What Every Woman Must Know About Myoma

By Gilbert de Guzman, MD

 

She has been with us for five years. A single mother in her late 40s, our helper is hard-working and very reliable. In one of our usual chitchat, I suddenly noticed that her belly was glaringly bigger than usual.

Despite her perky character, she looked pale and weak. I jokingly asked her, “Why is your tummy big? Are you pregnant?” She laughingly replied, “What do you mean? Immaculate Conception?”

 

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Then she turned serious. She admitted that she had also observed how her belly doubled its size in the past six months but  attributed the change to her voracious appetite. She noted a prolonged menstruation period—one lasting for 10 to 14 days and consuming six to eight menstrual pads a day. She had also been getting tired easily.

I measured her belly and found its size to be similar to that of a woman who is five months pregnant. She told me she dismissed all her symptoms as mere part of her menopausal phase.

Hysterectomy at 47

I had her examined by my ob-gynecologist-friend. A pelvic ultrasound revealed Myoma Uteri, a benign tumor of the uterus. Also, her Complete Blood Count showed anemia which could be due to her abnormal menstrual bleeding. She then underwent surgical removal of her uterus, fallopian tubes and ovaries (a procedure called Total Hysterectomy with Bilateral Salphingo-Oophorectomy).

What is Myoma? What makes one susceptible? Should you start calling your life insurance agent once you are diagnosed with the condition?

Myomas: Are You At Risk?

Myoma or Leiomyoma is the benign tumor of the muscle cells. Alternately, it is called as fibroids or fibromyoma.

It is the most common pelvic tumor among women.

Myomas can arise in any structure with smooth muscles, but in the pelvis, majority are found in the uterus, referred to as “Myoma Uteri.” In the succeeding section, allow me to use the term Myoma instead of Myoma Uteri as I refer to the smooth muscle tumor of the uterus.

Unfortunately, most, if not all of the risk factors associated with development of Myoma are not controllable:

• Increasing age (women in the fifth decade of life are the most frequently affected age group)
• Early Menarche (i.e. first onset of menstruation)
• Low parity (i.e., low number of pregnancies/deliveries)
• Intake of tamoxifen (a chemotherapeutic drug)
• Obesity
• High fat diet

There’s a reason it’s called bad diet. Photo credit: By Lucasmartin2 (Own work) [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons

The common denominator for the above risk factors is prolonged exposure to high levels of estrogen. For example, women who are single, have never been pregnant, or had their menstruation earlier than the average first onset of menstruation, have higher risks as compared to those who are married and have given birth.

When one gets pregnant, high levels of estrogen temporarily cease and get replaced by the pregnant hormone HCG (or Human Chorionic Gonadotrophin). Likewise, obesity, high fat diet, and long-term use of tamoxifen are all linked to high estrogen levels in the body.

Most Myomas reduce in size following menopause but often enlarge during pregnancy.

 

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As to genetic predisposition, African-American Women have the highest incidence while Hispanics and Asian Women have the same incidence as White women. Apparently, there is familial tendency. That is, if your mother or grandmother had Myoma, your risk to develop one is higher.

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