Myomas
What are myomas?
- Myoma is a benign tumor of the uterus muscle tissue.
- Some myomas are malignant (1 out of 1.000), but a benign myoma never becomes malignant.
- There can be one or more of them in the uterus.
- Myoma may vary in size from very small ones to bigger ones the size of 20 or 30 cm in diameter.
How are myomas formed?
- Due to unknown reasons, a part of uterus’ muscle starts expanding creating a tumor composed of muscle tissue.
- Both the growth and the reduction of myomas are considered to be under the influence of female sex hormones because they grow during pregnancy, when hormonal levels are high, and reduce in menopause, when hormone levels are dropping.
How often is the occurrence of myoma in women?
- Between 20 and 80 % of all women will have at least one myoma until they are 50 years of age.
- Myomas are most common in women aged 40 to 50.
Which women are under increased risk in developing a myoma?
- Women whose mothers, grandmothers or sisters have myomas.
- Women over 40.
- Overweight women (the risk being 2-3 times greater than in women of average weight).
- Women consuming a lot of red meat (vegetable-based diet protects from myoma development).
How are myomas diagnosed?
- During pelvic examination.
- The diagnosis is confirmed by performing ultrasonography.
What are the symptoms of myoma development?
- Myoma may not show any symptoms.
- Depending on the position and the speed of growth, myomas may cause pain (when being still, during intercourse, back pain, pain in the pelvis), pressure on the bladder causing frequent urination or bowl pressure.
- Very large myoma can lead to abdomen growth, making the women seem to be pregnant.
What types of myoma are there?
- Submucous – myoma growing inside the uterine cavity.
- Subserous – myoma growing outside the uterus bulging into the abdominal cavity.
- Intramural – myoma growing within the muscle tissue of the uterus enlarging the entire uterus.
Do myomas cause problems during pregnancy?
- Most often pregnancies are carried out without problems.
- Should problems arise, they are usually manifested in premature birth or C-section.
How are myomas treated?
- Small myomas or myomas showing no symptoms are simply monitored.
- If they cause pain, taking painkillers can help.
- If the woman is anemic, iron supplements are taken.
- In cases of excessive and/or irregular hemorrhaging, birth control pills or intrauterine device containing progesterone (e.g. Mirena) may be prescribed.
- There are drugs that can reduce the size of the myoma (GnRH agonists) but their effect is limited only during their use which cannot exceed 6 months.
- Selective progesterone receptor modulator (ulipristal acetate; e.g. Esmya) is also available.
- Uterine artery embolization – a radiologist induces particles into uterine arteries which results in the shrinking of myoma.
- Surgically, depending on the size of the myoma, by means of
- Laparoscopy
- Abdominal myomectomy
- One or more myomas may be removed, or hysterectomy may be performed.
