What are fibroids?

Fibroids are benign tumor of the uterus that many women deal with: it is estimated that in Europe every second to fifth woman of childbearing age has fibroids. The growths in the muscle layer of the uterus usually develop between the ages of 25 and 50. The fibroids in the uterus - the uterus - can vary in size - from a few millimeters to 20 centimeters, which is roughly the size of a melon. Their number in the uterine wall also varies: some women develop individual muscle nodes, while others develop a large number of tumors. Experts refer to a uterus with fibroids and possibly enlarged as a result as uterus myomatosus.

As long as fibroids are small and do not grow very close to the lining of the uterus, they usually do not cause any symptoms. Women don't even notice them then. Often gynecologists discover them by chance during a (routine) examination. As a rule, fibroids are not dangerous. However, if they get bigger and cause discomfort, they can have a significant impact on women's quality of life.

Myomas - different places of growth

Doctors differentiate between different types of fibroids - depending on the place where they develop:

• submucosal: The fibroids grow just below the lining of the uterus.
• intramural: The benign muscle nodes are located in the muscle layer of the uterus.
• Subserous: The fibroids form on the outside of the uterus under the peritoneum.
• intracervical: the tumors grow in the muscle layers around the cervix (cervical fibroids)
• intraligamentary: fibroids develop in the connective tissue layers on the side of the uterus
• stalked intracavity: the nodes protrude into the interior of the uterus

Can fibroids become cancerous?

Fibroids are extremely rarely malignant (less than one percent of cases). The medical term for malignant fibroids is myosarcoma or uterine sarcoma. Such degeneration of benign muscle nodes occurs almost exclusively during or after the menopause. Timely treatment is very important. Because - as with almost every type of cancer - the chances of recovery depend on how large the tumor is and whether it has already spread to the lymph nodes and other organs (metastases or cancerous settlements).

Fibroids: Symptoms are often excessive bleeding and pain

The fibroids cause symptoms in around 50 percent of women affected. The other half do not notice the tumors and therefore (mostly) do not need any treatment. Depending on the number, size and location of the benign tumors, myomas can manifest themselves through different symptoms. The most important are:

• Myomas often cause menstrual pain, which many women perceive as very severe and describe as cramp-like or labor-like. In addition, the menstrual period can be longer and longer than usual. Intermenstrual bleeding is also possible. If women bleed heavily or for a long time from fibroids, this can have consequences: anemia, clots or urinary tract infections.
• Back pain, increased urination, constipation or a feeling of pressure in the abdomen are less common with fibroids . Pain in the lower abdomen, legs, kidneys or during sexual intercourse is also possible. These symptoms arise when the fibroids become larger and press on neighboring organs (e.g. bladder, intestines) or nerve tracts.

Many of these symptoms follow the woman's menstrual cycle. That means: before and during menstruation they increase. However, fibroids above a certain size often cause symptoms throughout the cycle.

Sometimes fibroids grow to such an extent that the abdominal girth increases. However, some women rate such fibroid symptoms as weight gain and do not see a doctor. Some also misinterpret it as pregnancy. Always see your gynecologist if your belly gets inexplicably bigger. There could also be fibroids behind it.

Note: The menopause can be a good, "endogenous" remedy for fibroids symptoms: In the menopause the symptoms often subside by themselves. The reason is that the growth of the fibroids depends on the female estrogens. During the menopause, however, the production of these sex hormones decreases continuously.

Treating fibroids - there are several options

Whether you should have fibroids treated depends on whether the tumor is causing discomfort and how severe it is. There are various treatment option, depending on the symptoms, the size, number and location of the muscle nodes and your age (desire to have children?).

Medicines for fibroids

Doctors use drugs for fibroids that affect the production of the female sex hormones estrogen and progesterone. Examples are so-called GnRH analogues or ulipristal acetate (UPA). They don't get rid of the fibroids themselves, they just alleviate the symptoms. For example, doctors try to bridge the gap between menopause. The medication is also an option if the fibroids are to be operated on later or if an operation is not possible.

Painkillers such as nonsteroidal anti-inflammatory drugs (NSAIDs) help against period pain . Frequently used active ingredients are acetylsalicylic acid, iboprofen or diclofenac.

Remove fibroids using surgery

Surgeons can use surgery to remove fibroids from the uterus. Myomectomy is the technical term for it. It used to be the standard to remove the uterus (hysterectomy) in older women who did not wish to have children if they had fibroids. Today, however, doctors are increasingly using gentler, minimally invasive procedures that only remove the fibroids, regardless of age. For example, the surgeon switches off the fibroid. Myoma enucleation is the technical term for this procedure. The uterus is preserved. A fibroid operation is only advisable if medication does not have the desired effect or if women are not allowed to take them.

Treating fibroids using other methods

The Myomembolisation is a treatment option when women experience severe pain or menstrual period is very strong. This procedure take advantage of the fact that fibroids cannot grow without a supply of blood. The doctor inserts tiny plastic balls into the blood vessels of the fibroid. These globules clog the blood vessels and block the blood supply to the fibroid. The result is that the fibroids dry out, shrink, and in some cases die completely.

It is also possible to treat the fibroids using ultrasound . The doctor directs the sound waves of a so-called magnetic resonance-guided focused ultrasound (MRgFUS) onto the fibroid tissue, which dies under the great heat. However, this method only works for tumors up to a maximum of ten centimeters in size.

Fibroids: Homeopathy, Plants, and Home Remedies

If the fibroid are not causing you any symptoms, you can simply wait and see in consultation with your doctor. Some women treat their fibroids using homeopathy, naturopathy or home remedies. They try to keep them under control with "gentle" methods until they go away on their own during menopause. However, there is no clears scientific evidence for the effectiveness of these alternative healing methods.

• The herbal medicine , for example, relies on fibroids progesterone-containing plants such as lady's mantle, monk pepper or yarrow in the form of tinctures, teas or finished preparations. Warming plants such as ginger, lovage, marjoram or basil are also used.
• Some women also try to cure the fibroids by dissolving baking soda in water and drinking it. Due to the alkaline effect, the fibroids are supposed to shrink. Apple cider vinegars is said to have a similar effect. The effectiveness has not been proven.
• Warmth is good for abdominal pain, for example, in the form of a hot water bottle or a cherry stone pillow.

• Even baths with an addition of field horsetail, lady's mantle or yarrow should be good for myoma-related pain.
• In the case of heavy bleeding, preparations with tormentil or shepherd's purse as tincture, tea or ready-made preparations from the pharmacy can help. Always seek advice from an experienced expert.