Uterine fibroids. Symptoms and treatment with folk remedies according to Bolotov

Nature has awarded women the opportunity to bear, give birth and feed children, allowing them to fully enjoy the happiness of motherhood. But obstacles associated with the development of diseases of the female reproductive system can become an insurmountable obstacle to happiness. One of them is fibroids. What is fibroids, what are the reasons for its development, and what treatment methods can eliminate this pathology?

Various names are applied to uterine fibroids. These include the following definitions:

• myoma;
• leiomyoma;
• leiofibromyoma.

All of them mean damage to the uterine body by a benign tumor. The tumor develops in the muscular layer of the uterus called the myometrium. However, women often have to deal with a disease such as breast fibroids.

This disease affects a quarter of all women who have to deal with pathologies of the reproductive system. At the same time, fibroids most often develop in representatives of the fair half of humanity in the reproductive age range from 20 to 45 years. Often, fibroids occur in women whose age is close to menopause. With the onset of menopause, fibroids can significantly decrease in size or completely resolve.

Despite the fact that the reasons for the development of the disease are still unclear, experts associate them with hormonal dysfunction. This is evidenced by the following factors:

• the tumor contains many receptors for sex hormones;
• a tumor, including breast fibroids, most often develops in women with high estrogen levels;
• a decrease in estrogen levels during menopause leads to a decrease in fibroids;
• the tumor can occur in women during menopause under the influence of taking estrogen-containing drugs.

Causes of the disease

A benign tumor in the uterus or breast does not develop on its own. This is facilitated by various unfavorable factors.

• Women with impaired reproductive function who were unable to bear and give birth to a child before the age of 30 are susceptible to developing the disease. In this case, breastfeeding for at least six months is a prerequisite.
• The development of fibroids is promoted by multiple abortions and diagnostic curettages.
• Women who experience frequent stress are susceptible to the disease.
• A tumor, both benign and malignant, can develop due to intense exposure to ultraviolet radiation. This means that women should not be exposed to direct sunlight for long periods of time, nor should they visit a solarium.
• The disease is caused by inflammatory processes occurring in the body of the uterus or its appendages.
• The tumor can occur as a result of unreasonable long-term use of hormonal contraceptives.
• Fibroids can be caused by.

Signs of a neoplasm

In the early stages, fibroids do not manifest themselves in any way, and therefore women do not go to the doctor for diagnosis. Pathology is detected only when it reaches a significant size, worsening the quality of life.

The main manifestations of the disease include the following symptoms:

• heavy, prolonged menstruation, accompanied by severe pain;
• uterine bleeding and spotting during the intermenstrual period;
• pain in the chest and lower abdomen, accompanied by cramps;
• painful sexual intercourse;
• difficulty urinating with frequent urge;
• pain radiates to the lumbar region and lower limbs;
• abdominal enlargement;
• prolapse of the vaginal walls;
• infertility.

If a woman is diagnosed with a small tumor that does not cause inconvenience, does not impair the quality of life, and does not increase in size, treatment of fibroids can only consist of monitoring the course of the disease. Often this pathology develops in women on the eve of menopause.

Types of fibroids

There are several types of fibroids, differing depending on the location and intensity of growth.

• The submucosal form, implying a submucosal type of tumor location, develops inside the uterus under its mucous layer.
• Interligamentous fibroids are located between the ligaments that support the uterus.
• The diffuse form is characterized by the presence of multiple growths inside the uterine body.
• Subserous or serous fibroids are a hormone-dependent tumor in the muscle tissue of the uterus, located in its outer part.
• The nodular form is distinguished by the presence of nodes in the thickness of the uterus, which during the process of growth can change their location.
• The interstitial form is characterized by the location of the tumor in the muscular wall of the uterus and is characterized by accelerated growth rates.

Fibroids are also divided into the following types:

• simple, characterized by slow growth rates, and amenable to drug treatment;
• proliferating, which grow rapidly but do not contain abnormal cells;
• presarcoma is a tumor whose tissue contains abnormal cells that contribute to its degeneration into a malignant neoplasm.

How to distinguish fibroids from fibroids

Despite the fact that both of these names are applied to any benign tumor of the uterus, fibroids and fibroids are somewhat different from each other structurally.

Fibroids consist predominantly of muscle tissue. The main component of fibroids is connective tissue. Fibroids are diagnosed in cases where half of them consist of connective tissue.

The remaining features of fibroids are identical to fibroids. Its formation occurs from the muscle core, which during the process of growth is overgrown with connective tissue.

Diagnosis of the disease

To determine the tumor, various diagnostic measures are used, determined by the doctor based on the patient’s complaints. First of all, the doctor studies the nature of menstruation, and also pays attention to the presence of pain and other diseases.

Next, the woman is examined on a gynecological chair, as a result of which it is possible to determine how enlarged the uterus is. If leiomyoma is suspected, women should be systematically seen by a doctor so that he can determine the intensity of tumor growth. This indicator is assessed in the same way as during pregnancy. For example, if the tumor corresponds to 8 weeks of pregnancy, such uterine fibroids do not require treatment. It just requires careful monitoring.

If within a year the tumor has increased by up to 4 weeks, a slow growth of fibroids is diagnosed. If this indicator exceeds 4 weeks, it means that the tumor is growing rapidly and requires medical or surgical intervention.

Nodular uterine fibroids can be detected already during examination of the cervix using mirrors. However, colposcopy allows an accurate diagnosis. Considering that this disease is hormone-dependent, women are prescribed blood tests that determine their hormonal status, namely the level of estrogen and progesterone.

Ultrasound allows you to most reliably determine the presence of a tumor, its size and location. And with the help of echography, it is possible to determine the type of tumor and examine the processes occurring inside it. If a woman is concerned about prolonged heavy bleeding, she may be prescribed a diagnostic uterine curettage, which allows to exclude or confirm pathological growth of the endometrium, as well as identify the presence of cancer cells.

Specific studies

Other diagnostic methods include the following methods:

• metrosalpingography allows you to detect a submucosal node, as well as assess the condition of the endometrium of the uterus, its size and the presence of possible deformation of its body;
• hysteroscopy is used to examine the body of the uterus and obtain a tumor fragment for further study;
• laparoscopy is used to more accurately diagnose the condition of the organ and determine the subserous form of the tumor;
• intrauterine venography is performed to assess the condition of the uterine vessels, as well as detect nodes;
• MRI is used to study a tumor if ultrasound does not allow the ovaries to be seen, for example, with.

Treatment options

Treatment for uterine fibroids or a tumor located in the breast can be either medicinal or surgical. The method of medical intervention is determined only after a complete examination. Moreover, each of the methods used differs in many techniques and has specific indications.

Drug treatment involves taking medications that help preserve a woman’s reproductive function, reduce the intensity of tumor growth, and also reduce its size. In addition, during treatment, measures are taken to eliminate factors contributing to the development of fibroids.

This treatment method is prescribed in the following cases:

• if a woman is planning a pregnancy;
• in the absence of symptoms of the disease;
• if the size of fibroids does not exceed 12 weeks of pregnancy;
• in the presence of multiple nodes, both in the intramuscular and serous layers of the uterus;
• in the event that a woman is contraindicated for surgical intervention;
• if necessary, reduce the intensity of tumor growth before surgery;
• as an additional therapy used in the postoperative period.

The main drugs used in treatment are gestagen-containing drugs. The patient is also prescribed a remedy that can relieve pain during menstruation, as well as relieve anemia and other associated symptoms.

Treatment with medications is necessary for six months, after which the doctor evaluates the result that was achieved without resorting to surgery.

Surgical treatment

Surgeries are most often prescribed if hormonal therapy is contraindicated for women, or if the tumor in the uterus or breast is large. Young women are usually prescribed a myomectomy, which allows the removal of nodes in the uterus, preserving the organ and all its functions.

In some cases, part of the uterus is removed, which allows the menstrual functions of the organ to be preserved. If a woman is indicated for radical intervention, then either the uterus with appendages or all organs of the reproductive system are removed. The same method allows you to eliminate prolapse of the vaginal walls.

Recently, a method of treating a tumor without surgery, which involves embolization of the uterine artery, has become increasingly popular. This allows you to block the flow of blood to fibromatous nodes. Another method is to cauterize the nodes with ultrasound, which neutralizes tumor cells. However, these methods often lead to the development of relapses that can provoke uterine prolapse.

Treatment with folk remedies is used as an additional therapy to medical and surgical methods of treating tumors, both in the uterus and in the breast. However, herbal medicine can also be used as the main method of treatment in the presence of a small, slow-growing tumor that does not require treatment with hormones. In addition, this method of treatment is the safest.

Bibliography

1. Preeclampsia: theory and practice. Ailamazyan E.K., Mozgovaya E.V. 2008 Publisher: MEDpress-inform.
2. Clinical recommendations. Obstetrics and gynecology. Savelyeva G.M., Serov V.N., Sukhikh G.T. 2009 Publisher: Geotar-Media.
3. Pregnancy and childbirth with extragenital diseases. Grip of the UMO for medical education, Apresyan S.V., Radzinsky V.E. 2009 Publisher: Geotar-Media.
4. Clinical guidelines for contraception. /Translation from English/ Edited by Professor V.N. Prilepskaya - 2009, M.: BINOM Publishing House.
5. Obstetrics. Clinical lectures: textbook with CD / Ed. prof. O.V. Makarova. - M.: GEOTAR-Media, 2007. - 640 pp.: ill.

Fibroids are a common gynecological disease in which specific nodes consisting of muscle and fibrinous tissue form in the patient’s uterus.

To the question “how to treat uterine fibroids?” Only a gynecologist can answer after a thorough examination.

That is why it is important not to neglect preventive examinations, and also to consult a doctor at the first appearance of unpleasant symptoms. Timely diagnosis and early treatment can prevent complications and achieve successful recovery.

Uterine fibroids are a disease that can be subject to conservative therapy and surgical treatment. In some cases, such as the small size of the formation and its slow growth, you can do without surgery.

In this case, the woman is prescribed conservative therapy, which includes:

• GnRH analogues – Buserelin, Zoladex- agents that cause a decrease in the synthesis of estrogen in the body, which leads to a decrease in nodes. These drugs can be used both for treatment and as preoperative preparation for large fibroids.
• Gestagens– Norkolut, Duphaston – medications that suppress the release of gonadotropins, which leads to a decrease in the production of estrogen by the ovaries.
• Combined oral contraceptives– Novinet, Yarina, Jess, who, in addition to a pronounced therapeutic effect for fibroids, have a rebound effect. After their cancellation, the woman’s chances of a long-awaited pregnancy increase.
• An intrauterine device (Mirena) is used as hormonal therapy.

The attending physician also prescribes symptomatic therapy to patients. It includes iron supplements to correct anemia, analgesics and antispasmodics to relieve pain, sedatives, as well as vitamin and mineral complexes.

When treating fibroids and uterine leiomyomas, it is important to carefully follow all medical prescriptions, as well as adhere to a healthy lifestyle: avoid alcohol and smoking. To speed up the healing process, you need to eat right, eat foods rich in protein, fresh vegetables and fruits.

It is very important to improve blood circulation and eliminate venous congestion in the pelvic area. This requires sports (swimming, dancing), as well as regular sex life.

It has been proven that women with irregular sexual contact, as well as those who do not experience orgasm, are more likely to develop benign tumors in the uterus.

Surgical interventions for fibrous nodes in the uterus

Uterine fibroids can be treated surgically if they are large in size (12 or more weeks of pregnancy), have rapid growth dynamics (more than 4 times per month), and also in the presence of complications (necrosis, pedicle torsion, nascent submucosal node).

There are minimally invasive sparing and radical surgeries. The choice of surgical procedure is made by the doctor. This occurs depending on the characteristics of the tumor, the woman’s age and the presence of concomitant diseases of the internal organs. Methods used for uterine fibroids include:

• Arterial embolization. In which, with the help of a special drug, blood flow in the vessels supplying the uterus is blocked, as a result of which the node decreases and disappears. The recovery period for this intervention is 1-2 days.
• FUS ablation– removal of a pathological neoplasm with a directed ultrasound flow. This method is considered one of the most effective among minimally invasive interventions.
• Laparoscopic removal of nodes.

• Supravaginal uterine amputation and total hysterectomy– radical operations used in complex cases with multiple nodes, heavy, intractable bleeding, as well as malignancy of neoplasms.

By diagnosing fibroids at an early stage, it is possible to avoid serious surgery and get by with conservative therapy or gentle surgery with a short recovery period.

Home therapy methods

Treatment of fibroids with folk remedies cannot replace drug therapy and surgery, but only reduces the unpleasant symptoms of the disease. The most useful and effective methods, which have earned many positive reviews, are recognized as:

• Healing is guaranteed by the infusion of boron uterus. With regular use, this composition helps restore hormonal balance and regulates the menstrual cycle. To prepare it you need 2 tbsp. dry raw materials, pour 1 liter of boiling water and leave for 1 hour. You need to drink the resulting drink one glass 3 times a day. Many patients drinking this decoction noted an improvement in their condition and a decrease in pain 2 weeks after the start of treatment.

• In order to remove excess estrogen from the body and reduce the size of the nodes, you need to drink milk thistle, thistle, a decoction of dandelion leaves and yellow sorrel.
• In case of heavy, prolonged bleeding, it is necessary to drink tea from strawberry leaves, which has hemostatic properties.
• Many people are interested in the question “is it possible to get rid of fibroids using celandine?” in such ways - this remedy has a very strong effect, therefore, when prescribing, strict adherence to an individually selected dosage is required. To prepare an infusion from this plant, you need to fill a 3-liter jar, 1/2 filled with raw materials, with boiling water and leave for 5 hours in a place protected from light. The resulting liquid should be filtered and taken 1 tsp. 3 times a day.
• Bee products such as bee bread and propolis are popular among many patients. In order to eliminate the inflammatory process and to reduce the size of the tumor, it is necessary to place propolis balls into the vagina.

• Calamus root should be grated on a fine grater. Use the resulting pulp 1 tsp. 1 hour before meals 3 times a day.

Before starting treatment for uterine fibroids with folk remedies, you should definitely consult with a specialist to identify possible contraindications, as well as to select drug therapy.

What will help relieve the condition?

In the occurrence of hormone-dependent diseases of the uterus, an incorrect lifestyle plays an important role - moral exhaustion, physical fatigue or physical inactivity, bad habits.

To speed up recovery, it is important not only to exercise, give up alcohol and smoking, but also, if possible, avoid stressful situations. For this purpose, many patients visit a psychologist, practice dancing, music and art therapy.

Recently, the method of working with the healing energies of Reiki has gained particular popularity. The essence of the method is psychological work on oneself, during which patients understand the subconscious causes of their problem and find ways to solve them.

This method “morally healed” and improved the psycho-emotional state of many patients, which contributed to a speedy recovery compared to those who continued to be exposed to stress factors.

You should not rely on treatment with folk remedies and various energy practices in the treatment of fibroids.

Only properly selected hormonal therapy and surgical interventions to remove pathological nodes are effective.

It is important to know the symptoms and treatment of fibroids, so that at the first appearance of unpleasant manifestations you do not put off visiting a doctor and start therapy as early as possible. Timely treatment will help avoid many unpleasant and dangerous complications, speed up recovery and the onset of the desired pregnancy.

Uterine fibroids are a true benign tumor of the uterus. It develops from muscle tissue.

Depending on the ratio of muscle and connective tissue in its composition, this tumor previously had different names: myoma, fibroma, fibromyoma. However, taking into account that fibromyoma nodes often develop from muscle cells, most authors consider the more correct term to be leiofibromyoma (fibromyoma).

Uterine fibroids have their own characteristic features:

• This is the most common uterine tumor in women 35-55 years old
• It is capable of growth, reduction and even complete disappearance during menopause. However, in 10-15% of patients in the first 10 years of the postmenopausal period, the tumor may increase.
• Small uterine fibroids (up to 10 weeks of pregnancy) can remain stable for a long time, but when exposed to provoking factors (inflammatory process of the uterus and appendages, uterine curettage, prolonged venous congestion of the pelvic organs) it increases quickly and very quickly (the so-called “growth spurt” ).
• The tumor is characterized by a variety of clinical variants, depending on the location, size, location and growth pattern.
• Uterine fibroids have autonomous growth due to the influence of growth factors and the formation of hormonally sensitive and growth receptors.
• Like any tumor, the process of growth and development of fibroids is accompanied by the formation of new vessels, but in this case the vessels differ from normal ones, because have a sinusoidal character.

The onset of uterine fibroid nodes occurs at the age of 30, when somatic, gynecological diseases and neuroendocrine disorders accumulate in women.

Causes and risk factors

Subsequent growth of nodes requires further accumulation of unfavorable factors that cause tumor progression:

• absence of childbirth and lactation by age 30
• abortions
• long-term inadequate contraception
• chronic, subacute and acute inflammation of the uterus and appendages
• stress
• ultraviolet irradiation
• formation of cysts and ovarian cysts.

The age of 44-45 years accounts for the highest frequency of surgical interventions (most often it is removal of the uterus), the indication for which is the rapid growth of macular fibroids, its large size, the combination of the tumor with pathology of the endometrium and ovaries.

The growth of fibroids increases at the age of 35-45 years, when the functional activity of the ovaries and their sensitivity to hormones decreases, chronic functional tension occurs in the regulatory systems (neuroendocrine, hormonal, immune) and homeostasis (the internal balance of the body) is most often disturbed.

Long-term neuroendocrine disorders, pathological menopause, and the effects of factors such as obesity, carbohydrate and lipid metabolism disorders, endometriosis, and adenomyosis play a negative role.

Manifestations of uterine fibroids

Uterine fibroids have a wide variety of clinical courses. Patients' complaints depend on many factors: the location and size of the tumor, the duration of the disease, the presence of concomitant gynecological pathology, etc. The predominance of certain factors affects the symptoms of the disease.

Often the main and earliest symptom of uterine fibroids is menstrual dysfunction - uterine bleeding or scanty, prolonged spotting. Along with uterine bleeding, pain is often noted, usually localized in the lower abdomen, in the lumbosacral region, sometimes spreading to the lower extremities.

Treatment

Treatment of uterine fibroids is a very difficult problem, because... Despite hormonal dependence, this tumor is very heterogeneous.

Surgery

Initially, unconditional indications for surgical treatment should be identified:

• submucosal localization of fibroids
• large size of the node (the total size corresponds to the uterus of the 14th week of pregnancy)
• uterine bleeding accompanied by chronic anemia
• rapid tumor growth
• acute malnutrition of fibroids (torsion of the subserous node, tumor death)
• combination of uterine fibroids with endometrial hyperplasia, ovarian tumor
• compression of the ureter, bladder, rectum
• the presence of a node in the area of ​​the tubal angle of the uterus, which causes infertility
• cervical and cervical-isthmus localization
• non-regressive and growing uterine fibroids in postmenopausal age.

The extent of surgical intervention is largely determined by the age of the patient.

Up to 40 years of age, if there are indications for surgical treatment, if technical capabilities allow, conservative myomectomy is performed. It is especially advisable to remove medium-sized myomatous nodes (2 to 5 cm in diameter) before they rapidly increase in size. The preferred technique is laparoscopic. Relapses during conservative myomectomy for uterine fibroids occur in 15-37% of cases.

After 40 years and postmenopausal age, if there are surgical indications, surgery to remove uterine fibroids is necessary, because if the fibroid does not regress in the first 2 years of postmenopause, its continued existence is accompanied by the risk of oncology (adenocarcinoma, sarcoma).

According to corresponding member. RAMS, professor I.S. Sidorov, risk factors for the growth of uterine fibroids are: the presence of cysts and ovarian cysts, proliferative processes of the endometrium, untimely cessation of hormonal activity of the ovaries (late menopause) and severe obesity, carbohydrate metabolism disorders or liver disease.

Conservative treatment of uterine fibroids:

Conservative treatment, carried out immediately after the detection of small and medium-sized myomatous nodes, allows in some cases to slow down further tumor growth, prevent operations to remove the uterus, and preserve the opportunity to give birth to a child.

Indications for conservative treatment:

• young age of the patient
• small size of the myomatous uterus (up to 10-12 weeks of pregnancy)
• intermuscular location of myomatous nodes
• relatively slow growth of fibroids
• no deformation of the uterine cavity.

Conservative treatment consists of normalizing systemic disorders characteristic of patients with uterine fibroids, including:

• chronic anemia,
• inflammatory processes of the uterus and appendages,
• impaired blood supply to the pelvic organs with a predominance of venous stagnation and a decrease in arterial blood supply,
• disruption of the functional state of the nervous system and autonomic balance.

Methods for correcting systemic disorders include the following:

• maintaining a healthy lifestyle (normalization of sleep, balanced nutrition, physical activity, giving up bad habits, controlling body weight);
• normalization of sex life;
• periodic intake of vitamins and microelements in the winter-spring period;
• treatment of anemia;
• neurotropic effects if the patient exhibits traits of a disharmonious personality.

If pregnancy occurs, even if not planned, it is necessary to preserve it, because postpartum reduction of the uterus, breastfeeding the child for at least 4-6 months contribute to a change in the composition of fibroids, its transition to simple fibroids and, in some cases, the cessation of its further development.

To prevent the inevitable removal of the uterus when the tumor grows, the preservation and maintenance of reproductive function up to 40 years is of great importance.

The effectiveness of hormonal therapy varies greatly depending on the nature of hormonal disorders, the presence and density of receptors in myomatous nodes and myometrium. In fibroids, where connective tissue predominates, as well as in large nodes, hormonal receptors are usually absent. Therefore, hormonal therapy is not very effective in these patients.

However, it is used to correct irregular menstrual cycles. For this purpose, progesterone and its derivatives (dydrogesterone, cyproterone acetate), as well as androgen derivatives, 19-norsteroids (levonorgestrel, norethisterone acetate) are used. The latter are undesirable at a young age, with obesity, diabetes, and cardiovascular diseases.

The most promising drugs in the treatment of patients with uterine fibroids are antigonadotropins (gestrinone, danazol), which have an antiestrogenic and antiprogesterone effect, causing temporary amenorrhea (cessation of menstruation), as well as gonadotropin-releasing hormone agonists (triptorelin, goserelin, buserelin), which cause a reversible state hypogonadism.

The following antigonadotropin drugs are registered in Russia:

• Depot-goserelin 3.6 mg s.c.; triptorelin 3.75 mg IM and SC; leuprorelin 3.75 mg IM The drug is a ready-made kit with various methods of administration. Treatment begins on days 2-4 of the menstrual cycle: 1 injection every 28 days.
• Endonasal spray - 0.2% solution of buserelin acetate 0.9 mg per day. Treatment begins on days 1-2 of the menstrual cycle: 0.15 mg in each nasal passage 3 times a day at equal intervals.

Preparation for surgery with the help of antigonadotropins in the presence of uterine fibroids allows for gentle organ-preserving operations using endoscopic techniques.

To date, several strategies for long-term therapy with antigonadotropins have been described to avoid significant side effects while maintaining high clinical effectiveness:

• Add-back regimen - a combination of antigonadotropins with small doses of estradiol.
• On-off mode - therapy with antigonadotropins in intermittent courses (three-month therapy with a three-month break for up to 2 years).
• Drow-back - the use of high doses of antigonadotropins for 8 weeks with a transition to lower doses of the drug for 18 weeks.

The likely response to treatment can be predicted in most cases 4 weeks after the first injection.

The drugs are well tolerated, do not have antigenic properties, do not accumulate, and do not affect the lipid spectrum of the blood. Side effects: hot flashes, sweating, vaginal dryness, headache, depression, nervousness, changes in libido, seborrhea, peripheral edema, deterioration of prospective memory, decreased bone density.

Discontinuation of therapy leads to the restoration of the normal menstrual cycle and estrogen status approximately 60-100 days after discontinuation of the drug and the rapid re-growth of uterine fibroids to their original size (during the first 3-4 menstrual cycles) with all clinical symptoms (although some authors note that these symptoms are less pronounced).

Prevention of uterine fibroids

In addition to general recommendations on maintaining a rational lifestyle and preventing common diseases in childhood and adulthood, the exclusion of abortions, timely correction of hormonal disorders, and adequate treatment of gynecological diseases play a role.

There is also specific prevention of uterine fibroids. This is the timely implementation of reproductive function. The first birth is recommended at 22 years old, the second at 25 years old, and subsequent planned births up to 35 years old. Late first birth leads to premature aging of myocytes, a decrease in the adaptive ability to stretch and contract. Abortion and inflammation damage the structure of the myometrium.

It should be taken into account that the most common period for detection of uterine fibroids is 30-35 years, when the effects of damaging factors are summed up.

It is necessary to maintain the first pregnancy, especially in young women with so-called hereditary fibroids. Abortion causes the growth of myomatous nodes and growing fibroids are intensively formed from microscopic nodes.

Excessive ultraviolet radiation and elevated temperatures should be avoided, especially after 30 years. If there is a hereditary risk (uterine fibroids in the mother and close relatives), the tumor develops 5-10 years earlier, i.e. at 20-25 years old. Continuing breastfeeding for 4-6 months after birth normalizes prolactin levels, which affects changes in the growth of fibroids.

Uterine fibroids are a benign tumor that forms in the muscle layer of the uterus. The formation consists of muscle structures and connective tissue. Uterine fibroids have their own developmental characteristics.

So, it can not only increase in size, but also disappear completely without a trace during. If the tumor is small in size, then it may not show signs of its presence in the woman’s body for a long time. It may also not increase at all. Active growth can be provoked by a number of unfavorable factors, such as stagnation of blood in the pelvis, curettage, etc. This tumor most often affects women after 30 years of age.

The size of the formation varies from small to huge, filling the entire abdominal cavity of a woman. The tumor is localized mainly on the body or fundus of the uterus.

Causes

There are a number of factors that increase the risk of developing uterine fibroids:

• constant stressful situations;
• long-term exposure to ultraviolet radiation on a woman’s body;
• abortions;
• inflammatory pathologies of the reproductive system;
• long-term use of contraceptives;
• heredity;
• malfunction of the immune system;
• cysts;
• absence of childbirth due to anovulation until 30–35 years of age;
• past infectious diseases;
• blood stagnation in the pelvis;
• hormonal imbalances;
• extragenital pathologies;
• CNS disorders.

Stages

Tumor growth occurs in three stages:

• at the first stage, a specific growth zone is formed in the myometrium (near the microvessels), in which metabolism actively occurs;
• at the second stage, the tumor actively begins to develop, its cells are not identified. The presence of a node can be determined microscopically;
• at the third stage, the tumor already begins to grow expansively. Her growth is rapid. With its structures, it gradually begins to push aside the tissues that are located next to it. As a result, they become denser and form a kind of capsule.

Classification

Depending on the location of the nodular formations, as well as the nature of growth, fibroids are divided into:

• diffuse form. In this case, the tumor grows quite slowly and nodules do not form;
• nodular fibroids of the uterus. This form is characterized by the formation of pathological nodules;
• interstitial fibroids;
• submucous;
• subserous;
• interligamentous.

Classification by proliferative activity:

• simple fibroids. This is the simplest form of pathology, which does not have pronounced proliferation. The growth of the pathological formation occurs slowly. Its removal is usually not required. It resolves under the influence of drugs;
• proliferating fibroid. This is a benign formation with all its characteristic features - miotic division occurs quickly, cells grow without atypia;
• presarcoma This tumor has many atypical elements. It needs to be removed as soon as possible. The symptoms of the pathology are very pronounced. Most often, if this particular type has developed, the uterus is also removed during the operation.

Symptoms

Uterine fibroids can be completely asymptomatic, especially if they are small in size. If the tumor grows quite quickly and begins to put pressure on surrounding tissues, then the following symptoms are observed:

• the stomach increases in size;
• menstruation takes a long time. The discharge is copious and may contain blood clots;
• develops. This occurs due to the fact that during menstruation a woman loses a lot of blood (a characteristic symptom);
• apathy;
• general weakness;
• dizziness;
• lack of appetite;
• and bloating;
• pain in the back and legs;
• pain in the lower abdomen;
• the woman feels constant pressure on the pelvis;
• During sexual intercourse there is discomfort and sometimes even pain.

Fibroids and pregnancy

Pregnancy with uterine fibroids can occur if the nodes are localized intramural. If the nodes are located under the mucous membrane, then it is impossible to get pregnant.

Often, a pregnancy with this disease can end in miscarriage. In extremely rare cases, a woman may give birth at 38 weeks. Expectant mothers should be under the supervision of their attending physician, as the risk of miscarriage remains throughout the pregnancy. The reason for this may be hemorrhage or necrosis of the nodes.

If the nodes are located in the lower segment of the uterus, it is not possible to give birth to a child naturally. In this case, only a caesarean section is performed to save the life of the mother and child.

Diagnostics

If a woman exhibits symptoms of progression of this pathology, she should immediately seek qualified medical help. This disease is dangerous not only to the health, but also to the life of the patient. In addition, the earlier treatment is started, the greater the chance that it will be effective.

Basic and additional techniques are used to accurately diagnose pathology. This approach to examination makes it possible to accurately determine the location of fibroids, clarify its size and structure.

The standard diagnostic program includes:

• taking anamnesis;
• assessment of the patient’s complaints, clarification of symptoms;
• inspection;
• bimanual gynecological examination;
• colposcopy;
• flora smears;
• coagulogram;
• echography;
• hysteroscopy.

Treatment

If the symptoms of fibroids are not pronounced, then the doctor may suggest a “waiting” tactic. Its essence is that the patient periodically visits the doctor for examination, and so that he can assess the growth trend of the tumor.

If the symptoms of the pathology are quite pronounced, then the following methods of conservative treatment of uterine fibroids are used:

• taking medications: NSAIDs, hormones, and contraceptives;
• EMA. This is a non-surgical technique that allows you to save organs. Its essence is to block the flow of blood through the vessels that feed pathological formations.

Most often, doctors resort to surgery as the most effective method, but at the same time a radical method of treatment. Today, surgeons use two types of surgical intervention - hysterectomy and myomectomy. A hysterectomy is an operation during which the entire uterus is removed. Myomectomy is a more gentle operation, since in this case only pathological nodes are removed. The organ itself is preserved and continues to perform all its functions.

Doctors resort to surgery if conservative methods do not have the desired effect and the growth of the tumor does not stop. It is worth noting the fact that it is not always possible to save the uterus during surgery. If the tumor is large or several have formed, then it is necessary to remove the tumors along with the uterus.

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Traditional medicine also has a lot of recipes that should help treat uterine fibroids. But it is worth noting that all folk remedies can only be used as additional therapy to the main treatment plan. Any such remedy should be discussed with your healthcare professional. Because what suits one person does not always suit another. Uncontrolled use of folk remedies can only aggravate the course of the pathology.

Folk remedies for the treatment of fibroids:

• potato juice;
• Birch tar;
• propolis;
• bee bread

Prevention

To protect the body from the development of such a disease as uterine fibroids, a number of measures should be taken, which include:

• maintaining a healthy lifestyle;
• treatment of inflammatory and infectious diseases;
• competent therapy of gynecological ailments;
• complete exclusion of abortion.

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Diseases with similar symptoms:

Premenstrual syndrome is a complex of painful sensations that occur ten days before the onset of menstruation. The signs and symptoms of this disorder and their combination are individual in nature. Some female representatives may experience symptoms such as headaches, sudden changes in mood, depression or tearfulness, while others may experience pain in the mammary glands, vomiting or constant pain in the lower abdomen.

Tumor diseases of the genital organs are widespread in gynecology. And one of the most common formations is uterine fibroids. This benign tumor is detected in every sixth woman of reproductive age. Therefore, timely diagnosis and subsequent active treatment are of utmost importance.

Causes and mechanisms

To understand the essence of the pathological process, it is necessary to become familiar with its origin. The development of fibroids is mediated by general and local disorders. The main concept of the occurrence of a benign neoplasm is considered to be hormonal. Regulatory disorders in the hypothalamic-ovarian system give rise to proliferative processes in the uterus. In the muscle layer, hyperplasia and hypertrophy of fibers are observed, but the cells do not lose their differentiation.

A key role in maintaining tumor growth is played by increasing the concentration of estrogen - both absolute and relative. These substances are natural stimulators of cell growth. In addition, the metabolism of sex hormones changes in the tumor and the sensitivity of receptors to them increases. Of no small importance is given to cytokines and growth factors, immunological disorders and tissue hypoxia. It should also be remembered that the following conditions contribute to the development of fibroids:

• Infectious and inflammatory diseases.
• Menstrual cycle disorders.
• Endocrine metabolic pathology.
• Invasive interventions, including abortions.
• Genetic predisposition.
• Disturbances in the neuropsychic sphere.

All these factors must be taken into account when correcting the disease, because the basis of treatment, especially in the early stages, consists of eliminating the cause and mechanisms of development of fibroids. Without this, it is difficult to talk about further recovery.

Classification

There are several classification criteria for a diagnosis such as uterine fibroids. The doctor must take into account the location of the tumor, the direction of its growth, size, spread and morphological structure. The pathological process in most cases develops in the body of the uterus, including the fundus, and only in some cases affects the cervix. The most important influence on the nature of symptoms is the direction of fibroid growth. Based on this, the following node options are distinguished:

1. Submucosal (in the submucosal layer).
2. Intramural (in the thickness of the myometrium).
3. Subserous (in the outer membrane).

Fibroids growing between the uterine ligaments (interligamentous) can also be observed. In turn, the size of the nodes varies very widely: from clinically asymptomatic to those that are comparable to pregnancy for more than 12 weeks. Despite the fact that the tumor grows from the myometrium, it can have a different histological structure:

• Mainly muscle - leiomyoma.
• Mixed connective tissue-muscular fibromyoma.
• Mostly connective tissue – fibroma.

And based on the rate of growth and cellular changes, fibroids can be simple or proliferating. The first is called muscle hyperplasia, and the second is a true tumor with rapid development. In addition, the size of the intramural component in the structure of fibroids and the direction of its growth allow us to form another classification, according to which there are the following types of pathological process:

• 0 – superficial nodes on the pedicle.
• I – having a wide base and embedded in the wall of the uterus (less than half the thickness).
• II – the intramural component is allocated more than 50% of the tumor volume.

In terms of prevalence, there is a single uterine fibroid, but most often it is necessary to detect multiple nodular formations. The lesions are located randomly throughout the entire plane of the organ wall.

Each tumor feature indicated in the classification is necessary to make a clinical diagnosis.

Symptoms

The clinical picture of the pathology is very variable. With small sizes, intramural and subserous tumors do not manifest themselves at all. But submucosal lesions, even small ones, can give rise to certain symptoms, which intensify as the fibroids grow. The most common signs include:

• Heavy and prolonged periods.
• Intermenstrual bleeding.
• Pain in the lower abdomen.
• Problems conceiving a child.

Submucosal nodes disrupt the functioning of the endometrium, which creates such a picture. Due to severe menometrorrhagia, a woman experiences chronic blood loss, which causes anemia. Characterized by general weakness and fatigue, pale skin and mucous membranes, changes in taste, dizziness, brittle hair and nails. Infertility is caused by both hormonal disorders and local disorders in the uterine wall (tumor nodes prevent normal implantation).

If a large uterine fibroid is diagnosed, symptoms will include disorders of neighboring organs. Women urinate more frequently, develop constipation and chronic pelvic pain. Sometimes shortness of breath and tachycardia occur when lying down - this is the so-called inferior vena cava syndrome, which appears due to compression of the vascular bundle.

As the tumor grows, the risk of complications increases: pedicle torsion and node necrosis. In both cases, signs of an “acute abdomen” develop, in particular sharp pain, irritation of the peritoneum, reflex muscle tension and deterioration of the general condition. This situation requires an urgent response.

During a gynecological examination, the picture also varies. Small submucosal and intramural nodes cannot be palpated. But external tumors manifest themselves in the form of moderately dense, round and inactive foci, which give the impression of a “lumpy uterus”. With large nodes, the organ increases significantly in size, and with complications, diffuse pain appears.

Additional diagnostics

Uterine fibroids must be confirmed using additional diagnostics, because based on clinical data, a tumor can only be assumed. And its characteristics will become known based on the results of instrumental studies:

• Ultrasound of the pelvis.
• Metrosalpingography.
• Hysteroscopy with biopsy.
• Diagnostic curettage.
• Histological analysis.

To establish the mechanisms of development of fibroids and predisposing factors for their occurrence, laboratory tests should also be performed. The most important is a blood test for the hormonal spectrum (gonadotropins, estrogens, progesterone) and an immunogram. The attending physician may prescribe other tests necessary to identify concomitant disorders.

Additional diagnostic methods make it possible to obtain reliable information about the nature of the tumor process in the uterus and the prerequisites for its development.

Treatment

Treatment measures are determined by how uterine fibroids behave in a particular patient, depend on the size and number of tumor foci, clinical symptoms, and are also carried out taking into account the patient’s age and her reproductive characteristics. Based on the diagnostic results, the doctor creates an individual program for each woman.

Conservative correction

Until now, the question of the advisability of treating asymptomatic tumors remains open. Such patients are most often recommended to undergo ultrasound monitoring every six months to monitor fibroids. If its size increases, then therapeutic correction will have to be carried out.

In the early stages, when the nodes are still small, drug treatment is actively used. Hormone therapy becomes the basis of conservative correction. Considering the important role of regulatory disorders in the origin of the tumor, the following drugs are used to eliminate it:

1. Progestins (Norkolut, Duphaston).
2. Gonadotropin antagonists (Danoval).
3. Agonists of hypothalamic releasing hormones (Triptorelin).

In addition to systemic medications, gynecologists also have local forms of hormonal medications in their arsenal. We are talking about an intrauterine pharmacological system called Mirena. It contains the progestin levonorgestrel, which has a local effect directly on tumor nodes in the uterus. If fibroids are accompanied by heavy menstruation and bleeding, then symptomatic correction with the help of hemostatic agents (Dicinone, Vikasol, aminocaproic acid) is necessary.

Operation

Any pathological process, even of a benign nature, must be eliminated. If conservative correction does not help and the tumor continues to develop, then it is necessary to involve surgeons in the treatment of uterine fibroids. Surgery is indicated for large tumor sizes (exceeding 14 weeks), its rapid growth, submucosal localization, complications (pedicle torsion and necrosis), infertility and dysfunction of adjacent organs.

Uterine fibroids are removed in various ways. Recently, preference has been given to organ-preserving operations, which allow the woman to become pregnant in the future. Such interventions include myomectomy or node enucleation (enucleation), hysteroscopic or laparoscopic resection. The choice of technique and access is determined by the location of the tumor, its size and direction of growth. But in advanced cases, when the above methods are no longer effective, radical operations have to be done:

• Supravaginal amputation.
• Defundation (removal of the uterine fundus).
• Extirpation (hysterectomy).

Such interventions are more often performed in women of late reproductive and menopausal age, since they do not make it possible to carry a child to term. But low-traumatic techniques completely preserve menstrual and reproductive functions. After surgery, hormonal drugs are often prescribed to normalize the regulatory processes of the female body.

Modern treatment of fibroids consists of drug correction and surgical interventions aimed at eliminating the tumor.

Traditional methods

Some patients of traditional therapy prefer treatment with folk remedies.

Indeed, there are a number of natural components used to suppress the tumor process in the uterus and normalize menstrual function. But, unfortunately, they do not have proven effectiveness and safety, which makes taking such medications not entirely justified. In addition, independent use of traditional methods can result in serious consequences, ranging from allergic reactions to progression of the disease.

Therefore, you should first consult with your doctor and not refuse the traditional therapy prescribed by him. And as a supplement, you can try treatment with the following means:

1. Tinctures of propolis, marina root, walnuts, celandine.
2. Infusions of chamomile, St. John's wort, calendula, boron uterus.
3. A decoction of flaxseeds.
4. Aloe juice.

Any disease is easier to prevent than to treat. Therefore, it is important for women to undergo regular gynecological examinations. Early detection of the tumor will allow for greater success from conservative therapy. And late stages, unfortunately, will be almost impossible to cure without surgery. But in any case, the doctor will try to do everything possible to restore the impaired functions of the female body.