Dra. Joana Faria

Uterine Fibroids or Myomas

What are the uterine fibroids?

Uterine fibroids (or myomas) are benign (in 99% of the cases) growths that develop from the muscle tissue of the uterus. The size, shape, and location of fibroids can vary greatly. They may be present inside the uterus, on its outer surface or within its wall, or attached to it by a stem-like structure. Fibroids are most common in women aged 30–40 years, but they can occur at any age.

Which are the symptoms?

Fibroids may be asymptomatic or cause heavy or prolonged menstrual periods, pelvic pain (caused as the tumor presses on pelvic organs), pain during intercourse (dyspareunia) or other symptoms as frequent urination, constipation, belly bump, low back pain, infertility, etc, depending on their location and size.

What is the cause?

It is still not clear what causes fibroids. Nevertheless, it is believed that each tumor develops from an aberrant muscle cell in the uterus, which multiplies rapidly because of hormonal (estrogen) influence.

What is the treatment?

Small and asymptomatic fibroids may only need surveillance while fibroids that cause bothersome symptoms may be controlled with medication or treated by surgical removal. The treatment depends on the number, size and desire or not to maintain fertility.

Myomectomy means surgical removal of the fibroid(s) and can be done by abdominal route (laparoscopic or open surgery) or vaginal route (hysteroscopy).

Hysterectomy (uterus removal) is the definitive treatment that can be considered when other treatments fail, in very big fibroids or in women that don’t want to have more children.

When to see your doctor?

If you have prolonged, heavy bleeding or severe cramping during your periods that interfere with your daily regular activities or infertility. The doctor will perform a gynaecological evaluation and most of the times, a pelvic ultrasound will be needed. In complex cases, an MRI (magnetic resonance imaging) can be ordered to obtain high-resolution images of the uterus.

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