Fibroids - often annoying, almost always harmless

Growths of smooth muscle cells in the uterus are the most common benign tumors of the female genitalia. There is still little understanding of why fibroids develop - presumably female sex hormones play a role in their growth. Myomas in the uterus (uterine fibroids or uterus myomatosus) are common benign growths - about 15-20% of women have one or more of these tumors. About half of those affected develop complaints. Depending on where the fibroids lie, one differentiates:

  • intramural fibroids in the uterine wall,
  • subserous fibroids under the peritoneal covering (ie they grow towards the abdominal cavity),
  • submucosal fibroids just below the uterine lining (they grow toward the uterine cavity),
  • cervical fibroids in the cervix (rare).

How do myomas develop?

It is believed that altering the hormone concentration of estrogen promotes fibroid growth. This is probably one of the reasons why mainly women between the ages of 35 and 55 are affected and why, conversely, women who have been taking the pill for years are developing far fewer fibroids.

Various studies have revealed further risk factors for fibroids: For example, the risk is higher in black women than in white women, which suggests a genetic component. Women who have had their first menstruation very early develop fibroids more frequently, and excessive consumption of meat and alcohol (especially beer) and high blood pressure seem to increase the risk. Green vegetables, on the other hand, appear to reduce the myoma rate.

How do fibroids express themselves?

Whether fibroids cause discomfort or not depends on where and how they grow and how tall they are. The uterus lies deep in the abdomen and borders on the front of the bladder and behind the colon.

  • If a fibroid grows forward and presses on the bladder, it can cause discomfort such as constant urinary urgency or painful urination, but also pressure in the abdomen.
  • For example, rearward growth towards the gut can interfere with defecation but also cause back pain.
  • If the fibroids grow into the inside of the uterus, bleeding disorders such as increased menstrual bleeding or bleeding may occur. Complaints during sexual intercourse or during sports are also possible.

So there is no typical myoma problem, but the symptoms are manifold. The growth behavior is also very different, so that it is hardly possible to predict the trend in individual cases.

A special case are stalked fibroids, which do not grow directly as "tuber" in the musculature, but hang on a narrow "stem". This can twist and lead to an acute abdomen, a life-threatening complication that requires intensive care.

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