Uterine Fibroids Treatment

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Uterine Fibroids Treatment in Germany 2020-03-09 Uterine Fibroids Treatment
All you need to now about Uterine Fibroids Treatment

Uterine fibroids (or uterine myomas) are benign tumors formed by myometrium cells. Most often, the disease occurs because of hormonal disorders in women of reproductive age after 30 years.

Causes of Uterine Fibroids

The disease is always preceded by the metabolic changes in the muscular fibers of the uterus. The facilitating factors for development of uterine fibroids are the following:

Disease development begins fromthe increased division of the cells in the muscular tissues of the uterus. As a result, a 3-4 mm nodule is formed that can growup to 4 cm.

The uterus increases, as if a woman is pregnant, and size of the fibroid is also determined as weeks of pregnancy (e.g., a fibroidthe size of 9 week pregnancy).

The severity of the symptoms depends on the rate of tumor growth and its location relatively the uterine walls.

At the onset of menopause, due to a drop of the estrogenlevels, the tumor decreases or completely disappears.

How to Recognize the Signs of Uterine Fibroids?

For a long time, the disease can be asymptomatic. As a rule, symptoms and signs of uterine fibroids are revealed when a tumor has already grown by a few centimeters. The incubation period can last from six months to several years.

Depending on the localization, size and rate of nodule growth, the symptoms of uterine fibroid includes:

Types of Uterine Fibroids

By the number of nodules, the disease can be classified as a single fibroid (one nodule) and multiple fibroids (several nodules).

Depending on the location of a tumor, there are 5 types of fibroids:

Diagnosis of Uterine Fibroids

You need to visit a gynecologistfor diagnosis. After anamnesis, you will have the following procedures:

If there is a chance of multiple nodules, the doctor also may assign MRI of the abdominal cavity, hysteroscopy, angiography (x-ray scan of uterinearteries using the contrast method), laparoscopy and histological examination of the tumor tissue.

What Is the Treatment for Uterine Fibroids?

Medications can only give temporary relieffor fibroids while they are taken. Therefore, many women who suffer from heavy menstrual bleedings and pains consider surgery.

Drug therapy – whichcan inhibit the growth of the tumor and do not let it to reach a critical size –is prescribed forsubperitoneal and intramuscular fibroids up to 12 weeks only. Painkillers help to relieve pain. Concomitant infections are eliminated with broad-spectrum antibiotics.

Hormone therapy helps to decrease estrogen levels, causing what is called “temporary menopause.”As a result, the growth of nodules stops, pains are gone and bleeding decreases. After discontinuation of the medication course, the menstrual cycle is restored.

But for effectivetreatment of uterine fibroid, medication alone is not sufficient, as it can only stop the tumor growth for a while but do not give a complete cure. To exclude the risk of such complications as infertility, the use of various surgical techniques to eliminate fibroids is recommended.

What is the SurgicalProcedure for Uterine Fibroids?

There are a few types of surgeries withtheir ownadvantages and disadvantages.

When going for surgery, the greatest hope of patients is that pain will leave them forever. And in most cases, pains, indeed, disappear or become weaker after surgery. But each intervention has its risks and consequences. If you have agreedforsurgery, it is worth to be sober-mindedabout the possible consequences and evaluate all the pros and cons carefully. The details of the procedure are determined by the operating physician, depending on the size, localization and number of fibroids. Not all methods are suitable for thosewomen who want to have children in the future.

Prior to surgery, a course of hormonal drugs, GnRH analogues,is prescribed (up to 3 months, whichmakes fibroid tissuesshrink and reduce in size. Due to this, the procedure of fibroid removal is more sparing and, practically, does not affect the layers of the uterine wall. To achieve this goal, German doctors use the medicine Ulipristal.

Removal of a single fibroid of large size is rather complicated, because deep scars can cause uterine bleeding, and, further,this bleeding becomes constant. In addition, there is no guarantee that after surgerythe pain will disappear completely. If,after the intervention, pains do not go over time, the uterus removal can be a solution. It is also possible to use uterine artery embolization, which allows you to get rid radical surgery. With this method, the blood supply to the fibroids is blocked.

FibroidRemoval (Uterine Myomectomy)

Uterine myomectomy involvesthe removal of fibroids, with the preservation of the uterus.

There are several methods to remove fibroids:

Surgery is carried out under general anesthesia. Which of the above methods is preferable depends on the number of lesions, their location and size. Today, doctors mostly try to avoid open surgery and perform myomectomy with laparoscopy, which is not a radical intervention and does not leave large scars. But with one large myomaor with multiple fibroids of different sizes, the use of vaginal access or laparoscopy is not possible.

The same as with laparotomy, using laparoscopy, it is possible to remove fibroids from the outer wall of the uterus, as well as those located in the abdominal cavity (pedunculated fibroids). Laparoscopy also allows you to remove fibroids that are located in the uterus but bulge outward, partially germinating into other layers.

Hysteroscopic access is used when a fibroid is located in the uterus, closer to the cervix. Myomectomy with vaginal access is considered even a gentler method than laparoscopy. Studies show that surgical intervention through the vagina is quick and does not cause bleeding.

Does Surgery Eliminate Discomfort and Pain Completely?

Most of the women who experienced discomfort and pain for a long time feel much better after surgery or do not have any pain at all. Studies show that approximately 90 out of 100 operated women, for a year or two, are satisfied with the result. About 20 out of 100 women examined after surgery were diagnosed with recurrent uterine fibroids.

Are There Any Risks of Surgery?

Studies that surveyed myomectomy show that:

Also, wound infectionsmay result in fever and pains in the lower abdomen. With laparoscopy, blood loss is several times less than with laparotomy and complications, in turn, are rarer.

After a while, adhesions in the abdominal cavity may appear. They are the scar tissues that “stick” the organs of the abdominal cavity to the abdominal wall. Scars and adhesions cause pain in the lower abdomen when moving, rotating and bending. Depending on the location of the adhesions, there may be some problems with the intestines, and the adhesions of the internal genital organs can lead to infertility.

How Myomectomy Is Related to the Ability to Have Children?

In most cases, the removal of fibroids does not lead to infertility, unless adhesions and large scars form and prevent the ovaries and Fallopian tubes from performing their functions. Studies were conducted to collect statistics on the outcomes of myomectomy among women who wanted to have children and got pregnantafter myomectomy. The results showed that there is no much difference between laparotomy and laparoscopy for women who plan to have pregnancylater. In both groups, almost all patients with the intention of having children after the surgery got pregnant within the next 2 years.

Often, the fibroids are removed for the sake of one single goal –to be ableto get pregnant. If a fibroid, for example, is located in the mucous membrane of the uterus, it can interfere with the process of implantation of a fertilized egg. Unfortunately, there are no studies and statistics on the removal of fibroids to increase the chances of pregnancy. Only few studies have been carried outand they do not fully prove the effectiveness of the surgery to improve fertility.

Uterus Removal (Hysterectomy)

Hysterectomy is a radical operation, and it is considered, when there is one large fibroid in the uterusor a number of small fibroids that are difficult to remove. Patients gofor hysterectomy with the hope that all their complaints will disappear, once and for all.

As with the removal of fibroids, there are a few waysto remove the uterus: it can be removed by laparotomy, laparoscopy or through a vaginal access. The latter two methods cannot be applied for all women. There is also a technique when the uterus is removed through the vaginawith laparoscopy.

The uterus can be removed completely or partially. Partial removal of the uterus involves the removal of only the body of the uterus with preservation of the cervix and partial secretion of the uterus.

Are There Any Complaints after Surgery?

When the uterus is removed, of course, fibroids completely removed as well. This type of surgery will prevent possible bleeding in the future and all complaints associated with it. Some women complain of pain and cramps in the lower abdomen after removal of the uterus, but these symptoms can be causedby diseases of other organs of the small pelvis.

It is difficult to say whichof surgeries is more effective and allows keeping the genital organs healthy for longer, as well as all the advantages and disadvantages of each procedure are not fully studied.

What Are Surgery Complications?

In 5 out of 100 women, serious complications can occur during the operation, such as possible damage to neighboring organs (the bladder, ureters, or intestine) or heavy bleeding. About 2 out of 100 women may need repeated surgery or emergency medical care soonafter the surgery.

Shortly after the procedure, there may be fever, or wound infection, or bladder inflammation. All this can be easily cured if has detected promptly. But when the inflammatory process is not treated, it will give complications. The risk of complications depends on the surgery technique and the surgeon skill and experience.

Which of the Above Methods Is Safer?

Removal of the uterus through vaginal access is considered to be the gentlest technique. The risk of infection is also low, in contrast to an abdominal access, as well as, the rehabilitation is 10 days shorter and operating through a small incision does not leave a large scar.

What are the Consequences of Hysterectomy?

Many women are satisfied after surgery, as their pain is completely gone. But, unfortunately, not all of the patients successfully undergothe operation. Some of them think that hysterectomy has deprived them of femininity. Because of these prejudices, some women procrastinate till the very last moment and do not dare for surgery. It is necessary to explainindividually to every woman in detail what the functions of the uterus are and that it is possible to live a full life without it. Every woman responds to hysterectomy in her own way. Many of thempositively change the attitude towards sex, as it no longer causes any pain, but there are also those who feelemotionallybad after the operation.

Indeed, women who have the uterus removed, enter the menopause earlier. Worsening of blood flow to the ovaries, which leads to decrease in female hormone production, is that cause early menopause. If, the ovaries are removed together with the uterus, the climacteric comes much earlier than in women with preserved ovaries.

It also happens that the removal of the uterus affects the functional activity of the bladder. Most patients do not experience this problem, but the risk of bladder weakness is always remains. One of the symptoms of bladder weakness is if urine slightly leaks when coughing, sneezing, laughing, or lifting heavy objects.

The cervix is located in close proximity to the bladder and rectum. When removing the uterus, the bladder and rectum partially lose their support and sag. Vaginal prolapse also can happen. As a consequence, a woman experiences discomfort and a pressure in the lower abdomen. There is also a risk of pelvic prolapse, which is higher in women who had weakness of the pelvic floor prior to surgery.

Whether there are advantages of a partial removal of the uterus before total removal, it is not enough studied yet. All the data from the studies undertaken till now does not prove any great difference between the methods, as well as their negative effects on the bladder function or sexual activity. After partial removal of the uterus, minor bleedings may occur, which results from the functioning of the basal cells at the base of the cervix.

Comparison of Myomectomy and Hysterectomy

The risks of complications after myomectomy or hysterectomy are equally high. The advantages and disadvantages of each method have not been sufficiently studied, as a short time has passed since the introduction of methods and no major studies have been conducted on these issues. Myomectomy has a great advantage if the patient wants to have children after the operation. The surgery to remove uterine fibroids, in many cases, eliminates all complaints of the patient, and so does hysterectomy. But it is also possible that the lesions will appear again, causing pain and discomfort. There are no repeated complaints when the uterine body is removed.

Removing Fibroids: Does It Worth?

As a rule, surgery to remove uterine fibroids is not an exigency. So, you need to know all the pros and cons of each method to understand the situation better and make the right choice.

If a woman feels pressure from her private gynecologist, it is better to seek the advice of another doctorand listen to his or her opinion. The patient's family and friends should also study the situation and think it over in order to help her make the right decision. Although only a doctor can decide what treatment is best in each individual case, there aremany other factors to be considered.

The method of surgeryalso depends on the experience and skill of the operating doctor. Quite often, doctors in clinicsare skillful only in one technique and, therefore, only this technique will be suggested. That is why it is very important to have one more opinion of an independent specialist, who can impartially assess the situation and offer an alternative or agree with your doctor's decision.

Laparoscopy for Uterine Fibroids

Many women face gynecological conditions that cannot be treated without surgery. This range includes a severe form of uterine fibroids that can lead to harmful consequences to the woman’s health.

With small nodules in fibroid tissue, a drugtreatment is sufficient. However, with the progressive growth of a benign tumor surgery is required promptly.

After surgery, you have to be monitored for a long time, and it takes time to recover, and there are also many worries about possible complications. Sometimes, curing scars also requires repeated cosmetic procedures.

Fortunately, modern medicine can offer a unique technique to get rid of tumors without much damage to the body: removal of uterine fibroids by laparoscopic method. Unlike traditional surgery, this operation is performed through a small opening from 0.5 to 1 cm in size.

Thanks to the team of world-famous and dedicated experts, our clinic gives a chance to every woman to cure fibroidscompletely and finally. The most of surgeries arecarried out with aminimally invasive approach, which minimizes tissue trauma and the risk of further complications, and, consequently, eases rehabilitation.

If you have been diagnosed with a benign uterine tumor, contact our doctors. With us, you can have highly effective surgical procedure, removal of the uterine fibroids by a laparoscopic method, at affordable prices.

We offer all advances in the field of medicine together with know ledgeand high skill of the medical staff. We choose and apply only the best and safest methods of treatment that increase the chances of complete restoration of women's health.

When Laparoscopy for Uterine Fibroids Is Recommended?

The indications for the procedure are the following:

With subserous uterine fibroids, the surgery is mandatory; in this case, conservative methods cannot give the proper effect.

Surgery to remove uterine fibroids is not allowed if the size of the tumor is greater than 6 cm and myoma has penetrated into the muscular walls.

Why Laparoscopy for Uterine Fibroids Is Better than Traditional Surgery?

When Laparoscopic Removal of Uterine Fibroids Is Contraindicated?

If a patient has anemia, arterial hypertension and acute infections, it is necessary to treat them first. Only then,a non-cancerous tumor can be removed by a laparoscopic method.

The Procedure for Uterine Fibroids

Laparoscopy is an abdominal surgery to remove uterine fibroids. The duration of the surgery is from 40 minutes to 1.5-2 hours, depending on the severity of symptoms caused by one or more fibroids.

Surgery is strictly not allowed during menstruation. The operation can be assigned on any other day of the cycle, but best after ovulation (15-25 days of the cycle).

Laparoscopy to removeuterine fibroidsrequires general anesthesia and is performed in 3 stages:

  1. A puncture is made in the abdominal wall, and, then, the abdominal cavity is filled with carbon dioxide.
  2. A laparoscopic endoscope is introduced into the abdomen. It has a camera at the end that is used for viewing the uterus on the monitor at a large scale.
  3. Removal of the uterine fibroid.

What to Do before and after Laparoscopy?

Shortly before surgery, you should stop eating and drinking (a day before, you are allowed to eat till 6 p.m. and to drink till 10 p.m.). To prevent possible injuries to the intestines, a cleansing enema is assigned. And before the procedure you should exclude products that can cause flatulence (as cabbage, beans, etc.).

A few hours after the operation, doctors recommend a short walk. It will help prevent adhesions in the pelvic area. Excessive physical activity during rehabilitation is strictly prohibited.

Six months after the surgery, your doctor can recommend repeated laparoscopy. Itensures you from adhesions formedduring this time or relapse of uterine fibroids.

Our goal is to help you feel healthy and happy, and return back to normal life with your family and friendsas soon as possible. Your good health is the subject of our close attention. To succeed in this we have been continuously striving for excellence.

Uterine Artery Embolization for Uterine Fibroids

To date, uterine fibroids have been recognized as one of the most common benign tumors. According to statistics, every third woman after 30 years is diagnosed with this disease.

In the initial stages, the disease does not necessarily cause discomfort. However, the growth of the tumor leads to painful sensations and an abdominal growth, as in pregnancy.

Medication therapyis often ineffective, even for small tumors. Radical surgery is also not an option for everyone. For a young woman, removing a tumor together with the uterus means toput offforever hopes for the joy of motherhood and harmonious intimate relationships.

The newest methods of treatment of gynecological diseases in Germany are known throughout the world. The health of each patient is the main focus of the doctors of our clinic. They will help you not only completely cure the disease, but also maintain reproductive function without traumatic surgical interventions.

We provide our customers with a number of high-quality services. Our qualified surgeons perform the procedure using modern angiographyequipment. The use of advanced technologies minimizes your stay in the hospital.

There are various methods for treating uterine fibroids in Germany. Uterine artery embolization is one of the most popular. It is a non-surgical removal of the tumor that does not involve anincisionin the abdomen.

The state-of-the-art technologies and experts in gynecology of our clinic guarantee you effective treatment, a quick recovery and no relapse. The price for uterine arteryembolization is calculated individually for each patient based on the age, the diagnostic procedures held, the treatment methods and the rehabilitation measures.

When Uterine Artery Embolization Is Performed?

The procedure is indicated for the following cases:

When Uterine Artery Embolization Cannot Be Carried Out?

The procedure is contraindicated in patients the following diseases:

What Are the Advantages of Uterine Artery Embolization?

Studies in the field of gynecology showed that,in 90% of women who underwent the procedure, signs of uterine fibroids completely disappeared, including those patients who had a frequent urge to urinate, severe bleeding, and pains in the low back pain and lower abdomen.

After embolization, the tumor is reduced by half of the original size. In addition, it softens and stops pressingthe organs of the small pelvis. The procedure provides the best cosmetic effect, as it does not involve a surgical incision.

There are few complications in the postoperative period and almost no blood loss. Unlike with other treatments of fibroids, after embolization patients quickly return to their normallives.

Uterine Artery Embolization: Procedure

Medicine in Germany today is the treatment of diseases of female sexual organs by modern non-surgical methods. Tumorsare removed without damage to the pelvic organs, almost without blood loss and with preservation of healthy uterine tissues.

Treatment is assigned after the primary consultation of the gynecologist and ultrasound examination. Embolization of uterine arteries takes not more than half an hour and includes the following:

As a result, artery lumens in afibroid are clotted and the blood flow stops, after which the fibroid gradually dissolves.

Surgery versus Uterine Artery Embolization

The following table shows all the advantages and disadvantages of various surgical procedures aimed to help a patient to get rid of persistent bleedings and pains in the lower abdomen. The purpose of the surgeries is to remove or excise fibroids to exclude the patient's complaints.

Myomectomy is possiblein most cases. There are no well-founded scientific data on the removal of fibroids, as a solution for infertility.
  • Mitigates or eliminates complaints of 9 out of 10 women.
  • Women after surgery remain fertile.
  • Fibroids can relapse and after a while neoplasms will appear (in about 20 out of 100 women).
  • Possible complications: Damage to the abdominal organs, repeated surgery (approximately in 5 operated women out of 100).
Embolization of uterine arteries is often used as an alternative to myomectomy or hysterectomy. As a rule, this method is suitable for women who do not plan to have children in the future.
  • Eliminates complaints of 9 out of 10 women.
  • The recovery time after uterine artery embolization is much shorter than that with myomectomy or hysterectomy.
  • Sometimes pain disappears only for a while: about 20 women out of 100 need a second intervention.
  • Uterine arteryembolization adversely affects fertility, and if fertilization is successful, malformations of a fetus are probable. Possible side effects: pain, damage of blood vessels, inflammation, and recurrence of fibroids.
  • Side effects and required secondary treatment are the same as with myomectomy or hysterectomy.
Hysterectomy is used if a patient does not plan to have children in the future, or if other methods were ineffective.
  • After surgery, the patient does not have any unpleasant sensations.
  • Pregnancy is impossible.
  • Possible complications: damage to the abdominal organs (in 5 operated women out of 100).
  • Long-term complications: Weakness of the bladder, vaginal prolapse, and pelvic organ prolapse. Menopause occurs earlier.
  • Some women complain ofunpleasant feelings at rest or with sexual activity, as well as psychological disorders.

How Long Rehabilitation after Uterine Artery Embolization Takes?

After 1-2 hours after the procedure, mildnagging pains in the lower abdomen may appear. At the end of the day, the pain will decrease and after a week completely stop.

Sometimes, there may be bloody vaginaldischarge and a slightly increased body temperature. In this case, antibacterial and antipyretic drugs are prescribed. The patient is discharged from a hospital in 2-3 days after the procedure, when the general health condition improves and pains disappear.

Routine examinations and ultrasound are performed 1, 3, 6 and 12 months after embolization. In the future, they are recommended annually.

In the treatment of uterine fibroids in the German clinic, the chances for cure after uterine arteryembolization are high enough. Complete recovery with no subsequent relapse can be achieved in 90% of cases, regardless of a stage of the disease.

Strong research basis and application of the latest technological equipmentensure effectiveness of therapy.A high level of development in the field of gynecology in Germany allows us to expect successful result, even in the patients diagnosed with large tumors.

The medicines of new generation, innovative techniques, modern equipment, a delicate attitude of specialists, caring atmosphere, andreasonable prices for uterine artery embolization in our clinic are a guarantee of successful therapy that allows our patients to forget about uterine fibroids forever.

Non-surgical Treatment for Uterine Fibroids

In the treatment of uterine fibroids, the most important thing is to detect the tumor timely and slow down its growth. For this, conservative therapy is assigned that mostly administered on an outpatient basis.

If you are diagnosed with uterine fibroids, experienced German gynecologists will help you. In our clinic, the first step on the way to complete cure is non-surgical treatmentof uterine fibroid. Itincludes a complex conservative therapy involving the hormonal drugs intake.

In recent years, the newer medications for non-surgical treatment and prevention of uterine fibroidsareused in our clinic, which contributes to recovery in the shortest possible time.

Due to timely prescribed medication for uterine fibroids, nodules in the uterus are reduced significantly and symptoms disappear. Subsequently, you need routine examinations and ultrasound to monitor possible growth of residual myomas to their original size.

How to Treat Uterine Fibroids at Early Stages?

Non-surgical therapy is prescribed for small uterine fibroids in early stages of development and with slow rate of myomagrowth.

Drug treatment of uterine fibroids prevents further development of uterine benign tumors and helps maintaining reproductive function.

Hormonal medicines are one of the options for uterine fibroids. Theiradministration inhibitsthe ovulation cycle. As a result, the patient has an “artificial” menopause. Usually, the duration of the course lasts at least for six months.

Hormone therapy for uterine myomas is effective if the tumor has not reached the critical size (up to 12 weeks and up to 2 cm in diameter).

Sometimes, hormone therapy is used to reduce myoma before it is removed. Mostly, huge myomas cannot be treated with drugs and require immediate surgical intervention.

Typically, a doctor selects several hormonal drugs that complement each other: gestagens, androgens and combined contraceptives.

Like any other medication, hormones have a number of contraindications. It is not recommended to take medications after the onset of menopause, with dynamically developing osteoporosis, allergies to the components and reactions from the digestive organs.

Which Vitamins Are Prescribed for Uterine Fibroids?

Often the progressive growth of myomas is accompanied by heavy bleeding. Massive blood loss can lead to anemia. Therefore, maintenance therapy is required to prevent severe depletion of the body.

For such conditions, doctors prescribe to patients vitamin complexes containing the following elements:

Other Treatments for Uterine Fibroids

Treatment of uterine fibroids without surgery also includes such procedures as uterine artery embolization and FUS (or thermal ablation).

Using these methods helps achieve no less effective results than with surgical intervention.

Embolization of the uterine arteries is a relatively new therapeutic technique, but it has already become popular among patients of our clinic. The procedure involves puncturing the femoral artery and introduction a special agent through a catheter. The purpose of the procedure is to block the blood flow in the arteries supplying nutrients to fibroids, after which they aredeprived of oxygen and, then, gradually dissolves.

Advantages of embolization: it excludes the formation of a secondary tumor, has short rehabilitation and helps preservere productive function. With this method, treatment is carried out regardless the size of lesions.

FUS ablation is a unique technique, widely used in the treatment of uterine fibroids in Germany. The essence of the method is to destroy the tumor by ultrasound remotely under the control of MRI.

The procedure lasts about four hourson the average. The method is based on using sound waves to eliminate fibroids. Focused waves heat the tumor up to a temperature of 70-85°. As a result, thermal necrosis of fibroid tissue occurs.

The main advantages of this technique are the absence of blood loss, preservation of the uterus and highly effective results, even in the treatment of multiple myomas.

The procedure is not carried out in the following cases:

Studies have shown that in women who had the FUS ablation procedure, fibroids decreased by a factor of 2.

Non-surgical treatment of fibroids is reduced to the assignment of a number of sparing procedures. In the early stages of the disease, we will help you recover completely without any surgery.

Doctor talent and many years of experience are the main means in the fight against gynecological diseases in our clinic. Treatment assumes the careful control of the quality of the services provided, and our personnel are always affable and well-wishing. That is why women from all over the world trust the specialists of our clinic.

After a checkup, you will be prescribed medication for fibroids. Our gynecologists and surgeons will do their best to help you get away from the disease and normalize the functioning of the reproductive system. With our help, nothing will prevent you from becoming a happy mother.

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Latest News in Uterine Fibroids Treatment

Fibroids: when they become a problem


Benign growths in the uterus called fibroids are very common. Over time, around one in three causes symptoms such as bleeding and symptoms such as a feeling of pressure or increased menstrual pain. The professional association of gynecologists on the net points this out.

Fibroids occur because natural hormones act on the muscle cells in the uterus, causing them to overgrow. Two out of three fibroids remain normal for life and do not cause any symptoms of the disease. In about every third myoma disease, however, prolonged and increased bleeding or intermenstrual bleeding can occur, and rarely pain in the uterus or in the vicinity of the urinary bladder and intestinal anus. In some cases, fibroids can also be the cause of an unfulfilled desire to have children. “The most common symptom of fibroid disease is increased menstrual bleeding. But there are also intermenstrual bleeding and pain, ”explains Dr. med. Christian Albring, President of the Professional Association of Gynecologists and established gynecologist in Hanover. The diagnosis is secured with the help of ultrasound; only rarely do additional examinations need to be carried out.

If a fibroid does not cause any symptoms, does not press on neighboring organs and is not jointly responsible for an unfulfilled desire to have children, according to Albring it usually does not have to be treated. "If symptoms are already present, treatment must be considered, because these symptoms tend to get worse by waiting," says the gynecologist.

If a woman does not want to undergo an operation, the options are limited: "You can use drugs to inhibit the binding of the body's own progestin to the associated receptors," explains Albring. “Or you can use other drugs to intervene directly in the hormonal control of the cycle in the brain and block the natural production of estrogen and progestin. The growth of fibroids is slowed down. However, this treatment leads to symptoms of menopause - a side effect that many women reject."

In addition, there are a number of surgical procedures to shrink or remove fibroids: these include keyhole surgery, sclerotherapy of the blood vessels that supply the fibroids with blood, or localized heating with strong ultrasound. However, some of these procedures are not suitable if you still want to have children, if fibroids are too large, do not fit properly or there are too many. "It is important that the uterus heals well after an operation, the symptoms disappear and the bleeding stops," says Albring. The last option is to remove parts of the uterus or the entire organ. However, this is seldom necessary, the specialist reassures: “A woman who turns to her gynecologist about bleeding or other symptoms of a fibroid should not have to worry that such an operation will be carried out prematurely on her. The first choice is always to find a gentle therapy that makes it possible to preserve the uterus."

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