Myomas are benign tumors or masses that occur in the smooth muscles of the uterus due to reasons originating from the uterine tissue. Myomas are also called leiomyomas, leiomyomata and fibromyomas. Myomas , which are frequently seen in women, develop due to hormonal and genetic factors. Many women may learn that they have a myoma during a standard examination when they go to the doctor for pregnancy. Genetic changes in the uterine tissue also affect the estrogen and progesterone hormones. The increase in estrogen and progesterone hormones in women also causes myomas to grow. For this reason, they usually grow 2-3 times during the reproductive age and pregnancy. Detection of myomas during pregnancy is one of the issues that requires patients to be monitored more carefully. Myomas can form in the smooth muscles of the uterus, as well as outside the uterus or in the area where the ovaries are located.
What are the Types of Myoma?
There are different types of myomas depending on where they are located in the uterus. These are submucous myomas, intramural myomas and subserous myomas.
Submucous Myomas: They are myomas that develop towards the inner surface of the uterus. They are the least common type of myoma among the myomas seen in women. Although they are the least common, they are also the type that causes the most bleeding. They cause more menstrual bleeding and a longer menstrual period.
Intramural Myomas: These types of myomas are located within the uterine muscle tissue. They are the most common type of myoma. They cause the menstrual period to be prolonged and increase menstrual bleeding. They cause pain in the abdomen and cause the uterus to grow. They also cause frequent urination.
Subserous Myomas: They are myomas that appear and grow towards the outer surface of the uterus. They do not cause major bleeding like other types of myomas. They have symptoms such as abdominal pain, back pain, constipation and frequent urination.
Effects of Pregnancy on Fibroids
Since myomas enlarge the cells of the uterus, they can also change the growth of myomas during pregnancy. While some myomas do not cause any changes during pregnancy, some myomas grow. The rate of myomas that grow is a more common situation than myomas that do not grow. Myomas that are larger than 5 cm when pregnant are more likely to grow. Myomas usually grow in the first three months of pregnancy. This growth is slower in the following months.
Effects of Myomas on Pregnancy
Although there is no definitive information that fibroids prevent pregnancy, it is known that pregnant women carry some risks during the pregnancy, during pregnancy and afterwards. Women with fibroids may experience more frequent problems during the time it takes to get pregnant than women without fibroids. Problems such as increased risk of miscarriage, delayed growth and development of the baby, increased risk of premature birth, and problems with the baby's posture in the womb are more common in women with fibroids.
Do Fibroids Prevent Pregnancy?
Myomas that form in women before pregnancy may have some effects during pregnancy. Problems that may occur during pregnancy or pregnancy are evaluated depending on the location, number and size of the myomas in the uterus. While myomas located close to the cavity increase the risk of miscarriage during pregnancy, myomas that are not located in a very specific area do not pose any danger to pregnancy. However, complaints such as abdominal pain may be encountered during pregnancy.
Treatment Methods for Myoma
Myomas are detected by gynecologists during gynecological examinations. They can also be easily detected with radiological methods such as ultrasound and MRI. The treatment decision is made by considering factors such as the location of the myomas, the person's age, whether the myomas are growing or not, and whether they are in menopause. Even if young patients do not have any complaints, if the myomas are constantly growing during the examinations, it is necessary to decide on one of the appropriate treatment methods and perform the treatment so that it does not cause greater problems in the future. There are different treatment methods for myomas. Treatment is applied with the method deemed appropriate by the doctor depending on the condition of the myomas.
With hormone therapy, the patient is given drugs that reduce estrogen levels, causing the fibroids to shrink. At the same time, while the fibroids shrink, the vessels that feed the fibroids also thin out. However, these treatment methods are temporary solutions. When the drugs are stopped in the future, the fibroids continue to grow again at the same rate. Long-term use of the drugs also causes osteoporosis.
Myomectomy is based on the removal of all fibroids in the uterus by giving the patient general anesthesia. Since it is a treatment method performed without removing the uterus, it provides a great advantage in terms of fertility, especially for young women.
In the hysterectomy method, the entire uterus is removed with general anesthesia. It is a method generally used in cases where menopause has begun and pregnancy is not desired. Since the entire uterus is removed, all myomas are removed, and the risk of developing ovarian disease is eliminated by removing the ovaries. It is among the most commonly used methods for uterine myomas today.
Percutaneous Ablation is a method based on the destruction and fragmentation of myomas or tumors by entering the skin with a special needle with the help of radiological imaging. In order for the treatment to be successful, there must be a small number of myomas.
Embolization is a treatment method in which the patient is given local anesthesia and a thin catheter is inserted into the arteries that feed the uterus from the patient's groin and procedures are performed to block the vessels. Myomas shrink over time because there is a blockage in their vessels.
In the High Intensity Focused Ultrasound method, the tissues of the myomas are reached and burned with the help of radiological devices such as Ultrasound and MRI. This method may need to be repeated several times in order to completely burn the myomas. Since it is an application with few side effects and complications, it can be applied until the myomas are completely burned.
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