Myoma: What it is, causes and treatment

Myoma is a type of benign tumour that forms in the muscle tissue of the uterus and that can also be called fibroma or uterine leiomyoma. The location of the myoma in the uterus may vary, as well as its size which may be microscopic or may measure several centimetres.

Fibroids are relatively common and in most cases they are not accompanied by any symptoms. However, some women may experience colic, bleeding or difficulty getting pregnant. In such cases, it is necessary to begin treatment as directed by the gynaecologist depending on the characteristics of the myoma. He may prescribe the use of remedies that will relive symptoms or recommend surgery to remove the myoma or the whole uterus, for the most severe cases.

What causes myoma?

Myoma does not have a well known cause. However, is arises when the cells of the muscles that form the uterus multiply in a disorderly manner, leading to the growth of a tumour. It is possible that this disordered proliferation may be related to hormonal changes, in women because the symptoms arise in adult women and regress after menopause.

In addition, symptoms of myoma may also appear more often in women who have undergone hormone replacement therapy.

The women who are most likely to develop myoma are those who have not given birth, whose diet is rich in red meats and less vegetables, obese women and those who have a history of the disease in their family.

Types of myoma

Myoma can be classified into different types according to the place where it develops in the uterus, the main ones being:

• Subserosum, in which the myoma develops in the outermost part of the uterus
• Intramural, when it arises within the walls of the uterus
• Submucous, when it develops in the inner part, inside the cavity of the uterus

Knowing the type of myoma is important for the evaluation of how severe the myoma is and the need to start treatment shortly after.

Main symptoms

In most cases, uterine myoma is not accompanied by signs and symptoms. However, when the myoma is large or when there are several fibroids in the uterus, the woman may present symptoms such as severe cramps, pain during sexual intercourse and longer menstrual periods.

The presence of myoma is confirmed by the gynaecologist using scans and ultrasound, hysteroscopy and hysterosalpingography, which will asses the cavity of the uterus. In addition, women who have uterine myoma who may wish to become pregnant, even if they do not present any symptoms, should follow up with the gynaecologist, because the presence of the tumour can result to more complications such as abortions.

How treatment is done

Treatment is done when the woman presents intense symptoms such as a lot of pain and abundant menstruation or when she is trying to become pregnant without any success. This type of treatment depends on the symptoms, size and type of myoma, which may vary for each woman. She should be guided by the gynaecologist who may recommend:

• Use of anti-inflammatory drugs, such as Ibuprofen or Naproxen: Improves intense menstrual cramps and reduces excess bleeding caused by fibroids
• Use of hormonal remedies, such as the pill: Help relieve the intensity of menstruation and reduce the size of myoma
• Iron supplements: Prevent and treat cases of anaemia caused by excessive bleeding
• Surgery, known as myomectomy: Serves to remove the myoma, without having to remove the uterus. It is used especially when the myoma presses other organs or causes very intense symptoms

Moreover, when the myoma is too large, it may be necessary to reduce its size before conducting surgery and for this a technique known as embolization is used. It is where the doctor uses surgical procedure to make several injections using an embolizing agent diluted in iodated contrast through the femoral artery, until there is reduction of blood flow of the artery which will nourish the myoma, generating its death.

When the woman has myoma and she does not have plans of getting pregnant, the doctor may recommend the remove of the uterus to eliminate the myoma, which will prevent the tumour from forming again.

Does myoma make pregnancy difficult?

Some women who have myoma may have difficulty getting pregnant as the myoma can result to other deformities in the inner part of the uterus as well as changes in circulation and increased onset of inflammation. In such cases, treatment may be done using hormone-based remedies such as oestrogens and androgens, or surgeries such as myomectomy or embolization of myoma so as to increase the chances of becoming pregnant.