What is uterine fibroids?

We often hear the term uterine fibroids, and we also know that uterine fibroids are actually a type of tumor. Apart from this, I believe that most of our friends still do not have a deep understanding of uterine fibroids. In fact, we still must recognize and know what uterine fibroids are, especially female friends should understand what uterine fibroids are, how to prevent the occurrence of uterine fibroids, and how to deal with uterine fibroids if they have already occurred.

Uterine fibroids are a type of benign tumor that appears on the female uterus, so female friends should not be so afraid of uterine fibroids. Of course, they also need to actively seek treatment to prevent the uterine fibroids from worsening.

Uterine fibroids are the most common benign tumors in the female reproductive organs and one of the most common tumors in the human body. They are also called fibroids and uterine fibroids. Since uterine fibroids are mainly formed by the proliferation of uterine smooth muscle cells, with a small amount of fibrous connective tissue existing as a supporting tissue, it is more accurate to call them uterine leiomyomas. Referred to as uterine fibroids.

Causes of uterine fibroids

The etiology of uterine fibroids is still unclear and may involve complex interactions among normal myometrial cell mutations, sex hormones, and local growth factors.

A large number of clinical observations and experimental results indicate that uterine fibroids are a hormone-dependent tumor. Estrogen is the main factor that promotes the growth of fibroids. Some scholars also believe that growth hormone (GH) is also related to the growth of fibroids. GH can cooperate with estrogen to promote mitosis and promote the growth of fibroids. It is speculated that human placental lactogen (HPL) can also cooperate with estrogen to promote mitosis. It is believed that the accelerated growth of uterine fibroids during pregnancy is related to the high hormone environment during pregnancy, and HPL may also play a role.

In addition, ovarian function and hormone metabolism are controlled and regulated by higher nerve centers, so the activity of nerve centers may also play an important role in the occurrence of fibroids. Uterine fibroids are more common in women of childbearing age, widows, and those with disharmonious sexual lives. Chronic pelvic congestion caused by long-term sexual dysfunction may also be one of the causes of uterine fibroids.

In short, the occurrence and development of uterine fibroids may be the result of the combined action of multiple factors.

Treatment of uterine fibroids

1. Follow-up observation

If the patient has no obvious symptoms and no signs of malignancy, regular follow-up observation can be performed.

2. Medication

(1) Gonadotropin

GnRH-a agonists (GnRH-a) Currently, the commonly used GnRH-a in clinical practice include leuprorelin (Enanton), goserelin (Zoleide), triptorelin (Dapiga), etc. GnRH-a should not be used continuously for a long time. It is only used for pretreatment before surgery, generally for 3 to 6 months, to avoid causing severe menopausal symptoms caused by low estrogen. A small dose of estrogen can also be supplemented at the same time to counteract this side effect.

(2) Mifepristone is a progesterone antagonist that has been clinically tried in recent years to treat uterine fibroids. It can reduce the size of fibroids, but the fibroids often grow again after discontinuation of the drug.

(3) Danazol

Used for preoperative medication or treatment of uterine fibroids that are not suitable for surgery. Uterine fibroids may grow larger after medication is stopped. Danazol can cause liver damage and androgen-induced side effects (weight gain, acne, hoarse voice, etc.).

(4) Tamoxifen can inhibit the growth of fibroids. However, long-term use may cause enlargement of uterine fibroids in some patients, and may even induce endometriosis and endometrial cancer, so this should be paid attention to.

(5) Commonly used androgen drugs include methyltestosterone (methyltestosterone) and testosterone propionate (testosterone propionate), which can inhibit the growth of fibroids. The dosage should be used carefully to avoid virilization.

During the bleeding period of patients with uterine fibroids, if the amount of bleeding is heavy, uterine contractants (such as oxytocin, ergot) and hemostatic drugs (such as hemostatic acid, aminobenzoic acid (hemostatic aromatic acid), lizhihemostasis, Panax notoginseng tablets, etc.) can also be used, which can play a certain degree of auxiliary hemostatic effect.

3. Surgery

Surgical treatment of uterine fibroids includes myomectomy and hysterectomy, which can be performed abdominally or vaginally, or endoscopically (hysteroscopy or laparoscopy). The choice of surgical procedure and approach depends on factors such as the patient's age, whether or not they have fertility requirements, the size and location of the fibroids, and medical technology conditions.

(1) Myomectomy

Surgery to remove uterine fibroids while preserving the uterus is mainly used for young women under 40 who wish to retain their fertility. It is suitable for patients with larger fibroids, heavy menstruation, compression symptoms, infertility due to fibroids, submucosal fibroids, and fast-growing fibroids without malignant transformation.

(2) Hysterectomy

For patients with obvious symptoms, those with the possibility of malignant transformation of fibroids, and those with no desire to have children, hysterectomy is recommended. Hysterectomy can be performed with total hysterectomy or subtotal hysterectomy. For older women, total hysterectomy is more appropriate. The possibility of cervical malignancy must be excluded before surgery.

(3) Uterine artery embolization

Through the method of radiological intervention, an arterial catheter is directly inserted into the uterine artery, and permanent embolic particles are injected to block the blood supply to the uterine fibroids, so as to achieve the shrinkage or even disappearance of the fibroids. UAE is currently mainly suitable for uterine fibroids with symptoms such as abnormal uterine bleeding leading to anemia. Caution should be exercised when choosing interventional treatment for uterine fibroids, especially for those with uncontrolled pelvic inflammation, those who wish to retain their fertility, those with arteriosclerosis, and those who have contraindications to angiography, which should be listed as contraindications to this treatment. 5% of patients may experience premature ovarian failure after surgery, and there are also rare reports of pelvic infections.

4. Focused Ultrasound Therapy

By focusing ultrasound waves and raising the temperature locally inside the tumor to over 65°C, the tumor undergoes coagulative necrosis, which in turn has a therapeutic effect. The treatment can cause the fibroids to shrink and relieve symptoms. Indicated for symptomatic uterine fibroids. The advantages are that there are no surgical scars after treatment and recovery is fast. Adverse reactions have been reported including skin burns, adjacent intestinal damage, and hematuria.

Above we introduced what uterine fibroids are. We know that uterine fibroids are a common tumor on the female reproductive organs. Uterine fibroids are benign tumors, so female friends do not have to be too afraid. Once you suffer from uterine fibroids, we still have ways to treat them. The above article introduces in detail the causes and treatments of uterine fibroids.