Fibroids are benign tumors of variable size originated from the muscle cells that are part of the wall of the uterus. There are different types of myomas and the symptoms depend a lot on the kind of uterine myoma that is. Regarding the treatments, there are surgical ones that do not require intervention, and new drugs are emerging to treat fibroids.
They are also known as fibroids or leiomyomas. They can be located below the endometrium (inner lining of the uterus), these are called submucosal, or can grow below the outer covering of the uterus (subserosal) and grow inside the muscle wall of the uterus (intramural). Most often, they are multiple and of different sizes .
Clinical manifestations depend on the location and size of the myoma, and can vary from producing no discomfort to produce significant symptoms of bleeding or compression of neighboring organs.
They are very frequent tumors in women of reproductive age , so it is estimated that up to 70% of women may have a fibroid and its frequency increases with age, especially from 35-40 years. The cause of its occurrence is unknown, but it is known that its growth is influenced by sex hormones (estrogen and progestin), since its size usually increases during pregnancy and decreases with menopause.
As we have already mentioned, many myomas do not produce symptoms and are a casual finding during gynecological examination. Those that produce symptoms commonly cause alterations of menstrual bleeding (irregular or prolonged, excessive bleeding ...), discomfort at the pelvic level, compression of the bladder (need to urinate frequently, for example) or infertility.
How to treat fibroids
The treatment of myomas is very variable and depends on multiple factors, such as the age of the patient, whether or not you want to have children in the future, type and size of the tumor, the severity of the symptoms and the state of health of the patient. woman. It will be the gynecologist who makes the treatment independent in each case. If the fibroid does not give symptoms, in the vast majority of cases it will only require a periodic revision to control the size.
Although the classic treatment of fibroids has been the surgical one , nowadays there are different options that allow to individualize the treatment depending on the characteristics of the patient. Among the surgical treatments are myomectomy (removal of the myoma while preserving the uterus) and hysterectomy (radical treatment in which the uterus is removed).
Non-surgical treatments include embolization of the uterine arteries and medical treatment.. In the uterine artery embolization, the vessels supplying the uterus are occluded by injecting small particles or microspheres to stop the blood flow of the fibroid, which causes its cells to die and decrease in size.. The problem with this treatment is that it also compromises fertility.
Drugs for fibroids
Recently new drugs have appeared orally for the treatment of fibroids that represent a great advance in the clinical management of the disease. These are the so-called MSRP (selective progesterone receptor modulators), among which the ulipristal acetate stands out. They act by blocking the progesterone receptor selectively, which reduces excessive menstrual bleeding, improves anemia and improves the quality of life of patients. In turn they reduce the size of the fibroids improving compressive symptoms and pelvic pain.