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    Let's talk about uterine fibroids: diagnosis and treatment.

    Uterine fibroids, also known as fibroids, are nothing more than muscular tumors that grow in the womb, specifically in the walls of the uterus. Fibroids are 99% benign and non-cancerous, and women do not always have symptoms, although some have pain and heavy menstrual bleeding.

    In most women, fibroids develop before 50 and are very common in women between 40 and 50 years old.

    Although not all women have symptoms, for those who do, it is difficult and painful because fibroids put pressure on the bladder causing frequent urination, or exerting rectal pressure. If they are large, they can make a woman appear to be pregnant.

     

    Types of fibroids

    There are single or multiple fibroids, and there will always be a variation in size and location within the uterus. According to their location, four types of fibroids can be broadly classified as follows:

    1. Subserosal fibroids: They grow located in the external part, from the uterus towards the pelvis. They usually do not affect fertility.
    2. Intramuscular fibroids: They are located in the thickness of the uterine wall, which is greater than 4 centimeters, and can affect fertility.
    3. Submucosal fibroids: They are located in part or all of the interior of the uterine cavity. These types of fibroids affect the implantation of the embryo in the uterus.
    4. Fibroma or pedunculated myoma: They grow from the uterus outwards, stopped by a pedicle or stalk from which they feed. They can cause intense pain when rotated on the pedicle that holds it. 

    Classification of three types of Fibroids or Myomas can also be made according to their size, as follows:

    1. Large Elements: These are fibroids whose diameter exceeds 6 centimeters.
    2. Medium Elements: These are fibroids whose diameter ranges between 2 and 6 centimeters.
    3. Small Elements: Fibroids whose diameter is less than 2 centimeters.

    Diagnosis of Uterine Fibroids or Myomas

    They are usually found during a routine pelvic examination. If there are symptoms such as unexpected bleeding, heavy menstruation, and abdominal pain, one may suspect the presence of a fibroid or myoma. The treating physician may request that the following tests are performed:

    • Ultrasound: They can be abdominal or transvaginal. Through it, the doctor obtains the image of the uterus and confirms the diagnosis, and maps and measures the fibroids.
    • Laboratory tests: These tests are requested if there is abnormal menstrual bleeding and allow the doctor to determine if there is anemia, bleeding disorders, or thyroid problems.

    In case these tests do not provide enough information, the treating physician may request other imaging studies such as:

    • Magnetic Resonance Imaging.
    • Hysteroecography.
    • Hysterosalpingography.
    • Hysteroscopy.

    Treatment

    In most cases, because they are fibroids that do not produce symptoms, they do not require any treatment; only periodic evaluations with the treating physician are recommended to assess the growth and birth of new fibroids.

    But in cases where the fibroid produces abundant bleeding, there is treatment aimed at minimizing bleeding with drugs such as NSAIDs, antifibrinolytics, oral contraceptives, or hormonal contraceptives such as IUD with levonorgestrel or subcutaneous implant. Other drugs help to decrease the volume of fibroids.

    Hysterectomy or myomectomy are surgical treatments where a surgeon removes the uterus or myoma. They are reserved for those cases where the fibroid cannot be controlled with medical treatment.

    We can summarize then that the vast majority of women are exposed to suffer from uterine fibroids passively as they can be very small and without any symptoms. But in the case of presenting symptoms, it is necessary to go to a doctor of confidence to be able to diagnose and define a treatment in time.

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