A benign neoplasm that is formed from the tissues of the myometrium is called uterine myoma. Myometrium is the middle muscle layer in the uterus. The insidiousness of this disease lies in the development of endometrial hyperplasia, and sometimes in degeneration into a malignant tumor.
What is uterine fibroids?
Today it is a fairly common disease. As a result of its development, single neoplasms or multiple nodules occur simultaneously. Uterine fibroids, by the nature of their occurrence, are dependent on hormonal imbalance in a woman's body, when the amount of estrogen in the blood exceeds the permissible values. A feature of the course of the disease is the constant growth of the tumor. Because of this, the menstrual cycle is disturbed. In addition, intermenstrual discharge becomes much more intense, sometimes with blood impurities. The disease is accompanied by constant heavy bleeding.
Bleeding with uterine myoma is today considered one of the most frequently occurring pathological processes. Monthly prolonged bleeding with heavy blood loss leads to iron deficiency anemia and other ensuing consequences. Therefore, the presence of such disorders in the body cannot be ignored.
Provocative factors
Here are some of them:
- The formation of an uneven endometrium, and as a result, its incomplete rejection.
- Defective uterine contraction, and bleeding, not fully clamped uterine arteries.
Against the background of blood loss, the woman’s reproductive organs suffer from oxygen starvation and iron deficiency anemia develops. In this regard, the risk of breakthrough bleeding that threatens the life of a woman will increase. How to stop uterine bleeding with myoma? Need to contact an ambulance. However, it is important to provide first aid.
Varieties of uterine fibroids
In medicine, several types of fibroids are distinguished, which have common signs that differ from each other in the place of localization:
- Subserous myoma is located under the serous membrane of the uterus. Formed from muscle tissue. A neoplasm grows in the direction of the peritoneum, and in case of significant size it is able to compress organs located in the vicinity. In this case, the menstrual cycle remains unchanged and regular.
- Subendothelial myoma is located closer to the inner layer of the uterus.
- Myoma on the wall of the uterus. More often located on the back wall, increasing, expanding the boundaries of the uterus.
- Sambucosa - develops in a deep layer. It manifests itself as severe bleeding with myoma, which not everyone knows how to stop.
In turn, subserous fibroids are divided into subtypes:
- Intramural - is a nodule on a thin leg that affects the pelvic region. It grows through the muscle layer of the uterus, covering the inner layers and deforming its body. The number of entities may be single or multiple. The size of the nodules also varies from small to impressive. This type violates the cycle of menstruation.
- Interstitial - located on the surface of the uterus.
- Subserous fibroids on the leg - a dangerous form. Since the nodule enters the nodule through the leg, its torsion entails the development of a purulent-inflammatory process.
The reasons why intramural fibroids develop:
- first birth in adulthood;
- lack of childbirth;
- abortion;
- cesarean section;
- the presence of polyps and erosion;
- chronic diseases of the genitourinary system;
- a high estrogen content in the blood provokes the development of nodular neoplasms;
Very often, with the onset of the climatic period, myomatous nodes dissolve in women. This is because the level of estrogen at this time is markedly reduced.
Risk groups
Women with a bad heredity, as well as with deviations in work, are at risk of fibroids:
- endocrine system;
- metabolism (overweight);
- circulatory system.
Clinical picture
Often, some types of fibroids do not manifest themselves for a long time, especially in the initial stages of development, which only exacerbates the situation. More often, their detection occurs by chance at a routine examination by a gynecologist. Therefore, every girl and woman, starting from puberty, must visit a gynecologist and monitor her reproductive health.
The degree of manifestation of symptoms directly depends on the location of the myomatous nodes and their growth rate. For example, symptoms of fibroids can be expressed:
- weakness in the body;
- diagnosed anemia;
- regular pain in the lower abdomen;
- sharp pain during menstruation, requiring the use of painkillers;
- cycle disorders;
- intermenstrual spotting;
- frequent urination;
- systematic constipation;
- back pain and lower limbs;
- infertility
- pain during sexual intercourse.
If abundant blood discharge suddenly appears during menstruation, accompanied by severe pain, this most likely indicates the presence of developing fibroids. It is necessary to plan a visit to the gynecologist.
How to distinguish bleeding from menstruation?
You can distinguish uterine bleeding with myoma from heavy menstruation by certain signs. Some of them:
- Sharply occurring pain in the reproductive organs, radiating to the lower back.
- The presence of blood clots in menstruation. Bleeding with myoma causes large dense clots resembling chicken liver.
- Excessive fatigue and weakness, when every step is given with great difficulty, apathy. Reduced hemoglobin in the blood.
- Lingering discharge.
A woman must make an irregular cycle, pain and bleeding pause for thought. What to do with myoma when these symptoms are manifested? An emergency visit to the doctor will save you from serious consequences.
Menstrual irregularities
Provoking conditions that lead to violations of the flow of menstruation:
- The increase in the endometrium in the internal cavity of the uterus occurs unevenly. At the end of the cycle, when the cells are ready to be rejected as menstruation, some of them exit, and some remain inside the uterus. Due to this set of circumstances, the endometrium is not able to completely update and grows unevenly.
- Prolonged and heavy blood loss occurs due to uterine pathology. When the uterus contracts, it should overlap the spiral arteries. As a result of systematic bleeding, her functions decrease, and the arteries continue to bleed.
Bleeding caused by myoma is not only an unpleasant sensation, but also a danger to a woman's health. At first, a heavy menstruation provokes malaise. At the next stage, intermenstrual spotting appears. As a result, the female body weakens, loses a lot of blood and strength. Anemia causes sudden bouts of dizziness and fainting.
Myomatous nodes create difficulties with conceiving a child. Pregnancy does not occur or is interrupted. Ultimately infertility sets in. Over the years of inaction, the risk of degeneration of fibroids from a benign neoplasm to a malignant tumor increases. Therefore, it is important not to delay a visit to the doctor if there are similar signs.
Diagnosis of fibroids
To identify the causes of deviations from the norm (unstable cycle, heavy menstruation and pain), the patient is prescribed a full examination, which includes the following studies:
- Ultrasound diagnosis of the condition of the pelvic organs of a woman (ultrasound).
- Blood test for hormones.
- General blood analysis.
- Examination on a gynecological chair and taking a smear.
- The study of blood vessels by angiography.
- MRI of the abdominal cavity and pelvic organs.
Every woman should know and explain to the doctor the nature of her menstruation. For example, situations where the gasket for menstruation is completely filled in an hour are not normal, and require medical attention. It is possible that this is not menstruation, but uterine bleeding. Typical symptoms of uterine bleeding with myoma:
- the period of critical days has dragged on and lasts more than a week;
- discharge is accompanied by volumetric blood clots;
- cramping in the abdomen;
- low hemoglobin in the blood;
- disability during this period, weakness and poor health.
Submucous myoma is mainly accompanied by uterine bleeding. Type of submucous uterine fibroids provokes the growth of the endometrial layer, as well as an increase in the size of the uterus.
Important! Blood loss in excess of 70-80 ml of blood per day is an occasion for urgent hospitalization.
Can bleeding with myoma be a signal of a possible degeneration of the neoplasm into a malignant tumor? Yes, if a woman who has previously been diagnosed with fibroids is already in the menopause, and she is worried about spotting. This is a bad sign.
Causes of bleeding
Here's what doctors say, why a woman is bothered by copious discharge:
- excess amount of permissible estrogen levels in the blood;
- unevenly growing endometrial layer;
- decreased uterine contractions;
- intensive growth of fibroids;
- an increase in the size of the uterus due to the growth of the neoplasm.
First aid
In the event of excessive bleeding in the myoma, the first thing to do is call an ambulance. Further, if possible, a cold object should be applied to the lower abdomen. It can be ice or frozen foods. Drink hemostatic drugs, for example:
- "Vikasol" (vitamin K), which increases blood coagulability;
- "Ditsinon" - a styptic;
- "Tranexam" - reduces the amount of blood loss.
If there are no such medicines in the medicine cabinet, then you need to purchase them. In the hospital, medicines with hemostatic action are used to stop bleeding with uterine fibroids. After providing first aid, the patient is prescribed treatment.
How to stop bleeding with uterine myoma?
There are two treatment options:
- The drug process is hormonal and non-hormonal therapy.
- Surgery - curettage of the uterine cavity or removal of fibroids. In extreme cases, the uterus is removed.
Girls of childbearing age admitted to the hospital are cured for curettage (cleaning the uterus). Special tools scrape off the upper layer of the endometrium. The minus of the method is that it is a provoking moment in the occurrence of subsequent bleeding. Nevertheless, the method is effective for the treatment of bleeding fibroids, if the nodules are small and with clear boundaries. Therefore, it is used to this day. Unfortunately, with multiple nodes, curettage is not a productive method.
Then the patient is prescribed drugs that strengthen the walls of blood vessels, reducing their degree of fragility. Additionally, medications are used to increase blood coagulation.
Hormonal drugs are prescribed in three cases:
- when the patient's age has not reached puberty;
- to normalize the hormonal background of a patient of reproductive age and older;
- when a short period has passed since the last curettage, specifically less than six months.
To avoid such conditions, it is necessary to treat uterine fibroids, and not the numerous consequences of the disease in advanced cases.
Indications for removal of uterine fibroids
When conservative therapy fails, the question arises of the surgical removal of uterine fibroids. Indications for the operation are the following situations:
- large size of fibroids;
- bulky type;
- the rapid growth of myomatous nodes;
- anemia due to heavy blood loss;
- inability to bear a child or infertility.
Surgical methods for removing uterine fibroids
Gynecologists use such methods:
- Laparoscopy - removal of a neoplasm by means of punctures in the abdominal cavity with special devices.
- Hysteroscopy is the removal of myomatous nodes through the vagina.
- Uterine artery embolization is a method based on the loss of nutrition of fibroids using specific drugs that are injected into the artery. Due to the stoppage of blood flow, the myoma dies.
- Hysterectomy - removal of fibroids with the uterus (the method is used in extreme and advanced cases).
- FUS-ablation - destruction of fibroid cells by ultrasonic waves.
Single nodules are not difficult for surgical removal, because their boundaries are clear and they are delimited with the body of the uterus.