Be careful if you have anemia or excessive menstruation! What kind of disease is uterine fibroids?

Uterine fibroids are benign tumors that affect more than 50% of women of all ages. It gradually regresses after menopause, but if you are currently suffering from anemia or excessive menstruation, you may have uterine fibroids. We asked Mr. Hironori Asada, a specialist, about the types and symptoms of uterine fibroids.

Table of contents

  • Coverage and supervision: Profile of Hironori Asada
  • The cause of uterine fibroids is unknown 
  • Classification of uterine fibroids
  • Main symptoms of uterine fibroids

Coverage and supervision: Profile of Hironori Asada

Hironori Asada Director of Obstetrics and Gynecology at Shin-Yurigaoka General Hospital, Director of Minimally Invasive Gynecologic Surgery Center at Shin-Yurigaoka General Hospital. She is a certified physician of the Japan Society of Obstetrics and Gynecology, a board member of the Japan Society of Obstetrics and Gynecology Endoscopy, a laparoscopic technology certified physician, a reproductive medicine specialist of the Japan Society for Reproductive Medicine, and an obstetrics and gynecology instructor of the Japan Society of Obstetrics and Gynecology. Shin-Yurigaoka General Hospital in Kanagawa/Kawasaki City has the highest number of laparoscopic surgeries in Japan.

The cause of uterine fibroids is unknown 

Uterine fibroids are benign tumors that form in the muscle layer (inside the muscle) of the uterus. It is said to be the most common gynecologic tumor, occurring in 20-30% of women over the age of 30. Uterine fibroids are said to occur in more than 50% of women of all ages.

At this stage, we do not know the cause of why such a “bleed” occurs in the uterus. It is known that fibroids develop under the influence of female hormones secreted by the ovaries. is also not clearly understood.

Since fibroids are benign tumors, they do not grow indefinitely or spread to other organs like malignant tumors. Malignant tumors that form within the muscle of the uterus are called uterine sarcomas. If uterine fibroids are diagnosed by current image diagnosis such as MRI, it is almost certainly presumed to be a benign tumor. On the other hand, tumors that are suspected of being malignant in diagnostic imaging or that suddenly grow in size around menopause may be malignant diseases (sarcomas) and require early diagnosis and treatment.

Classification of uterine fibroids

In general, multiple uterine fibroids are often formed, and they are classified into three types according to the location of the uterine fibroids. The most common type is intramural fibroids, which occur in the muscles of the uterus, and account for about 70% of all uterine fibroids. In addition, there are “submucosal fibroids” that occur inside the uterus and “subserous fibroids” that occur outside the uterus.

Submucosal fibroids that form inside the uterus tend to cause strong symptoms even if they are small, and the amount of menstrual flow increases. Conversely, subserosal fibroids outside the uterus tend to be less symptomatic even if they grow larger. Intramural fibroids occur in the wall of the uterus, and can be said to be an intermediate type between submucosal fibroids and subserous fibroids in terms of location and symptoms.

Main symptoms of uterine fibroids

80-90% of people with uterine fibroids do not develop any symptoms and often go unnoticed until they are discovered during a cervical cancer screening. On the other hand, 10% to 20% of patients have symptoms that interfere with daily life and require some form of treatment.

Main symptoms of uterine fibroids

  • Menorrhagia, anemia
  • dysmenorrhea
  • Frequent urination
  • pain during intercourse
  • infertility

Typical symptoms include heavy bleeding (hypermenorrhea) and abdominal pain before or during menstruation (dysmenorrhea). However, dysmenorrhea, which causes severe pain, is more common in endometriosis (adenomyosis: a condition in which endometriosis occurs in the myometrium) than in fibroids. I can’t generalize.

It is estimated that about 60 to 70% of anemia is caused by menorrhagia if menstrual cycles occur. However, there are many cases in which anemia is neglected because the amount of bleeding is large and chronic anemia is difficult to recognize.

It can also affect fertility. A slight increase in menstrual flow may indicate a deformed uterine lining. If you are having trouble getting pregnant, we recommend that you take a checkup or consult with a nearby obstetrics and gynecology department.

On the other hand, the size of the fibroid may also cause symptoms. In general, the uterus of women in the sexual maturity period (from the end of puberty to menopause) is about the size of a hen’s egg. As a result, there are symptoms such as frequent urination and continued pressure symptoms in the pelvis.

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