the surface of the uterus.

Myoma cases usually appear in women of childbearing age. As many as 40-50% of them are asymptomatic in women aged 35. It is also not uncommon for myomas to be discovered accidentally during a pelvic examination or ultrasound.

Location of uterine myoma growth

Myomas are classified based on their location into four different categories. The following types describe the growth location and how the myoma attaches. Specific locations myomas can grow to include:

1. Submucosal fibroids: Myomas grow in the uterine cavity, where the fetus grows during pregnancy.
2. Intramural fibroids: Myomas are embedded and grow within the muscular wall of the uterus.
3. Subserosal fibroids: Myomas grow outside the uterus and attach close to the uterine wall.
4. Pedunculated fibroids: Myomas grow outside the uterus and attach to the uterus. This type is the rarest and is usually shaped like a mushroom because it has a stalk with a wider top.

Symptoms of uterine myoma

Indeed, many women with fibroids experience no symptoms. However, symptoms can still appear depending on the location, size, and the number of myomas. Some of the symptoms that occur in women with myoma include:

• Heavy bleeding during menstruation
• Menstrual periods last more than a week
• Pain in the pelvis is prolonged and does not go away
• Frequent urination
• Urinary disorders
• Accumulation of fluid in the abdominal cavity
• Constipation
• Pain in the lower back
• Chronic vaginal discharge
• Pain during sexual intercourse

Causes of uterine myomas

Until now, doctors can't be sure of the cause of uterine fibroids, but research shows these four factors can contribute:

1. Hormone. Estrogen and progesterone are two hormones that can trigger myoma growth. Myomas have more receptors for these two hormones than other uterine muscle cells. Myomas will usually disappear as hormone production decreases during menopause.
2. Extracellular matrix (ECM). ECM is the substance that causes cells to bind together. In fibroids, the ECM increases, making fibroids fibrous.
3. Genetic changes.
4. Other growth factors, such as insulin-like growth factor

Several risk factors contribute to myoma formation, including:

1. Obesity
2. Family history
3. Menstrual periods that occur too early
4. Late menopause

How to treat uterine myoma

Myoma cases can be initially handled according to the symptoms felt, such as by giving painkillers in paracetamol. If you experience profuse bleeding, don't delay to go to the nearest health facility immediately. The doctor will provide several treatment options for myoma, namely:

1. Ultrasound

Physical examination and ultrasound should be repeated every 6-8 weeks to monitor myoma growth, both size, and number. The patient will be observed every 3-4 months if the growth is stable.

2. Hormonal therapy

Hormonal therapy treatment can be taken using progestin preparations or gonadotropin-releasing hormone (GnRH). These preparations will produce a hypoestrogenic effect that can overcome myoma.

3. Myomectomy

Another way is through myomectomy, which is surgery to remove a myoma. Doctors will recommend myomectomy to a woman who is still young and wants more children. However, myomas still have a 20-25% chance of growing again after a myomectomy.

After surgery, patients are advised to postpone pregnancy for 4-6 months because the uterus is still fragile. Unfortunately, sometimes there are complications from the operation, namely the risk of bleeding.

4. Hysterectomy

A hysterectomy will be considered in women who no longer want children, pain that does not go away, and recurrent fibroid growth (despite having had surgery).

Myomas can grow or disappear at any time. Size changes can occur over a long time. Usually, the change in size is related to hormone levels in the body. Myomas can grow larger when hormone levels are high, such as during pregnancy. To prevent fibroids from occurring, you should exercise regularly, adopt a healthy diet, and avoid smoking.

It is important to consult a doctor before you decide to carry out myoma treatment. Discuss with the doctor the concerns and complaints that you experience at Fitie.