Signs and Symptoms of Myoma
The manifestations of Myoma could be quite tricky. More than two-thirds of affected women have no symptoms. The severity of symptoms will depend on the number, location and size of the mass. Other common symptoms are:
• Pressure from the mass
• Pelvic Pain
• Abnormal Menstrual Bleeding
An enlarged Myoma will produce pressure symptoms similar to an enlarging pregnant uterus. There is an increase in abdominal girth but without change in weight. A Myoma that grows in front of the uterus that presses on the bladder may produce urinary frequency and urgency.
One in three women with Myoma complains of pelvic pain or pressure. It is described as pelvic heaviness or a dull aching sensation that may be secondary to edematous swelling in the Myoma.
Thirty percent of women with Myoma will experience abnormal bleeding. The most common symptom is menorrhagia (or increased menstrual flow), but intermenstrual spotting and disruption of normal pattern are other frequent complaints. Menses are longer in duration and heavier.
If You Show the Signs
If you are showing signs, it would be best to consult your physician. Clinically, after getting your complete history, your physician could make an initial assessment through physical examination, particularly abdominal and pelvic examination. Upon palpitation, an enlarged, firm, irregular uterus may be felt.
To further validate, a diagnostic pelvic ultrasound may be performed to visualize the uterine mass, including its size, number, and location.
Other radiologic tests such as CT scan and MRI studies are options but not often recommended because they are more expensive, and the data required for diagnosis can almost always be provided by ultrasound.
Myomectomy Vs. Hysterectomy
Fortunately, majority of Myomas are benign. The key is early diagnosis and prompt management.
Management choices should be suitable to the patient’s symptoms and reproductive desires. Small and asymptomatic Myomas could be managed conservatively through observation and monitoring.
To determine the rate of growth, pelvic examination at six-month intervals is performed. Majority of cases will not need any operation, especially those in perimenopausal period, where the condition usually improves with diminishing levels of estrogen.
Cases of abnormal bleeding and Myoma should be investigated for concurrent problems with endometrial hyperplasia. If symptoms do not improve through conservative management, operative therapy may be considered. Two types of surgical management are:
• Myomectomy (removal of Myoma only)
• Hysterectomy (complete removal of the uterus, including the mass)
The choice between myomectomy and hysterectomy is determined by the patient’s age and most importantly, future reproductive plans.
Next: Myoma and Pregnancy — Hit “Next” below.