According to statistics, 20% -30% of women over the age of 30 suffer from uterine fibroids. As the most common benign tumor of the female reproductive system, it is like an "unwelcome guest" quietly growing inside the uterus. Faced with this common disease, whether to "cut" or "stay" has become a difficult problem for many patients. Treatment decisions are not only related to current health status, but also closely related to family planning and quality of life. This article deeply analyzes the health decision that troubles many women from a medical professional perspective.
1、 Understanding uterine fibroids
Uterine fibroids, also known as uterine smooth muscle 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 like a "small meatball" quietly growing in the uterus, which can be divided into intramural fibroids, subserosal fibroids, and submucosal fibroids according to their different growth locations.
Intrauterine fibroids are the most common type that grow within the uterine muscle wall; Subserosal fibroids grow towards the surface of the uterine body and protrude from the surface of the uterus; Submucosal fibroids grow towards the uterine cavity and protrude into it. The impact of different types of fibroids on uterine function and female health also varies.
The cause of uterine fibroids is still not fully understood, but research has found that it is closely related to estrogen levels in women's bodies. Women of childbearing age are at high risk for uterine fibroids due to their strong secretion of estrogen; After menopause, as estrogen levels decrease, fibroids often stop growing or even shrink. In addition, genetic factors, long-term mental stress, obesity, etc. may also increase the risk of developing uterine fibroids.
2、 What symptoms are 'alarming'? Don't ignore the signals from the body
In most cases, uterine fibroids may go unnoticed and the patient may not have any symptoms, but may be discovered accidentally during a physical examination. However, when the fibroids gradually enlarge or have a special location, a series of "alarms" will be triggered.
Increased menstrual flow and prolonged menstrual period are one of the most common symptoms, mainly due to submucosal fibroids or larger intramural fibroids that enlarge the uterine cavity, increase the area of the endometrium, affect uterine contractions, and lead to increased bleeding. Long term excessive menstruation may also lead to anemia, symptoms such as dizziness and fatigue.
A mass in the lower abdomen is also a common manifestation of uterine fibroids. When the fibroid grows to a certain extent, patients can feel a hard mass in the lower abdomen, especially when the bladder is full in the morning. In addition, the compression of surrounding tissues by fibroids may also cause symptoms such as frequent urination, difficulty urinating, constipation, abdominal pain, and lower back pain.
Uterine fibroids can also lead to infertility and miscarriage, with an incidence rate of approximately 1% to 2%, with submucosal fibroids being the most common. The impact of uterine fibroids on pregnancy is related to the anatomical changes they cause in the uterus. Submucosal fibroids and intramural fibroids protruding into the uterine cavity can affect the implantation of female fertilized eggs, leading to early miscarriage; Excessive intramural fibroids can cause deformation of the uterine cavity or insufficient blood supply to the endometrium, leading to miscarriage.
3、 The wisdom of 'staying': what situations can be observed and waited for?
Not all uterine fibroids require immediate surgical removal. If the fibroid is small (usually less than 5cm in diameter), has no obvious symptoms, and the patient is approaching menopause, "observation and waiting" is a good choice.
Because after menopause, as estrogen levels decrease, fibroids usually gradually shrink and their impact on the body decreases. During the observation period, patients need to undergo gynecological and ultrasound examinations every 3-6 months to closely monitor the size, location, and symptom changes of fibroids. Once fibroids are found to grow rapidly or new symptoms appear, it is necessary to reassess the treatment plan.
In addition, for some patients who are not suitable for surgery due to physical reasons or cannot withstand surgery due to high psychological pressure, if the symptoms of fibroids are mild, medication can also be chosen under the guidance of a doctor, such as using gonadotropin-releasing hormone analogs (GnRHa) to reduce estrogen levels, shrink fibroids, and alleviate symptoms. But drug treatment is generally short-term, and after stopping the medication, the fibroids may enlarge again.
4、 Considerations for "cutting": In which situations must surgery be performed decisively?
Surgical resection is often a more appropriate option when uterine fibroids exhibit the following conditions. Firstly, if the volume of the fibroid is too large, or if the fibroid is not large but has already caused obvious symptoms, such as anemia due to excessive menstruation, drug treatment is ineffective; Frequent urination, difficulty urinating and other compression symptoms seriously affect the quality of life, and surgery needs to be considered.
Secondly, for submucosal fibroids, due to their growth into the uterine cavity, they can easily cause irregular vaginal bleeding, infertility, miscarriage, and other problems. Even if the fibroids are small, surgical resection is recommended. In addition, if the fibroid grows rapidly, there is a suspicion of malignancy; If fibroids are combined with pregnancy and red like symptoms such as abdominal pain and fever occur during pregnancy, and conservative treatment is ineffective, surgery should also be performed in a timely manner.
The choice of surgical method varies from person to person, mainly including myomectomy and hysterectomy. Uterine fibroid removal surgery is suitable for patients who wish to preserve their fertility by surgically removing fibroids from the uterus and preserving the uterus; Hysterectomy is suitable for patients who are older, have no fertility needs, have multiple and oversized fibroids, and are suspected of malignant transformation. In recent years, with the development of medical technology, minimally invasive surgeries such as laparoscopy and hysteroscopy have gradually become popular. They have the advantages of minimal trauma, fast recovery, and short hospitalization time, and have become the first choice for many patients.
5、 Postoperative recuperation and prevention: protect the health of the uterus
Careful recuperation is required after myomectomy or hysterectomy. Patients should pay attention to rest, avoid heavy physical labor and intense exercise. Generally, sexual activity and baths should be avoided 1-3 months after surgery to prevent infection. In terms of diet, it is necessary to increase the intake of nutrients such as protein and vitamins to promote physical recovery. At the same time, regular check ups should be conducted according to the doctor's instructions to understand the recovery status of the body.
To prevent the occurrence of uterine fibroids, female friends should maintain a healthy lifestyle in their daily lives. Maintain a regular schedule and avoid staying up late; Reasonable diet, eat more fresh vegetables and fruits, and reduce the intake of high-fat and high calorie foods; Moderate exercise can enhance the body's immunity; Maintain a relaxed mood and avoid long-term mental tension and anxiety. In addition, regular gynecological examinations are also very important. It is recommended to undergo gynecological examinations and ultrasound examinations at least once a year to detect problems early and handle them in a timely manner.
6、 Conclusion
Whether to "cut" or "keep" uterine fibroids cannot be generalized. It is necessary to comprehensively consider multiple factors such as the size, location, symptoms, patient age, and fertility needs of the fibroids. When facing this problem, do not make blind decisions. You must go to a regular hospital, communicate fully with doctors, and choose the most suitable treatment plan under professional guidance. I hope every woman can understand her own health, make scientific decisions, and take good care of her body.