How to treat uterine fibroids that grow within the muscle wall?

If a woman's uterine fibroids grow between the muscle walls, it is clinically called intramural uterine fibroids. There are many causes of this disease. First of all, it is related to hormonal changes in the female body, especially changes in sex hormones are most likely to cause the disease. Some patients are caused by genetic factors. In addition, it is related to factors such as late childbearing and obesity in women. So what is the scientific treatment for this type of uterine fibroid disease?

How to treat uterine fibroids that grow within the muscle wall?

Intramural uterine fibroids are the most common, accounting for 60%-70% of all fibroids. Intramural fibroids are often multiple and of uncertain number, often with one or several larger ones, and sometimes with many small nodules distributed throughout the uterine wall, merging in irregular masses to form multiple uterine fibroids. Some of them involve the cervix or reach deep into the vault during development, and are easily confused with primary cervical fibroids. Intramural fibroids have better blood circulation, and generally the tumors rarely degenerate. They can cause severe deformation of the uterine body and affect uterine contraction. Due to the increase in uterine volume and endometrial area, they often cause excessive and frequent menstruation and prolonged menstruation.

The typical symptoms of submucosal uterine fibroids are menorrhagia and secondary anemia. The increased secretion of the intramural fibroid glands leads to increased leucorrhea. Patients with subserosal uterine fibroids may have no subjective symptoms, but if the tumor is too large or on the anterior wall, it may compress the bladder and cause frequent urination, and on the posterior wall, it may compress the rectum and cause constipation. The age of 40-50 is the most common age for gynecological diseases. Women with uterine fibroids should be treated early to prevent the tumor from continuing to grow or worsen.

Risk factors

There are many risk factors that contribute to the development or growth of uterine fibroids. Factors that increase the risk of uterine fibroids include: maternal use of estrogen during pregnancy, young age at menarche, nulliparity, late childbearing, obesity, African Americans, and tamoxifen. Factors that reduce the risk of uterine fibroids include exercise, multiple births, menopause, and oral contraceptives.

Sex hormones and their receptors

Modern medicine believes that uterine fibroids are hormone-dependent tumors. Uterine fibroids are common during the childbearing years, are rare before puberty, and shrink or disappear after menopause. Studies have shown that estrogen and progesterone synergistically promote the growth of fibroids. The main mechanism may be that estrogen in the follicular phase upregulates estrogen and progesterone receptors on uterine smooth muscle, and then progesterone promotes the mitotic activity of fibroids in the luteal phase, thereby stimulating the growth of fibroids.

Genetic factors

Cytogenetic studies have shown that 25-50% of uterine fibroids have cytogenetic abnormalities, including exchange of chromosome 12 and chromosome 17 fragments, rearrangement of chromosome 12, and partial deletion of chromosome 7.

Cytokines and extracellular mediators

There are increased expression levels of multiple growth factors and their receptors in uterine fibroids, which are considered to be mediators or effectors of the upregulation of ovarian sex hormones during uterine fibroid formation. However, the possibility of abnormal primary regulation of one or more growth factors cannot be ruled out. Uterine fibroids usually contain excessive extracellular media, which mainly contain fibroblasts and the collagen types I and III they produce. Myoma cells interact with fibroblasts and various growth factors, providing a suitable microenvironment for the formation and growth of myomas.