Bleeding from the genital tract and delayed menstruation in uterine myoma are the most common complaints with which patients come to the gynecologist. Disruption of the menstrual cycle is associated with hormonal imbalance, which is the main cause of the appearance of a tumor in the uterus. With a long course of fibroids complicated by pain, anemia, affects the sex life and the ability to have children. Therefore, its treatment requires an integrated approach and the implementation of all medical recommendations.
Causes of menstrual disorders in uterine myoma
Myomatous node is a benign neoplasm that grows in the uterus of muscle and fibrous cells. The main reason for its occurrence is considered to be increased synthesis and imbalance of ovarian hormones - estrogen and progesterone.
Changes in the nature of menstruation are associated both with impaired normal production of ovarian hormones, and with changes in the uterus itself, arising as the tumor grows.
The causes of menstrual disorders in uterine tumors are:
- Elevated estrogen levels. It is one of the causes of myomatous nodes, also affects the growth of uterine epithelium. In the first half of the cycle, under the influence of this hormone, heterogeneous growth of the endometrium (hyperplasia) occurs. His rejection occurs during the entire menstrual cycle, which is manifested by a thinning or bleeding during the intermenstrual period and abundant menstrual periods.
- Hormonal imbalance. Causes irregular menstrual cycle. It can both shorten and lengthen, leading to a delay in the onset of the next menstruation.
- Growth myoma node. Developing in the thickness of the myometrium, the tumor changes its structure and violates the contractility of the uterus muscles. This leads to prolonged menstruation, the occurrence of pain during this period. Abundant periods with myoma are observed due to an increase in the vascular network of the endometrium due to the blood vessels that feed the tumor.
- Localization of the tumor. The normal outflow of secretions during menstruation can be hindered by fibroids, localized in the area of the cervix. This is manifested by long delays, scant menstrual flow, and soreness.
- Concomitant pathology of the uterus. Myoma is often accompanied by adenomyosis - the germination of uterine epithelium cells in the muscle layer. This condition is manifested by pain during menstruation and uterine bleeding during the intermenstrual period.
To change the cycle and nature of the monthly with myoma
As a rule, the cycle with myoma tends to shorten. Monthly with uterine myoma can go several times a month, while their duration is more than 7 days. Menstrual flow is abundant, with a large number of large blood clots (areas of hyperplastic endometrium). Menstruation for myoma is often accompanied by pain in the lower abdomen, lower back, and anus.
Less frequently with fibroids, there may be a delay in menstruation, due to impaired hormonal function of the ovaries. In this case, menstrual flow becomes scarce, their duration is 2-3 days.
In the intermenstrual period, women with myomatous nodes often have bloody spotting.
With a large tumor and its malignancy, severe bleeding may occur, requiring surgical intervention. Also, bleeding is one of the symptoms of uterine tumors during menopause.
How to restore the cycle
Prolonged painful periods, arising from myoma, cause severe discomfort to the woman. Chronic blood loss leads to the development of anemic syndrome, which is manifested by weakness and fainting, deterioration of the skin, nails and hair, decreased mental and physical activity. In addition, menstrual disorders affect the emotional and mental state of a woman, irritability, tearfulness, and depressive state occur.
To restore the normal menstrual cycle, it is necessary to eliminate the cause of its violation - myoma.
Before starting treatment, the doctor prescribes a number of diagnostic studies, the main of which are:
- Ultrasound of the uterus and appendages.
- Blood tests: general, biochemical, coagulogram (study of the blood coagulation system), on tumor markers, to determine the hormonal status.
- Swabs from the urethra, vagina and cervix on the microflora and cellular composition.
- Hysteroscopy with biopsy - with tumors growing in the myometrium and the submucosal layer.
Additionally, CT or MRI may be prescribed, separate diagnostic curettage, cultured centr, etc. According to the research results, the gynecologist chooses the optimal treatment for benign nodules - conservative or surgical.
Drug myoma and its symptoms are treated with hormonal drugs that inhibit the production of own hormones by the ovaries. They should be taken for a long time (3-6 months), after which an ultrasound scan must be repeated to observe changes in the myoma node. Additionally, with heavy menses, hemostatic drugs are prescribed (Vikasol, Etamzilat, tranexamic acid) and iron preparations for the treatment of anemia (Ferrum Lek, Totem, Maltofer, etc.)
Surgical treatment of fibroids is indicated for:
- Node size greater than 12 weeks of pregnancy.
- Severe bleeding.
- Detecting signs of a malignant tumor.
- The lack of effect of conservative treatment.
The volume of surgery varies depending on the indications, the age and condition of the patient. Small fibroids in women of reproductive age are removed with the preservation of the uterus. Removal of the entire uterus (hysterectomy) is performed for large and multiple nodes, sarcomas, as well as in patients who have reached the age of menopause.
After an effective conservative treatment or myomectomy, the cycle is restored within 6-12 months.
It should be remembered that in the event of severe bleeding from the genital tract, as well as with heavy periods, lasting more than a week, you should definitely consult a doctor. Attempts to stop the bleeding by yourself can be ineffective and life threatening.
How do menstrual changes in uterine myoma
It is worth noting that the myoma formations originate from cells of the connective and muscle tissue. And depending on the location of the tumor is divided into several varieties. Regular examination by a gynecologist can reveal myoma, even in the early stages, which in the future will help avoid many problems. Doctors can make an accurate diagnosis only by ultrasound.
According to the location of the tumor (inside the uterus or outside), it is possible to predict which periods the woman will have.
The disease can occur for various reasons, including hormonal disorders. The main catalyst can be a genetic predisposition.
Basically, a tumor can occur if hormonal shift occurs in the direction of estrogen and at the same time decreases the concentration of progesterone in the body. These are the main two hormones that are actively involved in the formation of the female cycle. Any deviation of concentration from the norm of one of these hormones is immediately reflected in the monthly, more precisely, in their abundance. Due to abortions, a woman also increases the risk of fibroids.
Nonmenstrual uterine bleeding
Fibroids can be accompanied not only by abundant menstruation, but also by bleeding in the middle of the cycle. This situation is caused by an imbalance of hormones, especially estrogen, when its concentration becomes significantly higher than normal. The uterine membrane under its influence becomes uneven in thickness, so part of the cells during menstruation is updated, and some remains unchanged.
The contractile function of the uterus also decreases with myoma, so cell debris leaves in the form of bleeding after the end of menstruation. Bleeding is often heavy, due to increased stress on the uterus. A woman loses enough blood to sense the following symptoms of the disease:
- pallor of mucous membranes and skin
- weakness and fatigue even sutra.
It is very important to stop such bleeding in time to avoid even more complications.
Myoma causes menstrual disorders
In addition to enhancing the menstrual flow, the hormonal imbalance in the disease leads to temporary changes in the entire female cycle. Menstruation becomes much more frequent. This situation is due to the reduction in the normal duration of the full cycle. In addition, during menstruation, pain in the lower abdomen increases markedly.
It happens that menstruation happens twice a month and the reason for this is hormonal changes. Estrogen under its influence on the body causes the endometrium to develop faster, and, therefore, its update is also accelerated.
A rare event with myoma is delay. But she also happens. Such a turn of events can only happen at an early stage of tumor formation. This is due to disease-related ovarian dysfunction.
Violations in the female body becomes immediately noticeable when a delay occurs several times, which is replaced by heavy discharge on critical days. If the tumor was not diagnosed, the reason for this behavior of the uterus may lie in:
- changes in myometrium,
- violation of blood circulation in the endometrium.
The conception of the myoma formations may not interfere, but when a pregnancy occurs, the tumor provokes a possible miscarriage. Therefore, if there is a delay in myoma, then it is necessary to take a pregnancy test.
The nature of the discharge in the disease
The consistency of menstrual flow with myoma is very different from the normal menstruation in a healthy woman. The excreta contain a lot of blood, which in composition can be dense and dark red. The content of discharge is dominated by blood, in contrast to normal menstruation, when other components occupy more than half of the composition.
It happens that the clots are very large due to unevenly lined endometrium. The opposite may also happen: menstruation is like water, blood runs thin, which causes a woman to change a large number of gaskets per day. This situation requires a very urgent visit to the gynecologist's office.
Myoma and pain during menstruation
Pain during menstruation is not uncommon, and with myoma, they can also intensify. This is especially true of women who have had intermuscular myoma nodular formations. Then there may be frequent cramping pain. The uterus at this time as if trying to push out of themselves alien tumors. It happens that she succeeds, and together with the monthly they come out.
If the tumor grows inside the uterus, then menstruation, as a rule, differ in intensity. Pain syndrome is not so strong, but it does not go away even after the end of menstruation.
External myoma education can grow and put pressure on neighboring organs. Why a woman often notices that she often begins to want to use the toilet. Intestinal disorders can also be a sign of neoplasia growth.
How and what to treat myoma
Removal of the tumor can occur sparingly. Through laparoscopy. The operation is performed using a laparoscopic apparatus, which is introduced into the abdominal cavity through three small incisions in the patient's abdomen. Such an operation is good because after laparoscopy only three small scars remain, and the woman’s recovery occurs very quickly and, as a rule, without complications.
Doctors do not always operate on a tumor. If small uterine fibroids were found that do not develop, they will not be cut. But what to do if they still give their reflection on the menstruation, make them painful and abundant?
Without taking any measures, it is close to anemia and it is also not very pleasant to endure constant pain. In this case, the gynecologist must prescribe drugs that help reduce discharge in critical days and reduce pain. Often, decoctions and infusions of medicinal herbs are recommended, but whether it is possible to drink them and how long the course should last - this should be discussed with the doctor. Some herbs can only aggravate the condition.
Monthly after removal of the tumor
When drugs are powerless and the tumor continues to grow, it is necessarily removed. Monthly after myomectomy is required to stabilize. When they come, it is imperative to follow their course and note all deviations or extraneous sensations.
Delay after surgery is normal. The menstrual cycle should recover 30–60 days after laparoscopy or myomectomy. If the woman's body is very weak, the first periods will be scarce. However, sensations during critical days will improve significantly. The pain becomes mild, and further discharge passes within the normal range.
It is important to note that pregnancy after myomectomy is contraindicated for about 2 years. This is because the uterine scar after surgery should be well formed and strengthened, in order to further reduce the risk of miscarriage to a minimum.