Uterine fibroids in perimenopause: Causes and treatment

The article was professionally consulted with Specialist Doctor I Nguyen Thi Man - Obstetrician and Gynecologist - Department of Obstetrics and Gynecology - Vinmec Danang International General Hospital.

Uterine fibroids appear more in women of reproductive age, but this does not mean that the disease does not occur in premenopausal women, because this is also a period of abnormal hormonal changes. . So how to deal with uterine fibroids in perimenopause?

Uterine fibroids are benign tumors of mesenchymal cell origin that are genetically modified under the influence of gonadal hormones.
Uterine fibroids are the most common gynecological tumor in premenopausal women worldwide. According to statistics, in the world, about 30% to 60% of women over 35 years old will have uterine fibroids and in menopause (about 50 years old), this rate is up to 75%. This proves that uterine fibroids in premenopausal age are very likely to occur.

When women enter perimenopause, there will be sudden changes in hormones in the body. This causes an estrogen disturbance and can cause fibroids to form. Most patients with fibroids have abnormally high estrogen levels.
If in the previous reproductive age, you had multiple abortions, causing damage, infection and thinning of the uterine wall, this is also a favorable condition for fibroids to develop at the perimenopausal age. .

In general, the symptoms of uterine fibroids in perimenopause are quite similar to those of fibroids in other age groups, including:
Menstrual disorders: in perimenopause, menstruation Women's also began to erratic. However, it is also sometimes an early sign of uterine fibroids. Therefore, you should not be subjective when you see that your menstrual periods are irregular. The amount of menstrual blood changes abnormally: if a premenopausal woman has uterine fibroids, one of the common symptoms is that there is a clear difference in the amount of menstrual blood each month. very little menstruation. Frequent urination and constipation: as the fibroids grow larger, they will put pressure on other organs such as the bladder (leading to frequent urination) or press on the rectal area, leading to constipation. constipation. Unexplained abdominal pain: The more fibroids grow, the more frequent and more severe the lower abdominal pain will be. The patient may even feel a hard mass when pressing on the bladder as well as pain and discomfort. Back pain and body fatigue: The body often shows signs of fatigue even though you do not work much, this is a very clear but easily overlooked sign of uterine fibroids.

As mentioned above, uterine fibroids are a benign tumor and pose little risk to health. However, if the disease occurs during perimenopause - a period with many health declines, uterine fibroids are more likely to develop into complications.
The most dangerous complication of uterine fibroids from fibroids in menopause is menstrual bleeding. This is a phenomenon similar to the sequelae of postpartum haemorrhage: the body will suddenly lose a large amount of blood and if the patient is not treated immediately, this complication can even directly affect the patient. to life.
In addition, the disease can also reduce the patient's quality of life when the disease causes constipation, frequent urination, discomfort, body aches...

Declining health at menopause can make it more difficult to treat fibroids. However, treatment is necessary to ensure long-term health in women. Treatment for uterine fibroids in menopause will depend on two main factors: the condition of the tumor and the patient's health. From there, doctors will recommend the following two main methods.
5.1. Medical treatment with drugs This is the most common treatment for uterine fibroids in premenopausal patients because it can slow the growth of tumors and improve the uncomfortable symptoms caused by the fibroids. caused by this fiber. Currently, the 3 most commonly used drug groups are:
Progestin drugs: have the ability to inhibit the production of estrogen hormone and at the same time help reduce the size of fibroids, thereby improving symptoms of pain and swelling caused by tumors. caused by fiber. GnRH antagonists: improve clinical symptoms quickly such as pelvic pain, dysuria, fatigue, back pain... However, the use of the drug can lead to undesirable side effects such as ventricular temper. often, prone to hot flashes, affecting marital life... causing the patient's health and mental health to tend to be negative.
5.2. Surgical treatment Menopausal women often no longer need to reproduce, so doctors may recommend surgical treatment of uterine fibroids by completely removing the fibroids to prevent recurrence of the fibroids. sick. This ablation can be done in 1 of 2 ways:

Menopausal age patients because there is no longer a need to reproduce can undergo complete ovariectomy, which can effectively prevent the disease from coming back
Removal of uterine fibroids: applied to large tumors as well as patients who do not respond well to medical treatment. Complete removal of the ovaries: is often applied at the age of menopause because there is no longer a need to reproduce. Not only can it cure the disease quickly, it can also effectively prevent the return of uterine fibroids. Thus, not only in the reproductive age, uterine fibroids are also common in menopause. Therefore, regardless of age, gynecological examination with women is also extremely necessary. This is not only a method of assessing the current health status but also early detection of many dangerous diseases before the onset of symptoms.
Currently, Vinmec International General Hospital is implementing a package of pre-menopausal health care examination and consultation. The package is for the following subjects:
Women aged 45-55, possibly younger (when suffering from premature ovarian failure), menstrual irregularities, sexual disorders, suspected disorders endocrinology, or have a need to use hormone replacement therapy, or want to prepare themselves for perimenopause and menopause. The client has risk factors such as smoking, being under prolonged stress, undergoing cancer treatment, having surgery to remove 1 or 2 ovaries. Customers have symptoms such as menstrual irregularities, sexual disorders, changes in psychology, sleep In addition, when using the package, customers can also detect gynecological diseases early. may be encountered during this period for prompt treatment. All examinations are performed by a gynecologist. Perform tests to assess hormone status. From that result, doctors will advise and suggest treatment methods to minimize symptoms during this period.