Understanding Uterine Myoma
Myoma is a mass or flesh growth in the uterus or outside the uterus that is not malignant. Myomas originate from smooth muscle cells in the uterus and in some cases also originate from the smooth muscle of the uterine blood vessels. The number and size of myomas varies, sometimes one or more than one is found. In general, myomas are located on the uterine wall and protrude into the endometrial cavity or the surface of the uterus. Most asymptomatic myomas are found in women aged 35 years, while a small number are found accidentally during routine examinations in women of reproductive or childbearing age.
It is best to carry out regular health checks, so that the myoma does not become more malignant. The reason is, myoma can cause miscarriage and is one of the reasons for removing the uterus (hysterectomy). Myomas can develop into malignancies, and the condition is known as leiomyosarcoma. However, the possibility of myoma becoming malignant is quite small. Myomas can cause complications in the form of torsion or twisting, which can cause acute circulation disorders, resulting in tissue death.
Risk Factors for Uterine Myoma
The following are several risk factors that can increase a person’s risk of developing myoma:
- Family history of myoma/heredity.
- First menstruation before the age of 10 years.
- A diet high in red meat, but low in green vegetables.
- Have never been pregnant before (women who have had children tend to experience myomas less frequently).
- Excess weight or obesity.
- Habit of consuming alcoholic drinks.
- Smoking habit.
- African-American descent is 2.9 times more likely than Caucasian descent.
- Use of hormonal contraceptives that are high in estrogen.
Causes of Uterine Myoma
The exact cause of myoma is still unknown at this time. Even so, myoma growth is closely related to the production of the hormone estrogen. Myomas show maximum growth during the reproductive period, namely when estrogen production is high, so they tend to enlarge when women are pregnant and shrink when women enter menopause. Several other studies also explain that each myoma can arise from a single malignant cell located between the smooth muscles in a woman’s uterus.
Symptoms of Uterine Myoma
Generally, myoma does not cause symptoms that the sufferer is aware of. Some general symptoms that can be felt are:
- Menstruation in large quantities.
- The stomach feels full and enlarged.
- Urinary disorders due to the size of the myoma pressing on the urinary tract.
- Myoma discharge through the cervix is generally accompanied by severe pain, causing injury and secondary infection.
- Constipation due to myoma presses on the lower part of the large intestine.
- Prolonged and unresolved pelvic pain, which can be felt during menstruation, after sexual intercourse, or when there is pressure on the pelvis.
- Accumulation of fluid in the abdominal cavity.
Uterine Myoma Treatment
The doctor will diagnose myoma starting by conducting a complete medical interview regarding the symptoms and health history of the sufferer and family. In the advanced stage, the doctor will carry out a thorough physical examination, especially of the uterus, using a bimanual method to find a tumor in the uterus. After that, the doctor will carry out appropriate supporting examinations, which can include ultrasound and magnetic resonance imaging (MRI) to confirm the location and size of the tumor.
The doctor will carry out several treatment options that can be used to treat myoma, namely as follows:
- Giving anti-pain in the form of paracetamol.
- Physical examination and ultrasound, which should be repeated every 6-8 weeks to monitor myoma growth, both in size and number. If growth is stable, the sufferer is observed every 3-4 months.
- Treatment with hormonal therapy, using progestin or gonadotropin-releasing hormone (GnRH) preparations.
- Myomectomy procedure, which is a surgical procedure to remove myomas. This procedure is considered if a woman is still young and still wants to have more children. The possibility of myoma growing again after myomectomy is around 20-25 percent. After surgery, sufferers are advised to postpone pregnancy for 4-6 months, because the uterus is still fragile.
- Hysterectomy procedure, namely a surgical procedure to remove the uterus. This procedure must be considered first because women cannot get pregnant afterward. However, for those who often experience symptoms such as pain that does not go away, and experience recurring myoma growth even though they have undergone surgery, it is highly recommended to do so.
Prevention of Uterine Myoma
Several steps that can be taken to prevent myoma include:
- Do sports and physical activity regularly and regularly.
- Using hormonal contraceptives under the supervision of a doctor.
- Avoid smoking and drinking alcoholic beverages.
- Maintain ideal body weight.
- Follow a healthy diet that is high in fiber from vegetables and fruit, and avoid a diet that is high in fat and high in sugar.
If you experience symptoms such as pelvic pain that doesn’t go away, menstruation that lasts a long time and is painful, spotting or bleeding suddenly but not during menstruation, difficulty emptying the bladder, heavy bleeding from the vagina, or pelvic pain that comes on suddenly , you should immediately consult a gynecologist for further examination and treatment.
