Myomas are tumors that occur in the uterus and around the cervix, in the form of abnormal growth of smooth muscle tissue. Myoma formations occur as a result of abnormal growth of smooth muscle cells on the muscle layer called myometrium in the uterus. These usually develop in more than one way.
Myomas usually start to appear in women between the ages of 35-40. It affects 40% of women over the age of 40. Approximately 75% of women with myomas are not even aware of them. The causes that trigger myoma formation are not known for sure. However, it is thought that the secretion of the female hormone estrogen is effective in the formation of myomas. The reason for this is that the increase in estrogen levels during pregnancy accelerates the formation of myomas, and the decrease in estrogen secretion during menopause causes myomas to regress. In addition, it has been observed that genetic predisposition is important in the formation of myomas. It has been determined that women who have a family history of myomas in their mothers or sisters are more prone to myomas.
What are the types of myoma?
Although myomas are formed from the smooth muscle of the uterus, they cause different effects depending on their location, size and number. In particular, in treating myomas that cause complaints, it is necessary to determine the type. In this respect, myomas are classified according to their location and causes.
Submucosal myomas (myomas located in the inner layer of the uterus)
These types of myomas are usually the least common types of myomas. They form and develop in the lower part of the uterine cavity. When submucosal myomas grow, they can cause blockage in the tubes as they cause the uterine cavity to develop. For this reason, myomas can cause complications related to pregnancy. Although they usually do not cause many symptoms, some can lead to serious problems. Submucosal myomas that cause such problems cause bleeding that is heavier than normal. Menstrual bleeding occurs more than normal. Since these symptoms are effective in experiencing clotting problems, bleeding becomes continuous and begins to disrupt the woman's daily life.
Intramural myomas (myomas located in the middle layer of the uterus)
These myomas develop within the uterine wall and grow in this area. Myomas of this type are more common than others. When they grow, they cause a feeling of fullness in the uterus. However, women usually interpret them as weight gain or pregnancy. They usually cause bleeding with clots during menstruation. Growing myomas put pressure on the surrounding organs and tissues, causing pelvic pain and frequent urination.
Subserosal myomas (myomas located in the outer layer of the uterus)
These types of myomas usually develop outside the uterus, on the uterine wall. Myomas grow by developing outside the uterus. If they grow, they start to put pressure on the surrounding tissues. They cause excessive bleeding and discharge in women. They appear to be a mass outside the uterus, attached to the uterus by a stalk, but different from the uterus.
Pedunculated myomas
These types of myomas usually develop on a stalk. They grow inside the uterus and tend to hang outward. When they rotate around their stalks, they cause pain and pressure in the woman. When this rotation occurs, the blood supply to the area is disrupted, and deterioration, or degeneration, occurs in the myomas.
What problems do myomas cause depending on their types?
Myomas occur in the muscle tissue of the uterus. Usually benign, the pain, disturbing bleeding, and frequent urination caused by myomas are eliminated by treating them. Myomas, which rarely affect women in adolescence, cause various problems in some women until menopause.
Myomas, which are usually in the uterus, can range in size from pea-sized to grapefruit-sized. They can show different symptoms depending on their size, number and location. Myomas, which are usually in the mucosal layer that covers the inside of the uterus, irritate the inside of the uterus and cause irregular and excessive bleeding in women. Myomas that have grown towards the outer surface of the uterus usually progress without symptoms.
The most common problem in women with myoma is that menstrual bleeding is disturbingly excessive and prolonged. Due to this excessive bleeding, women inevitably experience anemia problems. In addition to increased and prolonged menstrual bleeding, women may also experience bleeding between periods. Due to anemia, women develop a feeling of weakness and fatigue. In women, some myomas can also cause pain in the groin or lower abdomen in addition to menstrual bleeding. These types of myomas should be removed because they impair women's quality of life. Myomas that have grown too much do not need to be removed if they do not press on the surrounding tissues. However, those that press on the tissues and cause complaints such as frequent urination, defecation problems or tension in the abdomen should be removed surgically.
Some myomas, especially those attached to the uterine wall, require more oxygen and blood. This is why women experience sharp pain in the lower abdomen. In such a complaint, the myomas should be removed immediately with surgery or treated with myoma embolization. Myomas are different in size, number and location in every woman. The general structure of women also varies. However, the complaints caused by myomas are generally the same.
Do myomas occur due to genetic predisposition?
The structure of the uterus consists of a muscle layer called myometrium. Although the formations on this muscle, namely myomas, are benign, they can show a tendency to become cancerous at a rate of five per thousand. Despite their benign nature, they cause some problems depending on their growth and the areas where they are located. Myomas are considered to be dependent on estrogen. The more estrogen a woman has, the more the myomas grow. This is why myomas shrink and even disappear in women who enter menopause. From this perspective, myomas can be defined as a disease of women who menstruate regularly every month. Myomas, which cause irregularity and excessive bleeding in menstrual periods, can cause clotting in bleeding.
Myomas are more common in black women. Women who have myomas in their mothers or first-degree female relatives have a higher risk of developing myomas. If there is such a family history of myomas, approximately one-third of women are likely to develop myomas. However, there is still no definitive information on whether myomas are hereditary or not. This issue is still controversial. However, it is said that these women are at twice the risk of having myomas than those who do not have a family history of myomas. In this respect, it can be assumed that myomas are hereditary. It can develop within the hormonal balance of these family members.
When do fibroids need to be removed?
Since myomas are very common, they should be monitored regularly to see if they are growing. This should be done regularly, especially if there are no complaints that bother women. Removal of myomas may be necessary for a small portion of them. If these myomas negatively affect the woman's daily life, if the mass in the uterus cannot be determined to be a myoma, surgical intervention may be necessary. When irregular bleeding occurs in women, if myomas are detected during a gynecological examination and myomas are seen as the cause of the irregularity, surgery should be performed to remove them or myoma embolization treatment should be applied. Especially in submucous myomas, since they settle inside the uterus, the inner layer is damaged and irregular bleeding occurs in women. Menstrual bleeding lasts for a long time, and there are intermenstrual bleedings between two menstrual bleedings. In this case, the myomas should be treated and removed.
Despite the discomfort caused by myomas in this way, it is not possible to prevent a woman from getting stressed if she is not treated. In order to eliminate the discomfort she experiences, the woman's age, desire to have children and other characteristics should be taken into consideration, myomas should be evaluated from every angle and the appropriate treatment method should be applied. Removal of myomas is evaluated in parallel with the discomforts that occur in the woman. If myomas that do not cause physical complaints in the woman cause an effect such as not being able to get pregnant, they should be removed surgically. In addition, myomas in women can cause various problems in the future pregnancy . Unwanted conditions such as premature birth and miscarriage may occur during pregnancy. For this reason, expectant mothers with myomas should be monitored more closely.
Myomas that are thought to prevent pregnancy can be removed with myomectomy. If there are many of them, myoma embolization treatment can be applied by administering small substances that block the artery that feeds the myomas. Degeneration occurs in myomas that are cut off from feeding in this way. If the woman with a large number of myomas in her uterus is over 40, then hysterectomy, which is the removal of the patient's uterus, can be applied in the treatment. In fact, the woman's ovaries can also be removed in this application. Because the woman is already past her fertile age. This treatment can be applied quite successfully in women who do not want to have children. In this way, the risk of cancer that may occur in the woman in the future is also eliminated.
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