Uterine myoma - Vejthani Hospital | JCI Accredited International Hospital in Bangkok, Thailand.

Uterine myoma

Overview

A uterine myoma (also called leiomyoma, myoma, fibroids, uterine fibroid) is a benign (non-cancerous) tumor that develops within the muscle tissue of the uterus, which can be one dominant fibroid, or a cluster of many small fibroids. Uterine fibroid sizes can range from larger than a melon to as small as a coin. 20-50% of women of reproductive age have uterine fibroid.

While many women do not experience any problems, symptoms can be severe myoma can be urgent enough for require immediate treatment. For example, a very large fibroid may cause the uterus to stretch to the size of a six or seven-month pregnancy.

Uterine fibroids are a common condition in women. However, because uterine fibroids frequently may not develop any symptoms, patients might not be aware that they have uterine fibroid. This condition may be found incidentally by doctors when performing a pelvic examination or prenatal ultrasound.

The locations of the fibroids in and on the uterus are known by a variety of names. These names explain the location as well as its attachment. Patient can get uterine fibroids in the following locations:

  • Intramural fibroid: The uterus own wall has these fibroids embedded within the muscular layer
  • Submucosal fibroid: The uterine cavity, which holds the fetus throughout pregnancy, is where the fibroids are developing.
  • Subserosal fibroid: The fibroid is attach to outside of the uterus and is closely attached to the outside wall of the uterus.
  • Pedunculated fibroid: These fibroids have stalk extending outside of the uterus. Pedunculated fibroids have a short stalk that connects them from the uterus. Because they have a stalk and wider top, they are frequently compared as mushroom-like fibroid.

Symptoms

Most cases of uterine fibroid do not develop any signs and symptoms and do not require treatment, only routine monitoring. Asymptomatic fibroid is those that do not cause any symptoms. The symptoms could be manifest based on the location, size, and number of fibroids found.

The most typical uterine fibroids signs and symptoms in women who experience them are as follows:

  • Pelvic pain or pressure
  • Very heavy and prolonged menstrual periods
  • Pressure on the bowel which may lead to constipation and/or bloating
  • An enlarged abdomen (this may be mistaken for weight gain or pregnancy)
  • Pain during sexual intercourse
  • Pressure on the bladder which results in: a perpetual need to urinate, incontinence, or the inability to empty the bladder

When the fibroid outgrows its blood supply and starts to die, it can rarely produce severe pain.

Patient may have a consultation with the healthcare provider if they are experiencing any signs and symptoms of uterine fibroid. However, it is recommended that patient seek immediate medical help if they are experiencing sudden severe vaginal bleeding or severe pelvic pain.

Causes

According to healthcare providers, uterine fibroid usually develops from a stem cell in the uterus’ smooth muscle tissue. Repeated cell division eventually results in the formation of a hard, rubbery mass that is different from its neighboring tissue.

The cause of uterine fibroid is still unknown, but some factors may lead to uterine fibroids, such as:

  • Age: Commonly found during reproductive age.
  • Genetic changes: Genetic changes differ from those in regular uterine muscles are common in uterine fibroid.
  • Hormones: The two hormones estrogen and progesterone, which promote the uterine lining to form during each menstrual cycle in preparation for pregnancy, also promote the development of uterine fibroid, however, it usually shrinks after menopause because of a decrease in the production of estrogen and progesterone.
  • Extracellular matrix (ECM): ECM is responsible for cell binding. Increased ECM causes fibroids. Additionally, the ECM stores growth substances and alters the biology of the cells.
  • Other growth factors: The development of fibroid tumors may be related to substances that promote tissue maintenance, such as insulin-like growth factor.

Some uterine fibroids may develop rapidly, while others may naturally shrink.

As the uterus returns to its normal size after delivery, many fibroids that were present during pregnancy diminish or dissappear.

Risk factors

There are several factors that can affect fibroid development, such as:

  • Age: Women in their reproductive age.
  • Family history: If a family member or siblings have history of uterine fibroid then the patient has a higher risk to develop the condition.
  • Race: Dark color skin women are more likely than women of other racial groups to have fibroids, even though fibroids are a possibility for all women of reproductive age.
  • Other factors: Early menstrual period, obesity, vitamin D deficiency, high red meat diet, low vegetables, and alcohol consumption are some factors that increases the risk of developing uterine fibroid.