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Myomas as benign smooth-cell tumours in women

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Myomas as benign smooth-cell tumours in women

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Myomas are categorised as benign smooth-cell tumours that originate from smooth muscle fibres. They most commonly affect women between the ages of 35 and 55. They are the most common non-malignant uterine tumours to date and in many cases require treatment. What do we know about uterine myomas? How are they diagnosed and treated? Do they contribute to problems in getting pregnant?

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Uterine myomas, are also known as uterine fibroids. They account for up to 95 per cent of all benign tumours of the female reproductive organs. Importantly, they very rarely become malignant, forming so-called smooth cell sarcomas. To date, the direct cause of their development remains unknown.

However, special attention is paid to:

  1. Hormonal disorders (too high levels of oestrogen, while at the same time very low levels of progesterone)
  2. Use of certain hormonal drugs (this is not a determinant, however - as not all women who take hormonal drugs have myomas)
  3. Genetic predisposition (unfortunately inheritance, also not always confirmed)
  4. Past pregnancies (myomas are more common in women who have not given birth)

For doctors, the key question remains where the myoma/muscle is located in the uterus. This is because they can be located in the body of the uterus or in the cervix (rarely). These tumours are made up of smooth muscle and usually occur in multiples. Their size varies greatly from 2 to 3cm, but there are cases of larger ones up to 12cm.

In most cases, gynaecologists use the following division of myomas according to their location:

  1. Intramural myomas, which usually give rise to other forms of myomas.
  2. Subserosal myomas, which grow intramural in the initial stages of growth. With time, they change direction and grow towards the outer surface of the uterine muscle. Importantly, only the pedicle remains attached to the uterus.
  3. Submucosal myomas, grow towards the inside of the uterine cavity. They locate under the surface of the endometrium.

The rate of growth of myomas is an individual issue for each woman. At the moment we are not able to estimate how fast they grow in a month or a year.

There are manysymptoms of my omas. Initially they are underestimated by most women, but over time they make it difficult to function normally. The most common include: lower abdominal pain (strong pressure on the bladder, but also sciatica-like pain), urinary incontinence, chronic constipation, painful periods, bleeding between menstrual periods, heavy periods with clots. The consequences of heavy bleeding are usually anaemia, weakness, headaches, shortness of breath but also an accelerated heart rate. Myomas, which are located under the mucous membrane of the uterus, can unfortunately contribute to miscarriages, premature births and can also be a direct cause of infertility.

Myomas are already diagnosed on the basis of the symptoms accompanying women. In addition, a medical transvaginal ultrasound is performed (the head of the apparatus is inserted into the vagina, which allows a precise view of the cervix, the entire interior of the uterine cavity and the ovaries. Myomas can then also be seen. In the case of myomas that do not give any symptoms, no treatment is needed. Myomas that give mild symptoms are treated with pharmacological agents. Drugs with analgesic, anti-inflammatory but also hormonal effects are administered. Here it is worth emphasising that these latter drugs do not cure myomas, but only contribute to their reduction. In the case of large, still growing myomas, it is necessary to remove them surgically (abdominal operation under epidural anaesthesia).

If you notice any of the symptoms described above, you should visit your gynaecologist as soon as possible and have yourself examined. It is possible that our complaints are caused by myomas.