Every year millions of women are diagnosed with uterine myomatosis, a disease characterised by the formation of non-cancerous tumours on uterine tissue (Giuliani, 2020). It affects approximately 70% of women globally (Brito, 2019). But, you may ask, what is it? To answer this and understand why it appears, we share a short summary below (Tochie, 2020; Stewart, 2016):

• A myoma or fibroma is a mass of muscles and other cells that make up the uterus.
• Research suggests that they are generated from a cell cloned into a mass.
• Such a cell and its clones also respond to hormones such as oestrogen.
• Hence, in the presence of hormones, the fibroid can grow and affect the functioning of the uterus.
• The size of the fibroids and their number can be variable. Although myomatosis is very common, only 25% of women usually present symptoms (Brito, 2019).

Considering that myomatosis is so common, here we will share more detail about the condition and why it can often be confused with traditional menopause symptoms.

Risk factors for uterine myomatosis

While many women may have fibroids right now, only some will grow and cause symptoms. This is due, in part, to the presence of certain risk factors, such as (NIH, 2018; Pavone, 2018):

• Myomas are more common in older women than in young women.
• Obesity.
• High blood pressure.
• Nulliparity (no history of pregnancy).
• Family history of fibroids.
• Vitamin D deficiency.
• Insulin resistance or diabetes.
• Consumption of alcohol or tobacco.
• Stress.
• Increased hormonal activity (for this reason, they usually decrease in size at menopause).

Signs and symptoms of uterine myomatosis

Uterine fibroids are responsible for a variety of signs and symptoms. Some of the most relevant are (Barjon, 2021; MedlinePlus, 2022):

• Irregular menstrual cycle, with increased bleeding or a mixture of these symptoms.
• Painful intercourse.
• Increased urge to urinate.
• Low back pain.
• Presence of anemia due to bleeding.
• Intestinal problems.
• Sensation of mass, fullness, or weight in the belly.
• Feminine infertility.
• Brown discharge (accumulated blood from previous periods) (Heger, 2022).

It should be noted that uterine myomatosis can be confused with the onset of perimenopause, with irregular menstrual cycles or an absence of menstruation at times (Hoffman, 2020).

How is uterine myomatosis diagnosed?

A medical professional will conduct one of the following tests to diagnose uterine fibroids (Stewart, 2016):

• Pelvic or transvaginal ultrasound.
• Hysterosalpingography (X-ray images where contrast material is used).
• Magnetic resonance imaging.
• Hysteroscopy.

Although some of these studies are pretty invasive, in most cases, an ultrasound is sufficient (Hoffman, 2020). In addition to this, your medical professional, during the diagnosis, may perform a complete gynecological examination (Barjon, 2021).

Treatments

Once the diagnosis is made, your doctor may order one of the following treatments, depending on the type of fibroid or the severity of the symptoms it is causing (Giukiani, 2020):

• Use of medications such as tranexamic acid (helps improve blood clotting), pain relievers, or oral contraceptives.
• Minimally invasive surgeries.
• Surgical removal of the fibroid, a portion of the uterus or the entire uterus.

Does this disease occur in menopause?

Uterine fibroids can often cause symptoms during perimenopause and be confused with this stage, where significant hormonal changes occur, which allow them to grow (Ulin, 2020). Typically, in menopause, the symptoms cease, and they decrease in size. But in a few women (especially those with risk factors such as obesity), symptoms may persist (Ulin, 2020). For this reason, proper control and monitoring of uterine fibroids are essential.

Complications of uterine fibroids

Several of the symptoms of fibroids can be responsible for complications such as (Hoffman, 2020):

• Anemia secondary to bleeding.
• Sexual dysfunction.
• Emotional stress.

Now that you understand more about uterine fibroids, consider the importance of diagnosis and treatment to prevent further complications.

References

• Barjon, K., & Mikhail, L. N. (2021). Uterine leiomyomata. StatPearls Publishing. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK546680/ Brito, L. G.; Stewart, E. A.; Olivi Chaim, S. O.;
• Martins, W. P.; & Farquhar, C. (2019). Interventions for uterine fibroids: an overview of Cochrane Reviews. Cochrane Database of Systematic Reviews. Retrieved from: https://doi.org/10.1002/14651858.CD013426
• Giuliani, E., As‐Sanie, S., & Marsh, E. E. (2020). Epidemiology and management of uterine fibroids. International Journal of Gynecology & Obstetrics. Retrieved from: https://doi.org/10.1002/ijgo.13102
• Heger, E. (2022). 6 reasons why you may experience brown discharge. Insider. Retrieved from: https://www.insider.com/brown-discharge
• Hoffman, B. L., Schorge, J. O., Halvorson, L. M., Hamid, C., Corton, M., & Schaffer, J. I. (2020). Williams Gynecology (4th ed.). McGraw-Hill. MedlinePlus. (2022). Uterine fibroids | fibroids. Retrieved from: https://medlineplus.gov/uterinefibroids.html NIH. (2018). What are the risk factors for uterine fibroids? Eunice Kennedy Shriver National Institute of Child Health and Human Development. Retrieved from: https://www.nichd.nih.gov/health/topics/uterine/conditioninfo/people-affected
• Pavone, D.; Clemenza, S.; Sorbi, F.; Fambrini, M.; & Petraglia, F. (2018). Epidemiology and Risk Factors of Uterine Fibroids. Best Practice & Research Clinical Obstetrics & Gynaecology, 46, 3–11. Retrieved from: https://doi.org/10.1016/j.bpobgyn.2017.09.004
• Stewart, E. A.; Laughlin-Tommaso, S. K.; Catherino, W. H.; Lalitkumar, S.; Gupta, D.; & Vollenhoven, B. (2016). Uterine fibroids. Nature Reviews Disease Primers, 2 (16043). Retrieved from: https://doi.org/10.1038/nrdp.2016.43
• Tochie, J. N.; Badjang, G. T.; Ayissi, G.; & Dohbit, J. S. (2020). Physiopathology and Management of Uterine Fibroids. In (Ed.), Abduljabbar, H. Fibroids. Retrieved from: https://doi.org/10.5772/intechopen.94162
• Ulin, M.; Ali, M.; Chaudhry, Z. T.; Al-Hendy, A.; & Yang, Q. (2020). Uterine fibroids in menopause and perimenopause. Menopause, 27(2), 238–242. Retrieved from: https://doi.org/10.1097/GME.0000000000001438