TL;DR:
- Uterine Myomas: Benign tumors in the uterus, composed of smooth muscle, common in reproductive-age women. They vary in size, location, and symptoms and do not metastasize.
- Types:
- Submucosal (beneath the endometrium).
- Intramural (within uterine wall).
- Subserosal (external uterine layer).
- Causes: Linked to hormonal changes, genetics, and environmental factors (diet, smoking, alcohol). Risk peaks in childbearing years and decreases post-menopause. Early pregnancy and childbirth are protective.
- Symptoms (40% experience them): Abnormal bleeding, anemia, abdominal pain, infertility, irregular cycles.
- Diagnosis: Transvaginal ultrasound, hysteroscopy, and imaging (MRI/CT).
- Treatment:
- Mild cases: Monitor.
- Severe cases: Drugs, myomectomy, embolization, or hysterectomy (for non-fertility cases).
- Pregnancy: May cause discomfort or risks (miscarriages, bleeding). Requires extra monitoring via ultrasound.
Although uterine myomas are one of the most common benign cancers in women, they still cause many women stress, pain and nerves. Their subtle symptoms, often underestimated, can lead to serious health complications and difficulties with pregnancy. It is a condition that affects millions of women around the world, but often goes unnoticed, which can lead to health complications.
What is a myoma of the uterus?
A benign tumor that occurs in the uterus is called a myoma. It is a benign neoplastic lesion that occurs mainly in women of reproductive age. It is made up of smooth cells of the uterine muscle (myometrium). Uterine myomas can range in size from small, unnoticeable nodules to large formations that can significantly affect health and quality of life. They usually take a spherical form with a compact consistency, are often multiple, do not spread to other tissues and do not metastasize. Depending on their location and size, myomas can cause a variety of symptoms and health complications. They are usually not life-threatening, while removal is often recommended due to their large size.
Types of myomas
Uterine myomas can be divided by location into three main types. The basic classification includes:
- submucosal myomas – are located directly under the endometrium, or endometrium,
- Intramural myomas – are located in the middle of the uterine wall,
- subserosal myomas – are located under the serous membrane outside the uterus.
Uterine myomas also differ in size, symptoms caused, and direction of growth and development. Recognizing the specific type of uterine myoma is important for determining the appropriate treatment plan. Each type of lesion may require an individualized therapeutic approach, so it is crucial to consult a gynecologist for an accurate diagnosis.
Causes of uterine myomas
The unequivocal causes of uterine myomas are not fully understood, while there are several factors that may contribute to an increased risk of their development. These primarily include hormonal problems, the period of pregnancy or menopause. It has been observed that there is a strong propensity for uterine myomas in families, suggesting a role for genetic factors in their formation. Women whose mothers or sisters had uterine myomas may be at higher risk of developing them. The risk of developing uterine myomas increases during childbearing age and usually peaks between the ages of 30 and 40, then often decreases after menopause, when estrogen levels decline. This is primarily due to the fact that some myomas grow under the influence of these female hormones. Other non-modifiable environmental factors we can also include the origin and early onset of the first menstrual period and late onset of the last. Some factors, such as a diet rich in red meat, vitamin and mineral deficiencies, smoking and alcohol abuse, may also contribute to a higher risk of uterine myomas. The researchers observed that pregnancies before the age of 25 and multiple births are protective elements when it comes to the formation of these benign lesions.
Uterine myomas – symptoms.
Uterine myomas can be present in women for many years without any symptoms. Data shows that only 40% of women experience discomfort caused by the presence of a myoma. Symptoms can be varied and non-specific. They depend on the number, size, location and type of tumor. The most common symptoms include:
- abnormal and heavy reproductive tract bleeding,
- irregular menstrual periods,
- bleeding between cycles,
- anemia and resulting general weakness, pale skin, fainting,
- pain or discomfort in the lower abdominal area,
- difficulty maintaining a pregnancy,
- problems getting pregnant.
It is worth noting that the symptoms of uterine myomas can vary from woman to woman and may change over time as the myoma grows. Some women may experience very severe symptoms, while others may have no signs at all.
Management of the diagnosis of uterine myoma
If you observe alarming symptoms in yourself that may suggest uterine myoma, you should urgently see a gynecologist. This is important not only in the context of making the diagnosis itself and implementing treatment, but also when differentiating this lesion from other pathologies of the intimate area, such as endometrial polyp, ovarian tumor or uterine sarcoma. Uterine tumors can be visualized by transvaginal ultrasound. It is the primary tool for diagnosing this condition. It makes it possible to precisely determine the location of the lesion and measure its dimensions. Large tumors may be palpable as early as a two-handed gynecological examination. The specialist may also order other additional tests, especially if there are doubts about the diagnosis. These include hysteroscopy, which involves inserting a camera into the uterine cavity, and imaging studies such as MRI or pelvic CT scans. An important consideration is a thorough clinical interview with a specialist, who can direct the doctor to the correct diagnosis, often based on symptoms alone.
Treatment of uterine myomas
Women who have myomas that cause clinical symptoms are eligible for treatment. Asymptomatic uterine tumors do not require treatment, but rather constant observation. Taking into account the age of the patient, the need to preserve fertility and the wishes to preserve the uterus, the doctor selects the appropriate method. In any case, pharmacological treatment to relieve symptoms should be considered. However, this is a symptomatic treatment. It is often aimed at reducing the size of the myoma and is a preparation for surgical treatment.
Patients undergo surgery if the drugs are not beneficial. If a woman has plans for pregnancy, a so-called myomectomy, a procedure to extrude the myomas, is usually performed. It can be performed laparoscopically. Another option is vascular embolization, which involves the closure and necrosis of a blood vessel that feeds the uterus. This effectively stops the growth of the tumor. For women who are not planning a pregnancy or are postmenopausal, removal of the uterus, or hysterectomy, is usually performed. Often other organs are also removed, including the fallopian tubes or cervix. As for the ovaries, they are usually left until the age of 60-65, as they are beneficial to a woman's health and overall well-being.
Uterine myomas and pregnancy
Uterine myomas can affect pregnancy, although they do not always lead to serious complications. Some women may experience no symptoms during pregnancy, while others experience significant discomfort, such as abdominal pain or heavy bleeding. In some cases, myomas can cause pregnancy complications such as miscarriages, premature rupture of fetal membranes or other complications. Such patients require additional monitoring, both for myoma development and pregnancy progress. This includes regular ultrasound examinations to assess the size and location of the tumor and observation for any symptoms. It is important that women who are diagnosed with uterine myomas undergo periodic follow-up visits to their gynecologist and have specialized tests performed as needed. With proper medical care, most patients with uterine myomas can safely go through pregnancy and give birth to a healthy baby.
Conclusion
Uterine myomas are common and often silent, yet they can impact health and fertility. Recognizing symptoms, understanding causes, and seeking timely diagnosis are critical steps for managing this condition. Treatment, ranging from observation to surgery, depends on the size, location, symptoms, and reproductive goals. Early action ensures better outcomes and minimizes risks during pregnancy or beyond. Don't ignore symptoms—partnering with a gynecologist can help protect your health and improve your quality of life.
