How to take serrapeptase for fibroids

Fibroids: These symptoms suggest removal

Fibroids grow in the muscle layer of the uterus. The tumors are benign, but can significantly reduce the quality of life and lead to childlessness. Myomas can be treated well with medication and, if necessary, gentle techniques.

Sometimes fibroids are as small as an inch, while others can grow as large as an orange. Fibroids are among the most common benign tumors of the female sexual organs. In Europe, around 30 percent of women over the age of 30 are affected.

The benign cell growths in the muscle layer (myometrium) of the uterus (uterus) are divided into different types depending on their location:

• Intramural fibroids grow within the muscle layer of the uterus
• Submucosal fibroids are located under the lining of the uterus, ie in the uterine cavity
• Subserous fibroids develop on the outside of the uterus towards the peritoneum
• Intraligamentary myomas are located in the connective tissue layers on the side of the uterus
• Cervical fibroids are growths in the muscle layers near the cervix

Fibroids - the search for the cause

There is probably a genetic predisposition to fibroids: the willingness to develop such a uterine tumor is often transferred from mother to daughter.

However, the exact trigger is still unknown today. What is certain is that fibroid tissue has far more receptors for estrogen than other uterine tissue. The female sex hormone estrogen stimulates the growth of the growth.

This explains why fibroids can grow uncontrollably in women of childbearing age who have a correspondingly high level of estrogen. On the other hand, the corpus luteum hormone progestin can slow down the growth.

Hormones therefore play the most important role in the development of these uterine growths, which is why myomas are also referred to as hormone-dependent tumors.

These symptoms are possible with a fibroid

The fibroid does not cause any symptoms in around a quarter of women. Often it is only discovered by chance during a preventive medical check-up. However, around three quarters of women will have one or more of the following symptoms:

• Bleeding disorders
• prolonged / heavy bleeding, which can lead to anemia and iron deficiency (anemia)
• Intermenstrual bleeding
• severe pain during your period
• Labor-like pain during menstruation
• Bladder problems such as pressure and the urge to urinate
• Unfulfilled desire to have children
• pain during sex
• kidney pain
• back pain

These often severe symptoms occur especially when the fibroid is very large or several fibroids have significantly enlarged the uterus (uterus myomatosus).

It also depends on the area in which the tumor grows. Typical symptoms of the most common type of myoma, intramural myoma, are around

• Bladder and bowel discomfort if the fibroid is pressing on the bladder or bowel.
• Lumbar pain and sciatica problems when the growth presses the nerve endings in the lumbar spine.

Influence of the fibroid on pregnancy

The subserous myoma is often the reason why the desire to have children is not fulfilled. Then the tumor blocks the fallopian tubes, for example. If the fibroid doesn't affect the fallopian tubes, pregnancy is entirely possible. However, statistics show that women who have a uterine fibroid are far more likely to miscarry or premature birth than others.

In addition, fibroids that were previously unproblematic can grow during pregnancy. The increased estrogen level during this time drives the growth.

Myoma - examinations for diagnosis

Each of the symptoms listed - from pain to heavy bleeding to an unfulfilled desire to have children - should be clarified by a doctor. The gynecologist can use the following examinations to determine whether a fibroid is present.

Based on the anamnesis, from the questioning about the symptoms, the doctor carries out the following examinations to diagnose a myoma:

• Palpation of the abdominal region from the outside as well as through the vagina
• Ultrasound examination of the vagina (vaginal sonography)

The size, shape and location of the growth also become apparent in this way.

If these examinations are inconclusive, the doctor will perform a uterine or laparoscopy. The uterine cavity is mirrored (hysteroscopy) through the vagina. If the fibroid is on the outside of the uterus, a laparoscopy is useful. Anesthesia is necessary for this, the incision is made in the navel so that the small scar is no longer noticeable later. Magnetic resonance imaging (MRI) also provides clarity.

Detecting uterine cancer and endometriosis

With these examinations, the doctor can also rule out whether a malignant tumor might be triggering the symptoms.

A special form of endometriosis, andenomyosis, also manifests itself in symptoms similar to those of a fibroid. The lining of the uterus (endometrium) grows into the muscle layer of the organ, the myometrium. This leads to numerous complaints because the scattered mucous membrane tissue is subject to the menstrual cycle, so it builds up and breaks down again with bleeding.

Differentiating between fibroid, cancer and endometriosis is very important because each of these diseases requires specific therapy.

Myoma - treatment depends on the symptoms and size

Various factors are important for the treatment of the fibroid, but above all how severe the symptoms are and how much the quality of life suffers. The patient's age also plays a role and whether she still wants to have children.

Together with the patient, the doctor will develop a treatment plan accordingly. There are different options for treating a fibroid:

• A hormone coil or long-term use of the pill (without a one-week break per month) can prevent the tumor from growing further.

• Hormone tablets, for example with progestins, slow down the production of estrogen and thus the growth of the fibroid. However, this hormone therapy puts women into premature menopause and is therefore only recommended for a few months. Doctors recommend this therapy if menopause could be reached soon anyway or before an operation in order to reduce the size of the fibroid and thus remove it more gently.

• Special fibroid tablets with the active ingredient ulipristal acetate can shrink the fibroid. The drug slows down the activity of the hormones that make the fibroid grow - and only works in the fibroid cells. The advantage: the tablet has a local effect and does not affect the entire hormonal balance. The tablets are taken at intervals of twelve weeks, followed by a break.

Myoma - when do you have to remove it?

If the fibroid does not respond to these therapies enough or if it is too big, the doctor advises other treatment options that shrink the fibroid significantly or even remove it completely. The goal is always to preserve the uterus.

There are the following options:

• Focused ultrasound: Here, high-frequency sound waves are directed onto the fibroid. They heat the growth to a little over 60 degrees, causing it to die. The treatment with focused ultrasound is controlled by magnetic resonance imaging and is painless. It is particularly suitable for women who still want to have children because the uterus is spared. However, the costs for this new method are not yet covered by all health insurers.

• Fibroids embolization: fibroids die when their blood supply is stopped. Myoma embolization takes advantage of this fact. The doctor pushes a tube through a small incision up to the blood vessels that supply the fibroid. Under X-ray control, he then injects tiny plastic particles that are biologically well tolerated into these branches. The blood supply is cut off and the fibroid shrinks in a few months. Myoma embolization takes place under local anesthesia.

• Endoscopic myoma enucleation: During a uterine or laparoscopy, the surgeon can peel the fibroid out of the uterine cavity or wall. The instruments used are now so sophisticated that they can even be used to remove larger myomas. General anesthesia is useful for minimally invasive surgery.

Myoma surgery (hysterectomy)

With all of the methods mentioned, the uterus is preserved. The whole uterus is only removed (hysterectomy) if the pain is very severe, if the fibroid is very large or if there are several fibroids (uterus myomatosus). Before making this decision, it is also important to have completed family planning.

The uterus can be surgically removed over

• the vagina,
• the rectum,
• a laparoscopy or
• a larger cut in the abdomen

A new development is the combination of a laparoscopy and removal of the uterus through the vagina.

The function of the ovaries remains after the hysterectomy, but may be somewhat limited. This is because the surgery sometimes affects the blood vessels that supply the ovaries. The hormonal cycle is more or less preserved, but there is no more menstrual bleeding and the childbearing ability is lost.

Menopause: Myoma resolves on its own

Fibroids must be treated as soon as they cause symptoms. Because they do not regress by themselves, on the contrary, they tend to gradually get bigger. There is one exception, however: With the onset of menopause, myomas shrink on their own. Because the sex hormones that fuel the growth of the growths are produced by the body to an ever smaller extent.

Author: MONIKA PREUK