What to do if you discover uterine fibroids

Female friends are often troubled by the discovery of "uterine fibroids" during physical examinations, worrying that it will affect their fertility, and some even "change color when talking about tumors" and are worried. Today we will talk about the impact of uterine fibroids on women and the treatment of uterine fibroids.

Uterine fibroids are the most common benign tumors in the female reproductive organs. Since many patients have no clinical symptoms, the reported incidence of uterine fibroids is much lower than the actual incidence. Uterine fibroids are more common in women of childbearing age. After menopause, uterine fibroids will shrink as the uterus shrinks. Therefore, it is generally believed that their occurrence and growth may be related to the long-term stimulation of female sex hormones.

Most patients with uterine fibroids have no obvious symptoms and are only discovered accidentally during physical examinations.

The most common symptoms of uterine fibroids are increased menstrual flow and prolonged menstruation, which are more common in submucosal fibroids and large intramural fibroids. Long-term excessive menstrual flow may lead to anemia and affect health.

When uterine fibroids are large and cause the uterus to enlarge beyond that of a 3-month pregnant uterus, the patient may feel a lump in the lower abdomen.

Submucosal uterine fibroids that grow in the uterine cavity can affect fertility, leading to infertility and miscarriage.

In addition, uterine fibroids can affect the bladder located in front of the uterus, causing symptoms of frequent urination and urgency. If they affect the rectum located behind the uterus, it will cause compression symptoms such as bleeding, constipation, and lower abdominal distension.

When submucosal uterine fibroids protrude into the vagina and become infected and necrotic, the patient will experience abdominal pain and vaginal discharge with a foul odor.

Can fibroids become malignant? Uterine fibroids can undergo degeneration, but most are benign, and occasionally they can become malignant sarcomas.

How to treat uterine fibroids?

This requires personalized treatment based on a comprehensive analysis of the patient's age, symptoms, fibroid size, growth location, and the patient's fertility requirements.

If the fibroids are small, the symptoms are not obvious, or the patient is near menopause, follow-up can be done every 3-6 months. If the fibroids cause menorrhagia leading to secondary anemia, compression symptoms are obvious, infertility or repeated miscarriages are caused by the fibroids, or the fibroids grow rapidly and are suspected of malignant transformation, further treatment should be considered.

Surgery is still the main treatment for uterine fibroids. The surgical approach can be performed through the abdomen, vagina, or by hysteroscopy and laparoscopy. For young patients who wish to retain their fertility, myomectomy/resection can be performed to preserve the uterus. For patients with large fibroids, many fibroids, obvious clinical symptoms, and no fertility requirements, hysterectomy can be performed.

In short, patients with uterine fibroids do not need to be overly anxious or nervous, and should strictly follow up and receive personalized treatment according to the doctor's advice.

Author: Chu Yi and Lin Min from Shanghai University of Medicine and Health Sciences

Funded by Shanghai Science and Technology Commission's Science Popularization Project

(Project No.: 20DZ2311100)