Uterine fibroids what to do to treat. Competent treatment of uterine fibroids: what to do if a tumor is discovered? Early symptoms include:

Uterine fibroids are a benign formation that occurs in the muscle tissue of the uterus due to hormonal pathologies.

Patients aged 35-50 years suffer the most from it, although such a deviation can occur much earlier.

This can seriously complicate the lives of young women dreaming of a child and those who are already carrying one. For this they do, where its size and the number of neoplasms are determined, after which it begins.

What it is?

It is important to note that fibroids are a benign neoplasm that is completely treatable. But it is very dangerous for the health and even life of a woman if there are many of them. An ultrasound determines the dimensions, which, due to the similarity of the growth process of the uterus with that during pregnancy, are usually compared with.

According to this criterion, fibroids are divided into 3 categories:

• – it is no more than 20 mm in size and corresponds to 4 obstetric weeks.
• The neoplasm is medium in size – 20-60 mm or 10-11 weeks.
• Large fibroids - over 60 mm or 12-16 weeks.

1. Heavy and prolonged periods with pain, which painkillers cannot relieve. They are often accompanied by anemia due to significant blood loss.
2. Uterine bleeding is possible in the middle of the menstrual cycle.
3. Due to the enlargement of the cervix, it is noticeable.
4. If the neoplasm has a leg and it is twisted, then the abdominal pain becomes unbearable. Due to impaired blood circulation in the tissues of the tumor and uterus, this is fraught with peritonitis.
5. Large nodes put pressure on neighboring organs, causing problems with bowel movements and urination. Also associated are lower back pain, heart pain, headaches, hot flashes, dizziness and weakness, and as a result of compression of the nerve roots in the rectal area, the legs go numb.
6. With large subserous fibroids, ultrasound shows adhesions of the uterine tissue with adjacent organs.
7. Pain during sexual intercourse.
8. Watery-mucous leucorrhoea of ​​a dark color with an unpleasant odor.

Causes

The main culprit in the appearance and development of uterine fibroids is a hormonal imbalance in estrogen metabolism. When broken down by liver enzymes, these female hormones can be transformed into high-quality, low-quality or even dangerous substances. Low-quality estrogen metabolites contribute to the appearance of benign tumors. Dangerous ones, by deforming cellular DNA, can cause them.

If the mass of such pathological modifications becomes critical, then several myomatous nodes appear. Dysfunction of the immune system (especially if there are chronic infectious foci) and hereditary predisposition play a significant role in their appearance.

Other risk factors:

• Prolonged stress, heavy physical labor.
• Lack of regular sexual intercourse.
• Abortion, childbirth complicated by injuries.
• Obesity, arterial hypertension, diabetes.
• Diseases of the endocrine system.
• Physical inactivity.
• Long-term use of hormonal contraceptives.
• No births by age 30.
• Long sunbathing.

Is treatment possible without surgery?

How to treat and cure large uterine fibroids without surgery is necessary for those who are faced with this problem. In many cases, fibroids can be treated without surgery.

This applies, first of all, to short periods of time, single tumors or a small number of them. And the choice of treatment method for large benign neoplasms is associated with the patient’s well-being, her age, the site of node removal and the presence of complications aggravating the course of the disease from other organs.

The widespread introduction of new treatment methods, which will be discussed below, will significantly reduce the share of in favor of conservative methods. But for now, surgical gynecology of uterine fibroids is a leader among other diseases.

Due to the diagnosis of myomatous nodes, almost 80% of gynecological operations are performed, in which in most cases. And this is the problem for a third of women over 55 years old.

Popular treatments

Can uterine fibroids be treated? The answer is yes, they are treated with conservative and surgical methods. Conservative treatment is carried out for fibroids up to 10-11 weeks. This and physical therapy. A set of measures stops tumor growth; such treatment is especially effective during reproductive age, during menopause and postmenopause.

Conservative treatment lasts up to six months in combination with the prevention of endometrial hyperplasia. During menopause, hormonal medications are prescribed for years.

If conservative methods are ineffective, uterine fibroids are removed, and in severe cases, along with the organ.

Surgery is indicated in such cases:

1. The size of the neoplasm is at least 12 weeks.
2. It is developing quickly.
3. Pregnancy planning.
4. At risk of developing a benign form into a malignant one.
5. Severe pain in which painkillers are ineffective.
6. Compression of the rectum, bladder and nerve roots.
7. Severe bleeding with the development of anemia.
8. Risk of peritonitis due to twisting of the tumor stalk.
9. Difficulty urinating with urinary stagnation.
10. General intoxication and bloating.
11. Infertility or failure to carry a pregnancy to term.

Conservative treatment of fibroids includes a number of methods, more about this.

Uterine artery embolization

– blockage of the blood vessels supplying the organ, preventing its blood supply. To understand the principle of uterine artery embolization (UAE), you need to understand the uterine blood supply. It is fed by 4 arteries: the left and right uterine, and the same ovarian. The main load lies on the uterine arteries.

If you block them, the nutrition of the organ will be disrupted. First of all, this will affect fibroids, the protective properties of which, due to their pathological nature, are not perfect. But well-adapted healthy tissues will survive even in such extreme conditions. The ovarian arteries and other small blood vessels will help them with this.

A special bonus of UAE is the extremely rare recurrence of the disease, and all myomatous nodes are exposed to its effects. There is no need to take medications here. Mini-operation is performed under local anesthesia. First, a puncture is taken from the right femoral artery, and then, under the control of an X-ray machine, micro-balls are alternately introduced into the veins, blocking the uterine arteries. The procedure lasts a maximum of 40 minutes, the patient does not feel pain.

Usually, after 3 months, fibroids are reduced by half, and in a year - by 2/3. The cessation of pain and bleeding during menstruation with the normalization of their duration in most patients is observed within a couple of months after UAE.

FUS ablation

is a non-surgical treatment method that comes down to removal of fibroids with focused ultrasound under MRI guidance. And tomography helps to identify the degree of its decay.

Advantages of this technique:

• Bloodless, no side effects, pain, intoxication.
• There is no need for anesthesia.
• Guaranteed preservation of the organ and its functionality.
• Effective for large knots, their rapid reduction by three times.
• Elimination of disease symptoms, no relapses.
• Possibility of outpatient treatment, quick recovery after the procedure.

Disadvantages of the method:

• Significant cost of equipment and high cost of procedure.
• A one-time impact is possible on a maximum of 2 nodes.
• Limitation of use for obesity and scar tissue changes.
• The duration of the treatment session and the patient’s uncomfortable posture during it.

Hormone therapy

Hormonal treatment helps restore reproduction, using the following drug groups:

1. Androgens(Gestrinone, Danazol) - their purpose is to reduce the impact of estrogens, which promote the growth of tumors. Treatment lasts 7-8 months.
2. Gestagens(Utrozhestan, Norkolut) - used for small fibroids to normalize the endometrium.
3. Installation of hormonal, which normalizes hormonal balance. This is achieved through a daily dose of the hormone, which can inhibit tumor growth. It is valid for 5 years and also has a contraceptive effect.
4. Combination drugs(, Regulon, Yarina) - they are effective for small tumors and are prescribed for a period of more than 3 months.

Folk remedies

List all effective not possible, this is only a small part of them:

1. Broccoli seed sprouts. The indole-3-carbinol they contain destroys tumor cells without affecting healthy ones. Sprouts grown from seeds to a height of 4 cm in a box of sand are ground with the addition of vodka. For a week, you need a glass of the drug, which you drink by spoon three times a day before meals. The course of treatment is up to 12 weeks.
2. Tincture of Vitex-Sacred fruits. Soak half a glass of ground raw materials in 0.5 liters of alcohol diluted by half in the dark for 3 weeks, shaking daily. Add 10 parts of vodka to the filtered product and shake well. It is dissolved in the mouth for a couple of minutes, 25 drops per spoon of water, twice a day - after waking up and before going to bed. The treatment course is at least 2 months.
3. Tincture of the Golden Mustache. Soak about 30 joints in half a liter of vodka for 2 weeks in the dark. In the morning, on an empty stomach, dissolve with 2 tablespoons of water, starting with a dozen drops, and in the evening 40 minutes before dinner. Every day, increase the dose one drop at a time, bringing it to 35. Then drop by drop, reduce it to the original amount. After the third course, introduce an additional dose. There are 5 of them in total, but after the first two take a week break, and then a ten-day break.

For medicinal purposes, an alcohol tincture of walnut partitions is also used - three times 20 drops for 2 months, an aqueous tincture of burdock root - half a glass 4 times a day for several months with 10-day breaks, a decoction of flaxseed - half a glass three times a day for at least a month. Infusions of other medicinal herbs are also used.

Hirudotherapy

Treatment with medicinal leeches can normalize blood circulation in the pelvis and eliminate congestion. Salivary enzymes from worms have an antitumor effect and can even out hormonal imbalances.

The duration of the procedure is half an hour, 10 sessions are practiced with a 2-3 month break. Small wounds at the bite sites heal within a couple of weeks.

Physiotherapy

This treatment method helps normalize hormonal levels, the menstrual cycle and the functions of the nervous system, and prevents the tumor from feeding.

These types of it are effective:

• Radon and iodine-bromine baths. They act through the skin and nerve receptors, increasing immunity, reducing estrogen production, improving metabolism, helping to relieve inflammation and normalizing ovarian function.
• Electrophoresis practiced for fibroids less than 12 weeks old and their slow growth from 5-7 days of the menstrual cycle. For 15-20 procedures (except for menstrual days), potassium or sodium iodide is used.
• Magnetotherapy– using a special device placed on the stomach where the tumors are located. The procedure lasts 10 minutes or more, and the course consists of one and a half dozen sessions.

Read also about uterine fibroids.

Douching

This is the introduction of medications into the vagina using a rubber bulb or Esmarch mug.

Several recipes:

1. Soda: 2 spoons per 2 liters of warm water - daily for up to six months.
2. : infused decoction of 2 tablespoons of crushed leaves in a liter of boiling water (cook for a quarter of an hour).
3. Pharmaceutical chamomile or calendula: 3-hour infusion of a spoonful of dry raw materials in a glass of boiling water.
4. Celandine: simmer a crushed spoonful of leaves for a quarter of an hour in a glass of boiling water, use daily for up to six months. Soak the dried celandine root in a glass of boiling water with the addition of a spoonful of honey for a quarter of an hour. Carry out the procedure twice a day.
5. Tincture of the Golden Mustache: before bedtime, ten drops per liter of warm water every day for 3 weeks with a week break.

Contraindications of the method:

• pregnancy;
• menstruation;
• after an abortion or any gynecological surgery.

Fibroids are a benign tumor that grows from connective tissue on the walls or in the uterine cavity. More often women encounter this problem after 30-35 years. But recently, the disease often occurs in younger women.

What is it - uterine fibroids, what and why does it appear, how and with what can the disease be treated in the early stages (small sizes) and later?

general description

The disease occurs as a result rapid and uncontrolled division of uterine cells. This process occurs due to increased secretion of estrogens (female sex hormones).

A blood test does not reveal hormonal imbalance. Often the disease can be a consequence mechanical damage to muscle tissue(abortion, intrauterine devices, inflammatory processes).

Fibroids are nodular neoplasms of varying sizes that appear on the inner or outer surface of the reproductive organ. Multiple nodes are more common.

The sizes of such formations are counted in “weeks”, just like the size of the uterus at different stages of pregnancy. This allows you to accurately determine the growth of education. Usually the tumor is located inside the muscle layer.

Previously, there was an opinion that a benign formation (fibroids) would eventually degenerate into a malignant one (cancer).

However, recent research disproves this theory. It has been scientifically proven that these diseases are formed from different tissues. Cancer can appear as a complication of fibroids, but this is quite rare.

Even a rapid increase in the size of a tumor is not always a sign of cancer. But it is possible to determine whether a tumor is benign or not only after a thorough examination.

Causes

The appearance of uterine fibroids can be caused by many reasons. The main factor will be high levels of the hormone estrogen, low levels of progesterone.

To identify this, one blood test will not be enough. It is necessary to determine the hormonal status as a whole.

In addition to hormonal disorders common reasons are:

• heredity;
• adenomyosis;
• diabetes;
• gynecological diseases;
• multiple abortions (including);
• hypertension;
• endocrine diseases;
• stress;
• obesity;
• bad ecology;
• use of intrauterine contraceptives;
• physical inactivity;
• chronic damage to internal organs;
• lack of orgasm;
• irregular sex.

It has been proven that women who have given birth are less likely to develop nodes. Often this tumor can appear during pregnancy. Especially if the first pregnancy is late.

A woman’s diet plays an important role in the development of the disease..

The predominance of meat, fats, carbohydrates, sweets, fast food in the diet, and lack of fiber increase the level of female hormones and obesity.

Consumption of fermented milk products, vegetables, cereals, and fruits significantly reduces the possibility of tumor development.

Classification of species: what is it like?

Depending on the size and location of the nodes, there are 3 types of uterine fibroids:

• or intramuscular - located in the middle of the muscle layer, characterized by large sizes;
• submucosa– grows inside the cavity, which leads to its deformation;
• subserous– located on the outside, grows into the abdominal cavity.

There is a separate type of disease - pedunculated fibroid. It grows on a narrow or wide base connecting it to the walls of the organ.

It can be submucosal or subserous, i.e. located outside or inside the uterine cavity. Very rarely, the tumor may be located in the cervix. Depending on the growth rate, there are simple and profiling ones.

Based on the composition of the tumor, they are divided into fibroma(from connective tissue) and leiomyoma(from muscle).

Symptoms and signs: how to recognize them in time

At an early stage, small uterine fibroids not accompanied by noticeable symptoms. It can be detected during the next gynecological examination.

As uterine fibroids grow the first signs may appear:

• long, heavy and irregular menstruation;
• constipation;
• infertility;
• bleeding;
• anemia;
• frequent urination;
• heaviness and constant pain in the lower abdomen;
• bleeding during sexual intercourse;
• lower back pain;
• abdominal enlargement not associated with significant weight gain;
• frequent miscarriages.

Why is pedunculated uterine fibroid dangerous? When the “leg” is twisted, inflammation and rupture of the tumor occurs. This causes severe bleeding, acute pain in the lower abdomen, and fever. This condition can be fatal.

The submucosal form of uterine fibroids when growing leads to constant, incessant bleeding, in which there is a high risk of complicating the situation with iron deficiency anemia, everything is accompanied by sharp cramping pain.

Nodes during pregnancy often lead to miscarriages or placental insufficiency.

Tumor growth during this period also causes fetal hypoxia and premature or protracted labor.

What to do, who to contact

It is impossible to determine the disease on your own. If the above symptoms appear, you should definitely undergo an examination by a gynecologist.

These signs may be accompanied by more dangerous diseases., for example, uterine or ovarian cancer, endometriosis. To find out the cause of the malaise, it is necessary to undergo a full medical examination.

In order not to start the disease, you must undergo routine examination by a gynecologist at least twice a year.

Diagnostic measures

More often, the disease can be detected during a gynecological examination by an increase in the size of the uterus, thickening or deformation of its walls.

To determine the location and size of the tumor, it is prescribed Ultrasound of the genital organs.

What tests should be taken for uterine fibroids? To exclude oncological diseases they carry out test for tumor markers, biochemical and hormonal blood tests.

If necessary, the doctor may prescribe hysteroscopy, x-ray, endoscopy, culdoscopy.

To get a complete picture of the disease, computed tomography, cervicoscopy and coagulation analysis are also used.

Treatment methods and regimens

Is it possible and how exactly to cure uterine fibroids? Therapy is carried out both surgically and conservatively.

At the initial stage of the disease, when the size of the tumor does not exceed 1-2 cm, drug treatment is used.

In case of severe bleeding with pain and with rapidly growing uterine fibroids, surgery is recommended.

If there are no symptoms of the disease, the size of the nodes is small, growth does not occur, then treatment may consist of constant supervision by a specialist, diet, and regular ultrasound examinations.

For pain and medium-sized tumors, hormonal drugs. However, there are no drugs that completely eliminate the tumor yet.

All remedies can only temporarily relieve symptoms and reduce the size of tumor nodes.

Such drugs include:

GnRH agonists: Leuprorelin (Eligard, Prostap), Buserelin, Goserelin, Triptorelin (Diferelin). Such drugs are used once a month to reduce the size of the tumor before surgery. The course of treatment is six months.

These drugs reduce the amount of estrogen in the body, but long-term use leads to osteoporosis. After treatment is completed, the nodes begin to actively grow again.

Oral contraceptives: Novinet, Rigevidon, Marvelon. As a rule, they do not reduce the size of the tumor, but they relieve pain well and stop bleeding.

• Antiprogestogens reduce tumor size and relieve symptoms. Used in preparation for surgery.
• Antigonadotropins: Nemestran, Danazol. The size of the nodes does not reduce, but only eliminates the symptoms. These drugs are used extremely rarely, because they have many side effects: hair growth on the body and face, voice changes, acne.

The safest method of non-surgical treatment is considered focused ultrasound ablation.

It is carried out under the control of a tomograph and involves heating and destroying the tumor with an ultrasound beam.

This procedure is non-traumatic and painless, has no side effects, and makes it easy to get pregnant and bear a child in the future.

In case of large size and rapid growth of nodes, severe bleeding or necrosis, surgical intervention may be required.

If a woman does not plan to have children, she begins menopause, and the node grows rapidly, accompanied by constant and heavy bleeding, then it is recommended complete removal of the reproductive organ.

In other cases, surgery is performed to remove uterine fibroids, or myomectomy. There are several methods of surgical treatment:

• laparoscopy (through small punctures in the abdomen);
• embolization (through the femoral artery);
• hysteroscopy (through the vagina).

Prevention of the disease:

• diet;
• exclusion of abortion;
• regular examination by a gynecologist;
• timely treatment of inflammatory diseases of the genital organs.

You should not delay the birth of your child. The optimal age for the first birth is 22-25 years.

By the way, breastfeeding can significantly reduce the risk of developing a tumor in the future. But after 35 years of age it is not recommended to give birth.

From this video you can learn more about uterine fibroids:

It is strictly forbidden to use folk remedies in treatment without consulting a doctor.

Better pay close attention to your health: eat right, don’t self-medicate, avoid stress and strengthen your immune system.

A hormone-dependent tumor that often occurs in women of childbearing age is called uterine fibroids (myoma). Vivid symptoms and signs of uterine fibroids appear, as a rule, at later stages of development, and in the early stages this disease develops asymptomatically, and there are usually no complaints from patients.

What is it - fibroids?

Myoma (fibromyoma, leiomyoma) is a female disease, which is a benign tumor that forms on the walls or in the uterine cavity from connective tissue. Myoma develops with an increased level of female sex hormones - estrogens, because of this it is classified as hormone-dependent. The tumor ranges from a small nodule to a very large size (weighing about 1 kg). When large, it can be easily recognized by palpation. Symptoms of the disease often do not appear immediately; with advanced disease, fibroids are more difficult to treat and there is a greater likelihood of complications. Although the disease has signs of tumors, it is different from it, so it would be more correct to classify fibroids as tumor-like formations.

This neoplasm can cause a lot of trouble (despite the fact that it is a benign disease) - uterine bleeding and complications during pregnancy can occur, which is why treatment is mandatory.

Leading clinics in Israel

Note! Most often, the localization of such a neoplasm is the body of the uterus, but its location is also possible in the cervix. If the disease develops in muscle tissue, it is considered typical, and if it occurs in the neck or ligaments, it is considered atypical.

The size of the neoplasm ranges from several millimeters to several centimeters, often multiple fibroids (when several tumors form at once).

Due to the fact that the tumor is a hormone-dependent tumor, with the onset of menopause its growth may stop and its size may decrease; sometimes it resolves completely and simply disappears.

Remember! Although this disease is benign and quite rarely degenerates into a malignant form, tumor growth can lead to serious disruptions in the functioning of the patient’s reproductive organ.

Most often, formation occurs in the uterus, but can be found in the mammary glands, vagina, sometimes it can form in the digestive organs: stomach, esophagus, intestines, kidneys, it is also diagnosed in the bladder, on the skin, transverse skeletal muscles, and heart muscle. Fibroids can affect the brain, bones, limbs - shins, legs, arms and other organs.

Who is at risk

This disease is diagnosed in almost 25% of women of fertile age, of which in 3% of cases this formation is first discovered during a routine examination; it can be felt. This disease can also occur in young and elderly nulliparous women, after childbirth, during pregnancy, menopause, and after gynecological operations. But women who have given birth have a much lower risk of getting fibroids.

The incidence of the disease among all women by the age of 35 reaches 35-45% of cases. The peak of the disease occurs at 35-50 years of age.

Remember! Myoma is in 2nd place among gynecological diseases. If the frequency of diagnosis in reproductive age is about 20%, then in premenopausal age it reaches 35% of cases.

Classification of the disease and stage of development

Uterine fibroids are classified by the number of nodes, according to this, it can be:

• multiple;
• single.

In accordance with the size, tumors are determined:

• large;
• average;
• small myomatous neoplasms.

Depending on the size of the nodes, they are compared with the stages of pregnancy and distinguished:

• small fibroids (5-6 weeks);
• medium size (7-11 weeks);
• large (more than 12 weeks).

Depending on the size and location of the nodes, the following varieties are distinguished:

Based on its location relative to the myometrium (muscular layer), the neoplasm is divided into the following types:

• interstitial fibroid. It is located in the center of the muscular layer of the uterine wall - it grows into the uterus (60% of all cases), usually of large size;
• submucosal (submucosal). This species grows towards the endometrium. When the node is located mostly in the myometrium, it is called intermuscular with centripetal growth. Such a neoplasm can be pedunculated or even broad-based; pedunculated tumors can “fall out” of the cervical canal, become infected and twist;
• subserous (subperitoneal). Her node is located near the peritoneum, under the mucous membrane of the outer layer of the uterus. This type can be divided into the following types:

1. type 0 – looks like: a knot on a wide base – 0-A, on a leg – 0-B;
2. Type 1 – a large proportion of the node is located in the serous membrane;
3. Type 2 – a large proportion is located in the thickness of the myometrium;

• diffuse. It does not manifest itself as a specific type of tumor, but has a diffusely unformed character.

If we consider the tumor by location, it can be located in the area:

If we consider the stages of formation, we get three stages of morphogenesis:

• development of the bud (active growth area) in the myometrium;
• development of an undifferentiated tumor;
• development and maturation of a tumor with differentiated cells.

Tumor growth does not always proceed in the same way, so they distinguish:

• simple fibroids, when the tumor grows slowly and is small, often single, with mild symptoms;
• proliferating, this species is fast growing and has clinical manifestations. It is considered multiple uterine fibroids or single large ones.

Based on the nature of growth, the neoplasm can be divided into:

• true;
• false.

What does it come from?

There are many causes of the disease:

• hormonal disorders (sharp decrease or increase in the amount of progesterone or estrogens);
• Sex life is irregular (especially after 25 years). Due to the lack of sexual dissatisfaction, stagnation of blood flow in the pelvic area predominates, and this provokes the formation of fibroids;
• the presence of chronic inflammation;
• genetic predisposition;
• late birth (or no birth at all);
• mechanical damage (traumatic childbirth, abortion, consequences of gynecological operations, etc.);
• various stresses, hard physical work;
• various pathologies - endocrine diseases (thyroid problems, diabetes).

We can note indirect causes of fibroids, for example, smoking, physical inactivity, as well as external factors, such as poor environment and poor nutrition. In order to prevent the appearance of fibroids, it is necessary to eliminate these provoking factors.

The growth rate of nodes depends on various factors:

Remember! Myoma begins to develop due to a mutation of one cell; its subsequent development and division is influenced by changes in hormonal levels, imbalance of estrogen and progesterone.

Symptoms of the disease

The early stages of the disease are most often asymptomatic.

Later the following signs begin to appear:

But the presence of all these signs is not enough to diagnose fibroids; to confirm the suspicion of the presence of this neoplasm and exclude its erroneous diagnosis, you must undergo a thorough examination and do an ultrasound. Some of these signs may indicate other, more dangerous diseases (uterine cancer, ovarian cancer, endometriosis).

Some signs of fibroids may indicate its localization:

Pregnancy

Usually, with small nodes in the early stages of pregnancy, problems should not arise; an exception occurs when fibroids form near the placenta. The tumor produces substances that provoke contractions of the uterus and the pregnancy may be terminated. If this happens at a later date, then the risk of premature birth is high. Often, due to compression by the tumor, the fetus may develop deformation of the skull bones or torticollis, and the supply of sufficient nutrients and oxygen to the fetus is disrupted.

If during gestation the neoplasm does not have a negative impact on the development of the fetus, then childbirth may be complicated by malpresentation of the fetus. In this case, a cesarean section is recommended, during which the tumor is also removed.

Possible complications during childbirth may also include:

• early rupture of amniotic fluid (as the tone of the muscular layer of the uterus is increased);
• there is a high risk of heavy postpartum bleeding;
• there is a high probability of premature placental abruption (if the tumor is located behind it).

Would you like to receive an estimate for treatment?

*Only upon receipt of information about the patient’s disease, a representative of the clinic will be able to calculate an accurate estimate for treatment.

Uterine fibroids are diagnosed in approximately 8% of pregnant women; in most of them, the size of the tumor does not increase during pregnancy or, on the contrary, decreases.

Important! When fibroids are located near the embryo, the likelihood of miscarriage increases several times.

Complications of the disease

Uterine fibroids can pose a threat to a woman’s health due to the development of complications of the disease:

• miscarriage or infertility;
• postpartum hemorrhage;
• degeneration of a tumor into malignant oncology;
• formation of a submucosal node;
• necrosis of myomatous node;
• posthemorrhagic anemia;
• hyperplastic processes of the endometrium.

Diagnosis of the disease

Due to the fact that the symptoms of the disease are similar to a number of other diseases, a number of diagnostic measures are required for a correct diagnosis.

Diagnostic methods include:

How to treat

If the size of the tumor is small, the tumor is located deep in the muscles of the uterus or subserous, and it does not grow, then conservative treatment is chosen.

The following groups of drugs are prescribed:

• androgen derivatives (gestrinone), which interfere with the formation of ovarian hormones, prevent tumor growth in the future;
• gestans (norkolut, utrozhestan), they stop the growth of the endometrium without affecting the fibroids;
• gonadotropic hormone agonists (zoladex, buserelin) – reduce the size of fibroids and its symptoms.

Surgical removal is prescribed for large tumors, if there is bleeding, pain, a tendency to rapid growth, miscarriage or infertility.

The following types of surgical medical intervention are used:

Treatment tactics are selected taking into account the location of the tumor, its type, the patient’s age, and her state of health. Although fibroids are not a dangerous disease, self-medication at home is fraught with complications.

Nutrition for uterine fibroids

There is no special diet for this disease, but it is recommended to adhere to some general nutritional recommendations:

• it must be balanced, include a sufficient amount of vitamins and microelements;
• You should eat 5 times a day, do not overeat and do not take long breaks between meals;
• Avoid cooking methods such as frying and smoking. Replace them with stewing, boiling, baking;
• Fatty meat, lard, sausages, fatty cheeses, butter, and sweets should be excluded from the diet;
• Your diet should include more vegetables, fruits, herbs, dark breads, and fish.

Traditional methods of treatment

The use of various folk remedies is possible only with the permission of a doctor and in conjunction with the main treatment

You can also use tampons soaked in sea buckthorn oil. The course of treatment is two weeks.

An infusion of boron uterus is prepared as follows: pour 50 g of herb into 0.5 liters of vodka and leave in a dark place for 10 days, shaking regularly. After this, take a teaspoon once a day for 10 days, a tablespoon for the next 10 days, then take a break and repeat the course.

Disease prognosis

If fibroids are detected early and treated correctly, the prognosis is favorable. After organ-conserving surgery, pregnancy may occur. If fibroids grow rapidly, radical surgery with complete removal of the uterus may be required.

Disease prevention

Preventive measures boil down to:

• regular sexual intercourse with one partner;
• taking vitamins and microelements;
• active lifestyle;
• preventive annual examinations.

If the diagnosis is confirmed and you are diagnosed with uterine fibroids, then the following recommendations should be followed:

• avoid lifting heavy objects;
• eliminate stress;
• increase the amount of fruits, vegetables, and seafood in the diet;
• walk more often;
• refuse to engage in sports that place heavy loads on the pelvic area;
• do not be exposed to thermal influences - sunbathe, visit saunas, baths.

Video on the topic

Uterine fibroids are a benign nodular neoplasm that occurs in the muscular layer of the uterus and can reach very large sizes. The medical literature mentions fibroids weighing 25, 40 and even 63 kg. The disease is diagnosed in 30-50% of women over 30 years of age. In Russia, about 280 thousand operations are performed annually to remove these tumors.

APPOINTMENT WITH A GYNECOLOGIST - 1000 rubles. CONSULTATION ON THE RESULTS OF ANALYSIS or ultrasound - 500 rubles.

What is uterine fibroid

Uterine fibroids are a benign tumor that develops in the walls of the cervix or in the uterus itself. In gynecological practice, fibroids of various sizes are encountered, ranging from a few millimeters to tens of centimeters. As a rule, several fibroids develop simultaneously.

Tumors are divided:

• By the number of nodes – single and multiple;
• By localization - submucosal, subperitoneal, interligamentous, intermuscular, cervical and isthmus. In 95% of cases, the tumor is located in the body of the uterus and only in 5% in its cervix.

Because uterine fibroids occur due to improper mitosis (a stage of cell division), all cells of the same tumor are identical. “Daughter” neoplasms can develop from previously existing neoplasms. therefore, even small fibroids need to be treated.

Causes and classification

The previously existing statement about the hereditary predisposition to the appearance of myomatous nodes is today controversial and the final pathogenesis of this disease is still unclear.

Presumably, the reasons for the development of this benign tumor are:

• mechanical damage to the walls of the uterus;
• hormonal imbalance;
• excess weight;
• gynecological diseases;
• pathologies of the cardiovascular system.

Risk factors

Fibroids are observed in every third woman and those who are most susceptible to it are those who are overweight and did not have the opportunity or desire to give birth to a child before the age of thirty. The appearance of fibroids is usually associated with hormonal imbalance, so women with hormonal imbalances, those who frequently have abortions, uncontrollably taking hormonal contraceptives, suffering from endocrine diseases - diabetes, etc. are at risk.

Surgeries with possible damage to the internal genital organs and untreated chronic infectious diseases can also lead to the formation of a benign uterine tumor.

Hereditary factors play an important role in the formation of fibroids. If sisters, grandmothers, aunts and mothers had benign tumors of the pelvic organs, then the likelihood of fibroids in the direct hereditary line is very high. Of course, this fact is not a death sentence, but a woman with poor heredity should regularly visit a gynecologist, undergo ultrasound examinations and donate blood for hormones.

Symptoms of fibroids

In approximately 20-30% of cases, symptoms of uterine fibroids are not expressed. The disease is detected by chance during a preventive medical examination or during an ultrasound scan prescribed for completely different reasons.

Availability Uterine fibroids can be suspected if:

• Increased menstrual bleeding, in which clots often appear.
• The appearance of acyclic (irregular, outside the cycle) bleeding of varying intensity.
• the occurrence of pain in the lower abdomen, a feeling of heaviness or discomfort.
• Pain during sexual intercourse.
• Miscarriages (miscarriages), frozen pregnancies, etc.

The pain becomes most intense when a complication occurs in the form of torsion of a subperitoneal myomatous node.The doctor can feel the large size of the tumor by pressing on the abdomen.

Submucosal uterine fibroids

Submucosal fibroids are formed from the uterine muscle layer, are submucosal fibroids, and grow into the uterine cavity.

Provoking causes: hormonal and metabolic disorders, chronic gynecological inflammation, factors affecting the suppression of the ovaries, thyroid gland, adrenal glands, frequent and multiple abortions.

Symptoms of submucous uterine fibroids:

• The disease begins with bleeding appearing in the middle of the menstrual cycle, and there are very large blood clots.
• Cramping pain occurs. The patient feels weakness and malaise associated with anemia caused by bleeding.
• Large fibroids can put pressure on adjacent uterine organs. This leads to frequent urination, and if it grows towards the back wall of the uterus, compression of the rectum occurs.
  

Although submucous fibroids are a benign tumor, there is a small percentage where they become malignant.

How is fibroid different from a malignant tumor - cancer?

Uterine fibroids are a benign tumor, which, unlike malignant ones, is surrounded by a special capsule. Thanks to this, it remains within the zone of occurrence, even increasing in growth, while the malignant tumor spreads to other organs, giving metastases.

The structure of the tumor itself is also different - it does not destroy the surrounding tissue and does not poison the body.

Why treat uterine fibroids: complications

Malignant degeneration is not typical for myomatous nodes, however, with rapid growth, they may compress internal organs,which interferes with the normal functioning of the body. Over time, very severe uterine bleeding appears, which is life-threatening for the woman.This disease often causes infertility.

If conception does occur, the presence of fibroids will definitely negatively affect the pregnancy - the prognosis, as a rule, is always disappointing. Due to changes in hormonal levels, during pregnancy, fibroids often increase in size, interfering with the normal development of the fetus. There are often cases when a tumor simply displaces it from the uterus or provokes it. Therefore, it is best to check for the presence of fibroids before conception, when planning a pregnancy.

Pregnancy and fibroids are compatible if the neoplasm is small.

But in any case, the course of such a pregnancy and the birth itself will always be complicated, so the patient will most likely be recommended for a cesarean section. During this operation, they try to remove all myomatous nodes. And although this does not provide a 100% guarantee that they will not appear again, it may save you from unnecessary surgical interventions in the future.

Diagnosis of neoplasm

Fibroids of any type are diagnosed when reporting complaints or during a routine examination.

In the early stages, fibroids cannot be seen on a normal one. If a neoplasm is suspected, the doctor recommends that the patient undergo a test, which makes it possible to determine the position, size and structure of the formation. If there is a tumor, the gynecologist will see in the imagethe focus is round in shape, having a denser structure compared to the myometrium.The enlargement of the uterus indicates how many weeks it looks like it is pregnant (length in weeks).

Due to the fact that the pathology is often accompanied by other diseases that have similar causes, for example, hormonal disorders, the doctor simultaneously assesses the condition of the endometrium (inner layer of the uterus) and ovaries, and differentiates the neoplasm from tumors of the uterine appendages.

In combination with an ultrasound examination, general blood and urine tests, smears for oncocytology and flora, colposcopy, a functional test for ovarian function, and a pregnancy test may be required. To exclude the development of anemia, if there has been bleeding, you need to conduct a clinical blood test to find out the level of hemoglobin in the blood.

Large fibroids can be easily diagnosed with a simple gynecological examination.When palpating the abdomen, the uterus is enlarged, dense nodes are felt. If a large tumor is detected, it is carried out, you need to determine the location and size of the fibroid. It is also necessary to do the endometrium. The procedure is done for the purpose of a biopsy to rule out the presence of cancer cells.

Ultrasound with Doppler and alternative diagnostics - MRI

Proliferating fibroids are ideally diagnosed using. This examination is also necessary if there is a suspicion of malignant degeneration of a myomatous node (cancer) or endometrial tumor and ovarian tumor. Using color Doppler ultrasound, it is possible to assess blood flow and establish vascular resistance, the presence of intense neovascularization and other signs indicating the quality of tumors.

An alternative examination is magnetic resonance therapy. MRI gives fairly clear results in diagnosing these tumors, but such a study is dangerous, since it is associated with little-studied magnetic scanning, so it is not prescribed unnecessarily.

Treatment of uterine fibroids of different sizes

Myoma is a dangerous disease, but it is not a death sentence.The treatment method for uterine fibroids is chosen based on its size, growth rate, age of the patient and the woman’s desire to preserve reproductive function.

• If the disease is detected in the initial stage, then light therapy will most likely be carried out, aimed at stopping the growth and reducing the fibroids.
• If numerous nodes of different types and sufficiently large sizes are observed, the doctor will suggest a surgical treatment method, which in most cases is successful.
• The third option is combination treatment with a combination of surgical and drug treatment.

Whatever option is proposed, you must agree, because fibroids themselves disappear in very rare cases and you definitely shouldn’t hope for a miracle.

Treatment of small fibroids

If the tumor is small in size, the patient is prescribed complex drug therapy. Proper treatment can slow or even stop tumor growth.Drug therapy for the treatment of fibroids includes drugs that reduce the size of nodes, hormones, immunomodulators, vitamin therapy, and drugs to normalize periodic blood flow.

Treatment of large fibroids without surgery

Conservative treatment for large tumor sizes is carried out:

• If the patient wishes to preserve reproductive function;
• Myoma does not exceed the size of a 12-week pregnancy;
• The disease is asymptomatic or there are concomitant diseases with a high surgical risk.

Often, conservative therapy for large fibroids is considered by the doctor as a preparatory stage for surgery.

Curettage of the uterine cavity for fibroids

Curettage of the uterus can be the main or additional treatmentfibroids, the procedure is also carried out for diagnostic purposes.

Why is curettage performed for fibroids?

If, during diagnostic curettage, the doctor removes a sumbucous myoma (pedunculated), all manipulations also become therapeutic, because they eliminate bleeding and the source of pain.

How to prepare for the procedure

If a patient with uterine fibroids is prescribed gynecological curettage, she should:

• on the day of the procedure, take a shower;
• refrain from food (do not overeat the day before);
• give a cleansing enema;
• remove hair from the external genitalia.

The manipulation is preceded by tests, a list of which will be provided by the gynecologist. The procedure can be performed under local or general anesthesia. carried out under the control of a hysteroscope. Using g hysteroscopy You can evaluate the uterine cavity visually, determine the presence of submucosal fibroids, and endometrial pathology.

After scraping

The first days after curettage of the uterus, bleeding is possible; this phenomenon is normal. It is important to pay maximum attention to intimate hygiene, to avoid physical overload, hypothermia and overheating, and not to have sex.

Treatment of large fibroids

If large or rapidly growing tumors are detected, as well as in case of pain, surgical treatment is indicated. It can be organ-saving (when some nodes are removed) and radical (in this case, the uterus is removed completely).

Modern methods of removing myomatous nodes include:

• Embolization of the uterine arteries, which consists in stopping the blood flow to the fibroid, as a result of which its tissue is replaced by connective tissue;
• FUS ablation – destruction of tumor nodes using ultrasound.

With these methods, it is possible to get rid of pathology without surgery.

Treatment of submucous fibroids

Treatment can be carried out in two ways, conservative and surgical. The conservative method inhibits tumor growth. This method is recommended for women of older reproductive age. You need to wait until menopause and there is a chance that by that time the tumor will resolve on its own. Conservative treatment involves the use of hormonal drugs (duphaston, premolute) - the gynecologist selects the drug based on the results of hormone tests.

As for operations, the decision depends on the age of the patient. If a woman is of reproductive age and there are no contraindications, then it is better to perform an operation in which the uterus is preserved and the node is removed. For women who have reached menopause, it is recommended to undergo an operation in which the node is removed along with the uterus. There is an option when such an operation is performed, but the cervix is ​​left.

Surgical treatment of fibroids using low-traumatic methods

There are clear indications in which cases urgent surgical intervention is necessary:

• for pain;
• for bleeding and anemia;
• for uterine fibroids larger than 12 weeks;
• with rapid growth of fibroids;
• in case of dysfunction of neighboring organs.

Surgery for fibroids most often involves laparoscopic intervention. This technique makes it possible to remove the tumor with a minimal level of trauma and is safe for the patient. A mini laparotomy can also be used, in which a small incision is made in the suprapubic abdomen and large fibromatous nodes are removed. Strip abdominal surgery (radical removal of the uterus with or without appendages) is used extremely rarely and only for patients who do not plan a future pregnancy.

The prognosis for fibroids is generally favorable even after complete removal of the organ. Regular visits to the doctor and ultrasound monitoring are required. For small tumors, the gynecologist may recommend herbal remedies that have anti-inflammatory and absorbable properties. Physiotherapeutic procedures are also used, such as radon baths, magnets, and electrophoresis.

Where in St. Petersburg can you treat uterine fibroids without surgery?

At the Diana Clinic, gynecologists have extensive experience in diagnosing and treating uterine fibroids of various locations. If the presence of this neoplasm is suspected, patients are prescribed a full range of studies to determine treatment tactics.

We use only safe, modern techniques that allow us to completely restore a woman’s sexual and reproductive health.You can make an appointment with a gynecologist at a convenient time - he works seven days a week and without lunch breaks.

It can interfere with getting pregnant or debilitate a woman with bleeding. But it is no longer necessary to remove fibroids - to reduce them, you can take pills or use modern minimally invasive methods of treating fibroids. What symptoms of fibroids can be treated without uterine surgery?

One of the reasons why women in our country do not like to visit a gynecologist (according to the Gedeon Richter Women’s Health Index 2016 study, only 29% do this regularly) sounds something like this: they will find something on me. And this “something” may well turn out to be a neoplasm that will have to be treated or, even worse, removed. Reluctance to take pills, change our usual lifestyle, and fear of surgery lead most of us to the behavior “the less you know, the better you sleep.”

One of the diagnoses that people tend to fear in advance is uterine fibroids: it is actually found in every third woman of reproductive age. With this disease, nodes form in the wall of the uterus, which can grow both inside the muscular layer of the uterus (intramural fibroids), and towards the abdominal cavity (subserous fibroids) or in the opposite direction - into the uterine cavity (submucosal fibroids).

Uterine fibroids are a benign tumor consisting of smooth muscle cells, and they are dangerous not in themselves (for example, they are unable to degenerate into a cancerous tumor), but because of the effect they have on the female body.

In 2/3 of women, uterine fibroids do not manifest themselves in any way and are most often detected only on ultrasound. The rest are brought to the doctor by the symptoms of fibroids: abundant and developing from this, pain in the lower abdomen and pressure on the bladder, pain during sexual intercourse. Failure to get pregnant is also often associated with fibroids.

Until recently, treatment tactics were not striking in variety: it was suggested to remove the fibroid. It was not always considered necessary (and it was possible) to preserve the uterus - approximately 1/3 of all hysterectomies (surgeries to remove the uterus) in the USA and more than half in Russia are still done because of fibroids. Among all abdominal operations in women, removal of fibroids is in second place after cesarean section. And the average age for a hysterectomy in the world is 40.5 years.

As a result, an essentially young woman not only cannot have more children - she experiences a sudden and early menopause, the most severe possible, and many of its consequences.

Here's just some data. On the second day after removal of the uterus, the level of estradiol, the main female hormone that is responsible for the quality of skin and hair, the rhythm of menstruation, emotional stability, and sexual desire, decreases 2-3 times. Against the backdrop of a lack of female sex hormones, metabolic syndrome develops literally within a year - blood pressure rises, blood sugar rises, and excess weight appears.

7 years after a hysterectomy, a woman's risk of having a heart attack may be greater than that of a man who smokes and drinks. And if the uterus is removed before the age of 55, then within a year after the operation, memory impairment and other cognitive functions may develop - a precursor to Alzheimer's disease.

Hormone replacement therapy, which is usually prescribed to premenopausal women to reduce symptoms, can partially prevent these complications. But maybe it’s worth abandoning such a large number of hysterectomy operations?

This is already happening in the world. According to international recommendations, asymptomatic uterine fibroids do not need to be operated on. A woman with uterine fibroids should be informed about all methods of treating fibroids: medicinal, surgical, radiological - and also involved in the choice of treatment method.

In what cases would drug treatment for fibroids be preferable? The story is told by Alexander Tikhomirov, MD, Professor of the Department of Obstetrics and Gynecology, Faculty of Medicine, Moscow State University of Medicine and Dentistry, President of the International Public Organization "Society of Doctors engaged in the Study and Treatment of Uterine Fibroids."

I'm planning a pregnancy. Will fibroids interfere?

Nowadays, the situation when a woman is diagnosed with fibroids when planning a pregnancy or unsuccessfully trying to get pregnant is not so rare. Myomatous nodes appear on average after 30-35 years, and the first pregnancy often occurs at the same age.

The decision to treat or remove fibroids is made based on the size and location of the fibroids. If they deform the uterine cavity, pregnancy is undesirable, because the nodes can either decrease or increase. If they get ahead of the development of the fetus, this can lead to its death and termination of pregnancy. Only about 4% of pregnancies occur with existing uterine fibroids, and from 10 to 40% of them occur with complications.

Is it possible to somehow prepare a uterus with fibroids for pregnancy? Or is it necessary to get rid of fibroids?

You can start with drug treatment, says Professor Tikhomirov. - Studies have shown that after 13 weeks of using ulipristal acetate, the fibroid node loses blood supply and can decrease in volume by up to 50%, and in diameter by 30%. If the myomatous nodes are small, this will solve the main problem - deformation of the uterus. In addition, after such treatment, the fibroids will no longer grow, and this may be enough to plan a pregnancy.

In addition, treatment with ulipristal acetate often leads to prolapse of the nodes into the uterine cavity, and then they can be removed by hysteroresectoscopy (this minimally invasive endoscopic procedure is performed through the cervix). Without prior drug treatment, this can be difficult to do at one time, and repeated interventions lead to damage to the endometrium and the formation of adhesions.

Exhausted by bleeding. Do myomas need to be removed?

One of the symptoms of uterine fibroids is an increase in bleeding during menstruation. Often on such days a woman cannot lead a normal life, in addition, regular heavy bleeding can lead to anemia. The increased energy, dizziness, and loss of strength characteristic of this condition further reduce the quality of life. Iron supplements provide only a temporary effect - because blood loss does not stop.

If a woman still plans to have children, it is better to start with drug treatment, advises Alexander Tikhomirov:

Under the influence of ulipristal acetate, the amount of bleeding is normalized, and the fibroid node may decrease. At the same time, iron supplements will increase hemoglobin. If necessary, the course of treatment can be repeated after two months. And then, depending on the result, make a decision on surgical intervention.

The same tactics can be followed by women for whom pregnancy is no longer relevant. They also have access to uterine artery embolization - a method of treating fibroids, in which, through a small puncture in the thigh, they penetrate to the vessels feeding the fibroid nodes and block them. After this intervention, heavy bleeding stops literally in the next menstrual cycle, and uterine fibroids regress and decrease in size.

Myoma after 45 years

Women after 40-45 years with fibroids have until recently been the main candidates for hysterectomy: the birth of children has either already happened or is unlikely to happen, and the “no organ - no problem” approach had many supporters. But after the severe consequences of “artificial menopause” that occurs after a hysterectomy were studied, and drugs for medicinal, organ-preserving treatment appeared (ulipristal acetate was registered in Russia in 2013), the situation began to change.

It is known that with the onset of menopause (on average at the age of 52 years), fibroids inevitably undergo regression along with regression of the woman’s entire reproductive system. Myomatous nodes lose nutrition and shrink. Today it is easier to delay tumor development with medication without resorting to surgery. Research shows that even with fairly large fibroids, its growth can be stopped, and sometimes it decreases in size. In this state, you can wait until postmenopause, when the problem ceases to be relevant.

Why do I have this? Causes and prevention of fibroids

There are many factors that influence the development of fibroids. But one of the most interesting versions is this: fibroids are a disease of women who have had few births or those who postpone having a child. One might say, the result of irrational use of the uterus.

Judge for yourself: a hundred years ago, girls began menstruating on average at 16 years old, and at 18 they were married off. Then pregnancy, childbirth, 2-3 years of breastfeeding, one or two or three menstruation, and again - pregnancy, childbirth... So over the period from 16 to 45 years, a woman only had about 40 menstruation. And today a woman has 250 menstruation by the age of 30, because... According to WHO, girls begin menstruation at an average age of 12 years.

What's wrong with having so many menstrual cycles? Because they do not end with pregnancy. Each time the uterus in the second phase of the cycle increases slightly, physiologically preparing for pregnancy. If pregnancy does not occur, it decreases. When these monthly changes occur over many years, breakdowns in cell division are possible, which triggers the development of fibroids. The uterus was designed for bearing children - and it turned out to be not designed for many years of “idle” work.

What if you are not planning your first pregnancy at 22, as gynecologists advise, and are not going to give birth to 4-5 children? From the beginning of sexual activity, on the recommendation of a doctor, take modern micro-dose hormonal contraceptives to avoid the cyclic changes described above.

And visit a gynecologist at least once a year so as not to miss the onset of fibroid development - the smaller it is, the easier it is to deal with it. If the doctor has discovered fibroids, but does not offer treatment and takes a wait-and-see approach, consult another specialist.