Uterine Fibroids
What Are Uterine Fibroids?
Uterine fibroids arebenign (noncancerous) growths of the muscular wall of the uterus. The growths, which may be solitary or multiple in number, range from the size of a pea to the size of a mass that can fill the entire abdomen and pelvis. They are the most common pelvic tumors, with an incidence of 70-80% in a woman’s lifetime. They may grow within the muscle wall of the uterus or extend into the endometrial cavity or abdominal cavity.
肌瘤常常不会导致任何症状，除非它们会变得如此大，以至于它们会给邻接器官带来压力，导致疼痛。它们也可能导致阴道出血增加，这可能导致贫血。
Fibroids may increase in size during pregnancy and shrink or disappear at menopause. The growths rarely become cancerous. But they can sometimes lead to miscarriage or to premature delivery of an infant, and they can also cause problems with fertility.
Who Gets Uterine Fibroids?
Uterine fibroids are extremely common; approximately 80% of women have fibroids. However, most of these women will be asymptomatic. Only about 30% of all women have fibroids large enough to be noted during a pelvic exam. Fibroids are more common in African-American women than in white women. The reason is unknown.
Symptoms
月经期间异常繁重;在时期之间出血。
痛苦的月经
腹部或盆腔不适、丰满或pain.
Lower back pain.
盆腔压力
尿频;便秘。
性交过程中的疼痛。
贫血
生育问题
原因/危险因素
子宫肌瘤的原因是未知的。
妊娠可促进肌瘤生长（但口腔避孕药似乎没有增加肌瘤的风险）。
肥胖/overweight may increase risk.
饮酒似乎增加了风险。
吸烟会降低风险（但这不是吸烟的理由）。
可能存在家族风险：如果您有母亲或姐妹的肌瘤，则有些证据表明您的风险增加。
Foods from sources treated with hormones, such as eggs or processed meat, may increase fibroid growth.
诊断
盆腔检查可能露出子宫肌瘤的存在。
Imaging tests can confirm the diagnosis and include the following:
Computed tomography (CT scan or CAT scan; uses x-rays from different angles to create three-dimensional images of tissues and organs).
磁共振成像（MRI扫描;使用电磁无线电波来创建组织和器官的详细图像）。
骨盆超声（使用声波创建组织和器官的图像）;这是最常见的测试。
Treatment
对于无症状肌瘤，不需要治疗。当肌瘤引起疼痛和其他症状时，药物和手术是选择。
Medical Treatment
在月经期间，铁丸可以补充较重的出血中损失的铁。
非甾体抗炎药（NSAID）如布洛芬（Advil）可以有助于减少与肌瘤相关的月经痉挛和出血。
口服避孕药（出生对照丸）可以稳定子宫的衬里以防止重重出血。也可以使用其他形式的出生控制（下面）。
通过宫颈开口通过子宫内的医生放置的荷尔蒙宫内系统（Mirena）释放出孕激素的孕激素，这有助于控制重型腓骨出血。
含有孕激素（Nexplanon / Implanon）的匹配棒尺寸植入物可以放置在臂的皮肤下，以慢慢释放孕激素进入血液中。
肌内注射Depo-Provera-一种长效形式的孕酮 - 可以每三个月给予每三个月给予肌瘤，导致大流血的肌瘤。
通过每月注射一次，促进促性腺激素 - 释放激素激素激动剂（GnRH激动剂）停止卵巢产生激素并降低子宫的大小 - 这可以暂时减少肌瘤尺寸。通常进行这是为了使肌瘤的手术更容易，更复杂。
外科选择
Dilation and curettage, or surgical scraping of uterine tissue.
Myomectomy. This entails surgical removal of fibroids but not the surrounding tissue of the uterus. A key advantage is that it preserves future fertility.
子宫内膜消融。使用电流烧灼子宫的衬里，虽然这种程序显着降低了女性怀孕的孕妇的机会，但仍然可能发生妊娠，并且如果发生的情况会增加并发症的风险增加。因此，建议进行避孕。
子宫动脉栓塞。这种相对较新的程序是由介入放射学家进行的，他将材料放置在子宫动脉中以减少对子宫的血液流动，剥夺其血液供应的肌瘤，从而导致它们缩小。目前尚不清楚子宫动脉栓塞如何影响怀孕的潜力。有一些证据可能会增加孕妇流产的风险。
具有聚焦超声的磁共振。高频超声波用于加热和破坏纤维组织。此程序仅适用于不打算怀孕的女性。它不能治疗所有类型的肌瘤。
Hysterectomy. Surgical removal of the uterus is performed either vaginally, abdominally, or laparoscopically, which ensures a permanent solution to fibroids. It is an option if other treatments have not worked or are not appropriate. The ovaries may also be removed, though this is not necessary for treatment of fibroids.
预防
女性应具有年度骨盆考试，以帮助早期发现和治疗任何异常。年骨盆考试对患有无症状肌瘤的女性尤为重要，以便可以监测肌瘤生长。
什么时候打电话给你的医生
如果你发展子宫肌瘤的症状，请致电妇科医生。
紧急情况立即获得锋利的医疗注意力，突然突然疼痛。
Reviewed by Thomas Moran, M.D., obstetrician-gynecologist in private practice, Springfield, MA.
