Fibroids are benign tumours of the uterus. Fibroids, which arise through abnormal growth from the muscle tissue in the uterus called the “myometrium”, can today be seen in approximately one in every four to five women.
These benign tumours, which appear particularly after the age of 30 to 40, may sometimes show no symptoms at all. For this reason, many women who have a fibroid are not even aware of it. Although it is not known why these masses form, they are generally closely related to an increased oestrogen level.
With the fall in the oestrogen level during the menopause, a rapid regression of fibroids and even their disappearance over time can occur. In pregnancy, on the other hand, fibroids can grow along with the enlargement of the uterus. However, after the birth has taken place, situations such as a reduction in the size of fibroids or their disappearance can be seen, or no change occurs at all.
The place of the progesterone hormone in fibroid treatment
The progesterone hormone is a hormone that serves to balance the effect oestrogen produces in the body and functions as its opposite. For this reason it was thought that progesterone could be used in the treatment of fibroids, which grow with oestrogen.
However, in the cases in which it was used, progesterone was found to be ineffective in treating the fibroid. It can only reduce bleeding by causing atrophy in the tissue lining the inside of the uterus known as the “endometrium”, where the bleeding during the period occurs. For this reason, progesterone treatment in fibroid treatment can only be effective in selected patients who have mild symptoms and small fibroids.
Treatment methods
The most definitive treatment method for fibroids is surgery. With other treatment methods the growth of the fibroid can be stopped or its shrinkage can be achieved.
With some new-generation treatment methods, fibroid tissues can be treated by being burned with a laser or frozen with liquid nitrogen without being removed from the body. These methods can be applied in a very limited number of fibroid types. They are also not much used in clinical practice.
Although oestrogen-suppressing medicines are considered as an alternative, the long-term use of these medicines causes complaints such as bone loss, the cessation of periods or hot flushes.
Suppressive medicines (false menopause injections) create a temporary menopause effect in the body. For this reason they are preferred only to shrink the fibroid before surgery.
Today the most effective method as treatment is surgery. The laparoscopic, robotic or hysteroscopic removal of fibroids consists of operations that are very advantageous for patients. Because these types of operation are carried out with minimal intervention in the patient’s body, they are also known as bloodless or scalpel-free operations.
After the operation the pain is slight, the need to use painkillers is therefore limited, and cosmetically the marks on the front wall of the abdomen are again so few as to be almost non-existent. After operations carried out with these techniques, patients can return to their social lives within a short time.
Assoc. Prof. Dr. Taner Usta
Specialist in Obstetrics and Gynaecology