What Are Gynecologic Myomas?
Gynecologic myomas, also known as uterine fibroids or leiomyomas, are non-cancerous growths that develop in or on the uterus. They are composed of muscle and fibrous tissue and are one of the most common types of gynecological tumors in women of reproductive age.
Myomas can vary in size, number, and location within the uterus. Some women may have just one fibroid, while others may have multiple. Although benign, myomas can lead to significant symptoms and impact quality of life, depending on their size and location.
What Causes Gynecologic Myomas?
The exact cause of uterine myomas is not fully understood, but several factors are believed to contribute to their development:
- Hormonal influence: Estrogen and progesterone promote the growth of fibroids.
- Genetics: A family history of fibroids increases the risk.
- Race and ethnicity: More common and more severe in African American women.
- Early menstruation: Starting periods at a young age may be a risk factor.
- Obesity: Excess weight can increase estrogen levels.
- Diet and lifestyle: A diet high in red meat and low in fruits and vegetables may increase risk.
What Are the Symptoms of Gynecologic Myomas?
Many women with fibroids have no symptoms. When symptoms do occur, they may include:
- Heavy or prolonged menstrual bleeding
- Pelvic pain or pressure
- Frequent urination or difficulty emptying the bladder
- Pain during sexual intercourse
- Constipation
- Backache or leg pain
- Infertility or recurrent miscarriages (in some cases)
What Are the Possible Complications of Gynecologic Myomas?
Although benign, fibroids can lead to complications such as:
- Anemia: From chronic heavy menstrual bleeding
- Reproductive issues: Infertility, miscarriage, or pregnancy complications
- Bladder and bowel dysfunction: Due to pressure from large fibroids
- Impact on quality of life: Due to pain, bleeding, and emotional distress
How Are Gynecologic Myomas Diagnosed?
Diagnosis typically involves a combination of:
- Pelvic examination: May reveal an enlarged or irregularly shaped uterus
- Ultrasound: A common imaging tool to confirm the presence and location of fibroids
- MRI: Provides detailed images for surgical planning or large or complex cases
- Hysteroscopy: A small camera inserted into the uterus to examine the lining
- Sonohysterography: A special ultrasound that uses saline to enhance imaging
How Are Gynecologic Myomas Treated?
Treatment depends on the severity of symptoms, size and location of fibroids, age, and desire for future fertility. Options include:
- Watchful waiting: For small, symptom-free fibroids
- Medications:
- Hormonal treatments (e.g., birth control pills, GnRH agonists)
- Non-hormonal options (e.g., NSAIDs for pain, tranexamic acid for bleeding)
- Minimally invasive procedures:
- Uterine artery embolization (UAE): Blocks blood flow to the fibroid
- MRI-guided focused ultrasound surgery (FUS): Destroys fibroid tissue using sound waves
- Surgical options:
- Myomectomy: Removal of fibroids while preserving the uterus
- Hysterectomy: Complete removal of the uterus, a definitive treatment
Can Gynecologic Myomas Be Prevented?
There is no guaranteed way to prevent fibroids, but you may reduce your risk by:
- Maintaining a healthy weight
- Eating a diet rich in fruits and vegetables
- Managing stress and hormonal health
- Regular gynecologic checkups for early detection
How to Manage Gynecologic Myomas for a Better Quality of Life?
- Monitor symptoms and seek care for changes in bleeding or pain
- Follow through with recommended imaging and treatment plans
- Maintain a healthy lifestyle to support hormonal balance
- Join support groups or seek counseling if emotional health is affected
- Explore fertility-preserving treatments if you plan to conceive