Many women who have just been diagnosed with uterine fibroids are often very confused and come to the doctor and ask, "Do I have any bad habits and hobbies?" How do fibroids grow in the body? ”
It's hard to answer this question because the pathogenesis of uterine fibroids is not yet very clear. In order to help you understand the truth as much as possible, I will explain it to you from the following aspects.
First, the uterus - where fibroids grow
Fibroids can grow anywhere in the uterus, but fibroids in different locations have different incidences.
The female uterus is a hollow reproductive organ with a cavity, and the uterine cavity is a triangular space with a narrow upper and lower width, located deep in the pelvic cavity, which we cannot touch ourselves.
The uterus is like a balloon, with a spherical part (uterine body) and an opening part (cervix), and the uterine body and neck are called "isthmus". Fibroids grow in the uterine body account for about 90 percent, and cervical and isthmus fibroids are less than 10 percent [1].
The uterine wall is like the outer layer of a balloon, divided from the outside to the inside into three layers: the serous membrane, the muscle layer and the mucous membrane (endometrium).
Fibroids can grow in every layer: interidional fibroids are the most common, accounting for 60% to 70% of the total. Subserosal fibroids account for about 20%. Submucosal fibroids account for 10% to 15% (see figure below).
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Second, estrogen and progesterone - the "driving force" of fibroid growth
The exact cause of uterine fibroids is not uniform. However, the academic community is more consistent in that estrogen and progesterone are the main promoters of uterine fibroid growth, and high hormone levels can easily lead to the occurrence of uterine fibroids.
In reality, uterine fibroids rarely occur in prepubertal girls. After pregnancy, fibroids will grow with pregnancy, and after menopause fibroids will gradually shrink.
Studies have also shown that the concentration of estrogen in fibroid tissue is significantly higher than that of surrounding normal tissue. This confirms that estrogen and progesterone play an important role in the development and growth of fibroids.
Third, the growth characteristics of fibroids - early and quiet
Fibroids tend to grow slowly, and there are no physical reactions and symptoms in the early stages, which can easily be ignored.
Most women are physically examined to do B-timeout and accidentally find fibroids, and some women are fibroids that have grown up enough to cause symptoms and go to the hospital for examination.
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Fourth, what do fibroids look like - the benign surface is smooth and clearly demarcated from the surrounding tissues
Fibroids are nodular "balls of flesh" that protrude from the surface of the uterus or in the uterine cavity, varying in size and generally have a smooth surface, white or reddish.
Some fibroids are connected to the wall of the uterus by the peduncle, and some protrude directly on the smooth surface of the uterus or in the uterine cavity, like small hills protruding from a flat ground.
On ultrasound examination or other imaging tests, doctors can tell if these "masses" or "echo zones" are uterine fibroids.
Fifth, fibroids can degenerate - but there are good and evil
The incidence of denaturation of uterine fibroids is approximately 60 percent [2]. There are benign and malignant degenerations, benign is more common, and the probability of malignancy (sarcoma-like changes) is very low. The occurrence of degeneration has little to do with the location of fibroids.
However, if it is pregnancy, puerperal period, and perimenopause, fibroid degeneration is more likely to be high. In addition, if the fibroid diameter is greater than 5 cm, it is more likely to degenerate.
Benign degeneration includes: vitreous change, cystic change, calcification, red like change, mainly due to various reasons caused by insufficient nutritional blood supply to fibroids themselves, resulting in the loss of the original structure of some tissues and occurs. The mechanism of sarcoma-like malignancy currently needs further study.
Can uterine fibroids be prevented?
There is currently no absolute cure for uterine fibroids. However, the risk of uterine fibroids can be reduced by strengthening exercise, eating a reasonable diet, maintaining a pleasant mood, controlling weight, etc.
Review expert: Wang Jianliu | Chief Physician, Department of Obstetrics and Gynecology, Peking University People's Hospital
bibliography:
Le jie. Obstetrics and Gynecology[M].Beijing:People's Medical Publishing House,2004:295-298.]
Wu Qingmei,Peng Guangxian,Zhou Li. Acousticography of uterine fibroid degeneration and its CDFI changes[J].Journal of Clinical Ultrasound Medicine,2001,3(Suppl):78-80.
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