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VERIFIED CONTENTConsultation: dr Tadeusz Oleszczuk, gynecologist-obstetrician

Uterine fibroids are the most common benign neoplastic lesions that affect women. Most of them are only subject to regular observation. Does this mean that they are not dangerous to your he alth at all? We asked the expert Dr. Tadeusz Oleszczuk about it.

Patrycja Pupiec: When you read about uterine fibroids that they are benign neoplastic changes, you may feel apprehensive. Are uterine fibroids dangerous?

Tadeusz Oleszczuk:Only 0.8-1 percent. of them turns out to be malignant, so there is such a possibility. Uterine fibroids are the most common benign neoplastic lesions in women, but on the other hand whether they are dangerous depends on several factors. So far, no single cause of fibroids has been identified, although they concern about 50 percent. women.

This means?

Maybe let's start with what uterine fibroids actually are. The muscle fibers in the uterus are arranged in layers, and when the connections between the fibers are broken, they contract, which results in the appearance of oval formations, i.e. myomas.

Their location is crucial. They give different symptoms depending on where they appear in the uterine wall. For example, if a myoma grows outside the uterus, the symptoms will be milder, but if it appears inside the uterus and it grows there, it can cause uncomfortable bleeding. Such heavy bleeding can cause anemia over time.

There is a vicious circle, because the increasing anemia causes the deteriorating he alth of a woman who has fibroids. The anemia itself worsens the blood coagulation parameters, which additionally increases it. I studied the formation of fibroids and in my experience it has to do with the digestive tract and what we eat. Very often when I asked the women I have operated on for myomas if they have problems with the thyroid gland, half answered that they actually treat thyroid disease.

I recommended an ultrasound of this gland in the second half, which confirmed its structure disorders. The relationship of uterine and thyroid fibroids is strong, but the symptoms also come from the digestive system - apart from bleeding, there are pains in theabdominal pain, diarrhea, constipation, gas. This may be related to an intolerance to certain food ingredients.

However, if these symptoms are not persistent, uterine fibroids are monitored. Why? After all, these tumors can turn into cancer, right?

As I already mentioned - 99 percent uterine fibroids are benign changes. This 1 percent. That's a lot? No, but it may turn out to be a malicious lesion. Suppose a woman in her 20-25 years begins to grow a myoma in the uterus, which the girl does not know. After 10-15 years, the myoma, which was 2-3 millimeters long, is already a lesion that is 3-4 centimeters long.

Overall, about 40-50 percent women have problems with myomas. If the doctor notices a small, a few millimeters of fibroids in a woman who is over 45 years old, it is not a problem, because in a moment she will be menopausal and menopausal bleeding will stop and the uterus will gradually involution. However, when she sees a fire above a centimeter in a young girl, who is about 30 years old, depending on the dynamics of growth, she is subjected to observation.

Although if this fibroids in the uterus is more than this 1cm, larger fibroids produce more symptoms. These symptoms really make life difficult, so it's worth getting rid of them, especially when heavy bleeding worsens the quality of life.

What else should worry a woman? It is often heard that the fibroids turned out to be a surprise during examinations at the gynecologist's office, where it turned out that they were even a few centimeters …

Such a patient certainly had symptoms, but simply ignored them, or maybe she got used to them? In this case, it can be said that time determines the size of this change, because when the myoma begins to grow in the uterine cavity, profuse bleeding is the main symptom. Hence, there is a straightforward path to anemia, and anemia, in turn, is related to iron levels, and iron is absorbed in the digestive tract.

If the myoma is located in the wall of the uterus or further outside, the symptoms will be from the abdominal cavity. Bloating, aching, constipation or diarrhea. We will constantly refer to what our he alth depends on. In 15-20 percent. it's genes. However, in general, lifestyle and diet have the greatest influence. Can what we eat have multiple allergenic factors.

These may be food preservatives, antibiotics, pesticides, etc., because it affects our immunity - the lower the quality of the food we eat, the more vulnerable we are to digestive system disorders. Often the diagnosis is a surprise for a woman, because I sometimes hear that it is "impossible that I have fibroids, because I have neverI didn't have them. "

This is no argument, but fibroids can often be found in the same family. Ultimately, we not only inherit our genes, but our diet as well.

What is the diagnosis of uterine fibroids?

An ultrasound of the uterus is performed, which shows the structure, location, shape and morphology of the lesion. You can see exactly this very clearly, so you can determine whether the problem should be de alt with immediately or whether you can wait. The most important thing, however, is that when I know that a woman in my immediate family has problems with the thyroid gland, digestive system, myomas, it is necessary to do tests and check if everything is well, because this is the risk group.

As a doctor, I know that women often ignore these problems. Recently, I had a 34-year-old patient with a hormonal disorder whose mother and sisters are receiving treatment for the thyroid gland. However, she herself has never had an ultrasound of this gland. Blood analyzes will not show everything, sometimes ultrasound examinations are needed to see the structure of the reproductive organ or the gland, which is the thyroid gland.

When I see symptoms, and some of them are really bothersome, you have to go to a specialist and check if everything is okay, because of course, most fibroids are not malignant changes, but the chances are that there is 1% of them exist, so you have to remember about it. Especially when an increase in the size of fibroids is observed in subsequent studies.

Uterine fibroids is a specific disease that causes problems with getting pregnant, but on the other hand, in the case of fibroids, pregnancy can contribute to their formation and, above all, increase the size of those which you already have, right?

Yes, because with pregnancy, the uterus grows, and so does the myoma, but in this case its location matters. If this lump appears inside the uterus and is a few centimeters in size, it will constrict the developing fetal egg as it grows. Once it is a few centimeters, it may hinder the growth of the fetus and lead to a miscarriage. The size and location of the lesion and its impact on the course of pregnancy are important.

Does this mean that pregnancy of a woman with fibroids requires an individual, careful approach?

Yes, and even very careful, as it would be best to remove them before you become pregnant. In general, the diagnosis of uterine fibroids makes it difficult to try for a baby, so it is better to get rid of them first, then the uterus has a better chance of carrying a pregnancy.

Is it true that uterine fibroids most often arise inwomen using oral contraception, is it just a myth?

The body of a woman who has periods produces estrogens which determine whether the epithelium grows. The earlier a woman starts menstruating and the later her menopause occurs, the greater the chance of fibroids developing. Uterine fibroids appear in menstruating women. If a woman has been taking contraception for 20 years, and whether or not she is taking it, she may be one of the ladies who have fibroids.

On the other hand, by taking birth control, it prolongs the period of hormonal activity. Therefore, for example, women who take HRT in their 50s may have an increased risk of developing fibroids. The problem here is precisely this effect of estrogens on fibroids, because contraception gives them good conditions for growth if they appear. However, you can choose a method of contraception that will avoid this problem, but whether a woman takes hormonal contraception or not - anyway, she may be in the group that has fibroids. It is not contraception that causes them.

What is the treatment effectiveness in uterine fibroids? Is it permanent?

Here again we have to come back to the relationship of fibroids with the immune system. Suppose a woman has fibroids, she has tested and is found to be food intolerant, e.g. dairy, gluten, casein, sugar or pesticides are not good for her. On the other hand, her mother and sister have fibroids, problems with thyroid disorders. Usually, large fibroids are removed depending on the he alth problems identified.

A fast-growing myoma is unlikely to begin to disappear by itself. Each situation must be assessed individually. If you don't change your approach and don't rule out the cause of the problem, the chances of fibroids appearing are high. That is why it is so important to assess the risk and eliminate what is harmful. First you need to spend energy to find the cause, do an ultrasound of the reproductive organ.

The effectiveness of treatment also depends on the size, symptoms, age of the woman and the location of the lesions.

gynecologist-obstetrician Tadeusz OleszczukGynecologist-obstetrician with over 30 years of experience. Author of the books "What the gynecologist will not tell you" and "Calm your hormones". / drtadeusz

Read other articles from the StrefaKobiety series:

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  • Dr. Oleszczuk: If a woman comes to the doctor with stage II or III cancer, the chances of successful treatment are reduced
  • 20 percent par is measuredwith infertility. Mostly not the fault of the woman
  • Last menstruation and menopause. How to prepare for it?
  • A woman must be he althy before starting contraception
  • How to take care of intimate hygiene to avoid infections?
  • Allergies - where do they come from? Allergy to semen and condoms
  • Gynecologist banning abortion: Let's not condemn women to suffering at risk of losing he alth and life
  • Pain in the intimate areas. Is it normal to feel pain?
  • Sexually transmitted diseases. How to take care of your safety?
  • Polycystic Ovary Syndrome (PCOS), or when the body and mind suffer
  • Gynecological visit during a pandemic. What has changed?
  • Breasts. What about their appearance should worry us?
  • Are you pregnant and afraid to vaccinate against COVID-19? Expert explains why it is worth doing this
  • Why is it so long to be diagnosed with endometriosis?
  • Endometrial cancer, i.e. a cancer in which lifestyle is important
  • Gynecologist: People are afraid to name the basic elements of the reproductive system, let alone know what the physiology of the cycle looks like

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