Uterine fibroids - without symptoms, but with big problems

Uterine fibroids - without symptoms, but with big problems
A benign tumor

hysteromyoma If we evaluate the structure of gynecological diseases, the uterine fibroids in the first place on prevalence. At the heart of the development of pathological changes are the processes of proliferation of poorly managed (or proliferation) of the individual cells of the muscular layer of the uterus. This benign changes that may be unfavorable background for the development of deeper tissue disorders.

What may predispose to the appearance of this type of tumor

It is proved that the development of pathological processes in the muscle layer of the uterus due to hormonal influence of sex steroid hormones and receptors sensitive to them. The risk of uterine depends on certain predisposing factors:

ethnic factors. The highest incidence of tumors was observed in African-American women
age group. Women aged over 40 years, the disease is diagnosed in 40% of cases
the risk of fibroids increases in case of an early formation of menstrual function. It may equally be attributed to the absence of a woman giving birth
It affects the number (or parity) delivery

High risk appeared in patients who were newly diagnosed with hypertension under the age of 35 years. Negative influence the duration of antihypertensive drugs more than five years, as well as the long-term nature of hypertension.

The risk of developing fibroids increases in the presence of a woman being overweight. When obesity develops in the reproductive period (ie after 18 years), it will be a help to increase the risk of uterine fibroids compared to overweight in adolescence.

The main clinical manifestations

In half of the clinical cases with uterine fibroids can detect the characteristic clinical symptoms. On the nature of their symptoms affect the localization of myoma node, its size and the presence of secondary alteration. Most often the woman has menstrual dysfunction in the form of heavy, prolonged bleeding (in every third case, leiomyomas). Blood loss is the cause of iron deficiency anemia. Can cause discharge spreadable nature that are irregular. This is also the reason anemizatsii women. First, we should exclude the development of hyperplastic processes of the mucosa of the uterus, or polyps Polyps: problem to solve So the woman is recommended as a medical diagnostic procedure to pass separate scraping.

If the fibroids are mostly subserous or submucosal localization, the pain develops. Abdominal pain are permanent, can seldom be a sharp pain, if the node occurred degenerative processes or ischemia node. In some cases, women with uterine noted severe pain during menstruation (dysmenorrhea).

There are many publications about the existence of the mutual relationship between the presence of uterine fibroids and infertility. As the cause of infertility is considered to form a multiple mold assemblies. Infertility can be caused by the development of miscarriage, while noted that a role has a number of nodes. If a woman has found a single node, then the risk of miscarriage Miscarriage - is more common than you think 7%, at the same time at multiple sites, this figure rises to 15%.

How justified expectant management

In the treatment of uterine fibroids can be used the methods of conservative and operative treatment, the choice of which is determined by specific symptoms of the disease, tumor size, and number of nodes. If a woman is not interested in preserving reproductive function, it is also a defining moment for the choice of further tactics. Not all clinical types of uterine fibroids need to take urgent remedial measures. In the absence of tumor growth in a dynamic observation, when the disease has no clinical manifestations, the patient is subject only to the regular monitoring visits to the doctor with a periodicity of once every six months.

At the present stage it is possible to identify the main trends in the choice of treatment tactics:

wider use of conservative methods of treatment, ie, medical treatment
tactics of the patients to be more active
introduction of technologies to implement conserving surgery and minimally invasive techniques

Progestin drugs previously used for therapeutic purposes in uterine myoma now rarely used. The best-known drug in this group is norkolut, which are widely used for many years for treatment. It is proved that progestins can only be used with a combination of fibroids and polyps or hyperplastic processes. The question of the appointment of drugs progestin physician determines on the basis of histological findings, since not all forms of polyps are sensitive to hormonal therapy.

As monotherapy is recommended antigonadotropnym agents affecting the central level (there is a blockade of the central emission of hormones produced by the pituitary gland). These drugs have proved the therapeutic efficacy, but their widespread application is limited to the development of side effects. Preparations "danazol" and "gestrinone" the patient should be used for 3 to 6 months, the duration of the reception can be increased up to one year, but this situation is rare. Given the possible complications, a woman should be under medical supervision throughout the treatment. Treatment is carried out in a clinic, with the need for hospitalization is determined by the severity of the clinical picture of the disease and its complications.