Growths of smooth muscle cells in the uterus are the most common benign growths of the female reproductive organs. Still, quite little is known about why fibroids develop – female sex hormones probably 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 growths. About half of those affected develop symptoms. Depending on where the fibroids are located, a distinction is made:
- Intramural fibroids in the uterine wall,
- Subserosal fibroids under the peritoneal covering (i.e., they grow toward the abdominal cavity),
- Submucosal fibroids directly under the endometrium (they grow towards the uterine cavity),
- Cervical fibroids in the cervix (rare).
How do fibroids develop?
It is believed that changes in the hormone concentration of estrogen promotes fibroid growth. This is probably one reason why women between the ages of 35 and 55 are most affected and, conversely, why women who have taken the pill for years are far less likely to develop fibroids.
Various studies have revealed other 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 menstrual period very early are more likely to develop fibroids, and excessive consumption of meat and alcohol (especially beer) and elevated blood pressure also seem to increase the risk. Green vegetables, on the other hand, appear to reduce fibroid rates.
How do fibroids manifest themselves?
Whether fibroids cause discomfort or not depends on where and how they grow and how large they are. The uterus lies deep in the abdomen, bordering the bladder in front and the colon in back.
- If a fibroid grows forward and presses on the bladder, then symptoms such as a constant urge to urinate or pain when urinating, as well as a feeling of pressure in the abdomen, can result.
- A growth backwards towards the intestine can, for example, interfere with defecation, but also cause back pain.
- If the fibroids grow into the interior of the uterus, there may be bleeding disorders such as increased menstruation or bleeding between periods. Discomfort during sexual intercourse or exercise is also possible.
So there are no typical myoma complaints, but the symptoms are varied. The growth behavior is also very different, so that in individual cases, a prognosis about the tendency can hardly be given.
A special case are pedunculated fibroids, which do not grow directly as a “bulb” in the muscles, but hang on a narrow “stalk”. This can twist, leading to acute abdomen, a life-threatening complication requiring intensive medical care.
