Myoma and Pregnancy
Myomectomy is the preferred choice to preserve fertility. Other classic indications include persistent abnormal bleeding, pain or pressure, or enlargement of an asymptomatic Myoma to more than 8 cm in women who have not completed childbearing.
Indications for hysterectomy are similar to indications for myomectomy but with the additional condition that the uterine size is similar to a 14- to 16-week gestation, as most cases of this size will develop symptoms.
Rapid growth after menopause, and prolapse of a Myoma through the cervix are the other rare indications.
For those who still wish to get pregnant, there are two other alternatives to surgical myomectomy:
- Anti-estrogen and progesterone drugs ( GnRH antagonists, medroxyprogesterone acetate, danazol and antiprogesterone);
- Insertion of a catheter to deliver an embolizing agent that will block the blood supply of the uterus (a process called uterine artery embolization)
Still, it is best to study all options with the guidance of your attending physician.
3 Tips on Early Detection
Women in advanced age are more likely to develop reproductive diseases. Ironically, the estrogen hormone known to protect women’s heart, among others, also predisposes one to develop Myoma.
Below are three practical tips, which are applicable not only to preventing or managing Myoma, but also in dealing with other medical conditions:
- Do not ignore your symptoms
Our housekeeper intentionally denied what her body was telling her. She dismissed her enlarging abdomen and abnormal menstrual bleeding as mere perimenopausal signs.
2. Seek early medical attention
Like any medical condition, early detection and management is crucial. For women of advanced age, it is important to rule out other medical conditions.
Majority of Myomas are benign, but other more serious conditions of the reproductive system may have similar symptoms, such as endometrial hyperplasia, endometriosis, or ovarian tumors.
3. Know your treatment options
Aside from the severity of symptoms and the size of the mass, the management of Myoma should fit your reproductive desires.
If you wish to preserve your fertility, surgical myomectomy (removal of the tumor only) is the preferred management.
Katz, V., G. Lentz, R. Lobo, and D. Gershenson (2007). Benign Gynecologic Conditions, Comprehensive Gynecology. Mosby, Philadelphia, USA. 5th edition.