Intramural myoma is a type of benign tumor that forms within the muscular wall of the uterus, called myometrium, and in most cases is caused by changes in hormonal levels, mainly estrogen, which leads to the disordered multiplication of cells in the uterine muscular tissue.
Uterine fibroids do not always cause symptoms and can be discovered during routine gynecological examinations. However, symptoms such as abdominal pain, increased menstrual flow and changes in fertility may appear, especially when the fibroid increases in size or when there are several fibroids.
Read too: Types of uterine fibroids: main symptoms and how to treat
Therefore, in the presence of symptoms of intramural fibroids, a gynecologist should be consulted so that the diagnosis can be made and, if necessary, the most appropriate treatment can be initiated, which can be done by performing surgery or using medication to control the condition. fibroid growth.
Intramural fibroid symptoms
The main symptoms of intramural fibroids are:
- Pain in the lower abdomen;
- Increased abdominal volume;
- Abnormal menstrual bleeding;
- Constipation;
- Difficulty urinating;
- Bleeding outside of the menstrual period, however, is not as common in this type of fibroid.
These symptoms may appear, especially when there are many intramural fibroids or when the fibroid increases in size, as in most cases the intramural fibroid does not cause symptoms, being identified through gynecological imaging tests.
Therefore, in the presence of symptoms indicative of intramural fibroids, it is important to consult a gynecologist so that tests can be carried out and the most appropriate treatment can be started.
Intramural fibroids make pregnancy difficult?
Intramural fibroids usually do not cause difficulty getting pregnant or infertility. However, if the fibroid is very large, it can cause changes in the shape of the uterus, as well as changes in circulation and increased inflammation, which can make embryo implantation and pregnancy difficult.
A woman who has myoma and becomes pregnant can have a normal pregnancy, however, in cases of very large tumors or those that cause many symptoms, there may be greater difficulty in the development of the fetus. Therefore, it is important that women who have fibroids and who plan to become pregnant follow up with a gynecologist, so that treatment can begin, if necessary.
How to confirm the diagnosis
The diagnosis of intramural fibroids is made by the gynecologist through the evaluation of symptoms, health history, gynecological examination and blood tests, such as beta-HCG to rule out pregnancy, complete blood count, and hormonal levels of TSH and prolactin, to rule out others. diseases that may have similar symptoms, such as uterine polyps, adenomyosis or leiomyosarcoma, for example.
Make an appointment with the gynecologist in the region closest to you:
In addition, the doctor must order imaging tests, such as transvaginal or pelvic ultrasound, magnetic resonance imaging or diagnostic hysteroscopy, which allow the size, quantity and shape of the fibroid to be assessed and confirm the diagnosis. Check out other tests and symptoms that help confirm the diagnosis of myoma.
Possible causes
The exact cause of intramural fibroids is not yet fully known, however, some factors may contribute to its development, such as:
- Hormonal changes, especially high estrogen levels;
- Early first menstruation, before the age of 12;
- Late menopause;
- Never having been pregnant;
- Obesity;
- Family history of uterine fibroids.
Furthermore, some factors can increase the risk of developing this type of fibroid, such as a diet rich in red meat and low in vegetables and excessive consumption of alcoholic beverages.
Although intramural fibroids are the most common type of fibroids, other places that tumors can develop include the inner lining of the uterus, called submucosal fibroids, or in its outermost part, called subserosal fibroids. See more details about the types of fibroids and causes.
How the treatment is carried out
Treatment for intramural fibroids is not always necessary, and only follow-up with a gynecologist, with gynecological and imaging exams, to evaluate the growth of the fibroid and symptoms may be recommended.
However, in the presence of intense symptoms of intramural fibroids, the gynecologist may recommend some treatments, which include:
- Anti-inflammatory medicinessuch as ibuprofen or naproxen, to relieve abdominal pain and reduce excess bleeding;
- Oral contraceptives combined or containing only progesterone, to help alleviate the intensity of menstruation and reduce the size of the fibroid;
- Gonadotropin-releasing hormone agonists (GnRH), which help inhibit the production of estrogen and progesterone, preventing women from menstruating and reducing the size of fibroids;
- hormonal IUDsuch as Mirena, which helps reduce the size of intramural fibroids;
- Miomectomia, which is surgery to remove the fibroid, without having to remove the uterus. See how myomectomy is performed;
- Hysterectomyis another type of surgery, performed to remove the entire uterus, preventing complications from myoma.
Another possibility is to perform surgical procedures, which include embolization or occlusion of the uterine artery, which allows the blood supply to the uterus to be interrupted, thus reducing the flow to the fibroids, relieving the symptoms of heavy bleeding, and is normally indicated for women who they want to preserve fertility.
Read too: Embolization: what it is, what it is for, how it is done (and care)
