Symptoms such as constant pelvic pain, fatigue, bloating or abundant menstruation become considered “ordinary”, although they are signs of a condition that are diagnosed with more than half of women between the ages of 21 and 49. Complications can be serious.
Patients get used to pain, presenting to the photo doctor late: Archive
Normalized or ignored symptoms in a row by women between the ages of 21 and 49 may be the signs of a frequently encountered condition: uterine fibroids. Constant pelvic pain, fatigue, bloating or abundant menstruation significantly affects the quality of life but many women believe them “normal”.
The platform of sexual education and reproductive health plans the unforeseen draws attention to this “silent condition”, which affects millions of women, but that is too little talked about. Symptoms must be recognized, women being encouraged to seek medical help, because there are treatments adapted to each case.
According to an analysis published in BMC Public Health (2023), between 40 and 60% of fertile women develop a uterine fibroids up to 50, and in Romania, the incidence is one of the highest in Eastern Europe – 582 cases per 100,000 women annually. The data are also supported by recent estimates published in sources such as interventional medicine and PMC (2023).
Dr. Alina Dascălu, primary obstetrics-gynecology doctor with expertise in the uterine pathology and a specialist partner of the platform is planning the unforeseen, answered at large, for “Adevărul”, to the questions related to this condition.
“I have patients who at the age of 23 came directly with fibroids”
Uterine fibroid is a benign (non -cancer) tumor that appears more often than in the past and in women under the age of 40. “It appears as a result of a hormonal disorder and then we can meet them for people over 20 years. I have patients who at 23 came directly with fibroids. It is not something to inherit, so it is not hereditary, but if you have a hormonal disorder, in this case it predominates estrogens and not have enough progesterone, these changes appear: fibroadenomas are called in the breast or uterine fibroid. So the uterine fibroid is a benign tumor of the uterus that can occur in people over 23 – 25, and somewhere until the menopause. Obviously, in the menopause they have no way to appear, because at the menopause we have no hormones ”explained the doctor.
The signs appear after the fibroid already exists, the symptoms differ depending on the area in which it is positioned. There may be abundant bleeding in menstruation, with so-called clots, or bleeding during menstruation, but this only happens if the fibroid is positioned inside the uterine cavity or near the uterine cavity, explains Dr. Dascălu.
“The symptoms of fibroids are not necessarily given by their size, as their position. They are of several types. In medical terms, they are called: submucos – that is, at the level of the uterine cavity and then hemorrhage is one of the signs that send patients to the doctor; Inside the uterine muscle – intramurally, when they can not give bleeding at all and can reach impressive dimensions and you do not even realize that you have fibroids; And outside the uterine cavity – the so -called undersides, which can also reach incredible dimensions ”the doctor exposed the variants.
Sometimes it happens that patients reach the doctor by suspecting completely and completely other health problems. This is the case of a patient with a gigant-size fibroma. The patient addressed doctors from several specialties until he reached the gynecologist.
“I had a patient with a fibroma of 30 cm. When you have such a big fibroid, you may reach the doctor for other signs, such as: the fibroid can compress the intestines, have a constipation. It can be so large that they reach the diaphragm, in exceptional cases, but there are situations. And then patients came because they did not breathe well ”, He exemplified the doctor. In the mentioned cases, the patients also had excess weight, so that they put on this excess weight the problems related to breathing.
When the fibroid is positioned behind the uterus, abdominal pain may occur during sexual contact or if the tumor formation enters the necrobiosis.
The fibroid, detected at the simple periodic medical check -up
The simple gesture to perform a medical check -up can escape women of major complications. The fibroid can be easily detected, ultrasound, in this control, said Dr. Dascălu, the condition is for the patients to come. The difference between the surprise of a fibroid in the early stages and the late presentation is huge, from the treatment possibilities to possible complications.
“Treatments exist until we reach the operation. There are treatments that stop the increase of fibroids. When you have not been controlled in time and the doctor has already diagnosed you with a fibroid, you can help the patient through several surgery. They can be minimally invasive, such as invasive uterine embolization, such as their ablation with radiofrequency, if they have up to 3 centimeters, but if they have exceeded the dimensions have another impact on health. If they are very big and give pain, if the patient bleeds a lot, then you have to stop his “tap”. You can not give it only a treatment not to grow, but a surgery is required to remove this fibroid, respectively myomectomy, so it is called, when you remove the fibroid, the uterus remaining on the spot ”the doctor detailed.
The treatments are personalized from one patient to another, depending on her age, her obstetric history. “One is to be a young patient who is about to have children and wants this and the other is to be a person close to menopause or to be in pre-humanopause. Others are the variants. So you adapt according to the patient, her age and obstetric history,” said Dr. Dascălu.
There are situations in which patients simply get used to bleeding, considering them something normal. I put them on account of heredity, when in fact, in control, he learns that a polyp or fibroid has been developed. Other times the symptoms do not only cause discomfort, but can seriously affect the health of the woman. There have been cases, the doctor gives other examples, in which women had hemoglobin 6, headaches and accentuated condition, “”They could not stand on their feet. “
“These fibroids can end up giving major depreciation in a woman’s body. But, unfortunately, in Romania we do not have the cult or culture of routine controls and we go to the doctor only when we can no longer ”, a Puncate Dr. Alina Dascălu.
How to diagnose uterine fibroids
The diagnosis of uterine fibroids can be accurately made in a transvaginal ultrasound, which is a faithful investigation within which fibroids from dimensions can be detected even half a centimeter. “When they are very large, the abdominal ultrasound is detected. But, I repeat, it is a diagnosis that you can easily put on a transvaginal ultrasound.” insisted the doctor on the importance of this investigation.
How late do women get in the office? “Sometimes very late, I specified the case of the lady who had a 30 cm fibroid, the fibroid weighing almost 6 kg. When I removed it, it was harder than a child. And then, of course, You can no longer just remove the fibroid, Remove the uterus altogether. But in the vast majority, I don’t get so late. After bothering them for a year, on average, they arrive. But what I would like to point out is the need for young girls, which we begin to educate, have the cult of periodic control. This is why, by the platform, the unforeseen platform, I like that they want to popularize this basic part of the medical checks, because you have to go to the doctor even if you think you have no problem. You cannot know what appears ”said Dr. Dascălu.
“Social media for young people has an impact”
The first visit to the gynecologist should be when puberty was installed, even before the beginning of sexual life, because the doctor will explain to the girl what happens to her body after installing menstruation. It is all the more necessary because, with all the attempts, the hours of sexual education, which in fact have a strong medical component, are still missing from schools.
“In sex education, they do not necessarily teach them how to protect themselves during sex, because for this reason they did not want to introduce this, but you can explain them what can occur, as diseases, in the first part of life, when you still do not train yourself. It would be good when the girls enter puberty to be taken to a doctor to have a discussion on how menstruation occurs, what to do later as contraception, when they have to come to the doctor, that is to teach them to do these things alone. Then, at a control it is simply to reach the first sexual relationship, because at that moment you can, as a doctor, also examine the neck, to learn when to perform the papanicolaou exam. We need to train parents, not only children, for anti-HPV vaccination, because HPV, unfortunately, spreads extraordinarily quickly, by simply touching the pubic skin, you do not have to have sexual contact. “said Dr. Dascălu.
Dr. Alina Dascălu, primary obstetrics-gynecology Photo: Pesron Archive
In order to help their patients, all the more so as the need is among young people, Dr. Alina Dascălu decided to address, especially young people, on social media platforms, where they are the most. “Because I see so many ugly things, I decided, during the time I have, to post on the clinic’s tiktok. Because Tiktok are a lot of young people. And I talked about HPV, and fibroids, and other things that interest them. And you know that I had an impact. Of course, exposed to their meaning, because we do not do medicine lesson on Tiktok.
When women get to the doctor
The women who present themselves at the gynecological control once a year are still too few. In the case of those diagnosed with fibroids the symptoms are the ones that bring them, most often, to the doctor’s office. Otherwise they come after a friend, a relative, an office colleague, has faced a problem and thus realizes how important it is to find out that you are good, or to detect a problem in time.
“T.It’s happy when you came to control and the doctor told you: you have nothing. If you come and discover something, you have to be glad that you have discovered on time. There are also situations in which they come, discover something, maybe at Papanicolaou, and I say: Well, last year it was good. This is why you came to control, to find a small change in time, not when it is too late. In a year, very serious things cannot happen, so once a year you have to check. Because it is an easy exposed organ, as a doctor you can check it easily, and it is not a painful exam. If it was about colon, or gastric, or something else, we discuss analyzes that are done under anesthesia, while not here. A woman should be aware that she has to take care of her genital health, because from here many, including sex life, ”a more attracted to the doctor’s attention.
