Is it possible to treat uterine fibroids without surgery? Uterine fibroids: how to do without surgery and hormonal therapy. Non-surgical treatment options

Uterine fibroids are a benign neoplasm and are usually not life-threatening, but if they are large in size they can cause many unpleasant symptoms.

For this pathology, there are certain indications for surgical intervention, but this method is not applicable in all cases, and some women are offered treatment for uterine fibroids without surgery. Feedback on such approaches is mostly positive. In what cases can gentle treatment be used, and when is surgery indispensable?

The main methods of treating fibroids

It is a hormone-sensitive benign tumor, the causes of which are not fully understood. The influence of relative hyperestrogenism on initial stage the formation of nodes, which then gain the ability to grow autonomously. Therefore, treatment methods for this disease should be aimed at eliminating its cause, and not just at eliminating external manifestation problems – myomatous node.

The following official methods of treating uterine fibroids have been developed:

Hormone therapy - taking drugs that reduce the size of the node;
Radical removal of the uterus - hysterectomy;
Conservative surgery to remove nodes - myomectomy;
Uterine artery embolization;
FUS ablation;
Electromyolysis and cryomyolysis.

Uterine artery embolization is one of the most effective methods for treating benign tumors.

Treatment methods that are not accompanied by intervention in the abdominal cavity can be conditionally classified as non-surgical.

Indications for surgery

Treatment with surgery for uterine fibroids operates on the principle of “no organ, no problem.” Plastic surgery can also be performed to remove myomatous lesions while preserving the reproductive organ. After a hysterectomy, even with a persistent hormone imbalance, there is no substrate left for the growth of new nodes. Therefore, the disease is considered defeated. After plastic surgery, small lesions may remain unnoticed in the uterus, which can begin to grow after some time.

However, not all cases require surgery when a tumor is detected. There are strict indications for surgical intervention:

(if the growth rate of fibroids exceeds 4 weeks per year);
Large tumor sizes: the uterus is enlarged for a period of 14-16 weeks;
Growth of the node after menopause;
Impaired nutrition in the node, its necrosis, infection;
Location of fibroids in the cervical area;
Dysfunction of neighboring organs;
Uterine bleeding, which leads to severe anemia and is not treated conservatively;
Ineffective drug treatment within 6 months.

Surgical treatment of fibroids is necessary, including if the tumor is located in the cervix.

Modern medicine tries to perform operations with minimal damage, so it is possible to remove the uterus with fibroids using laparoscopic access. But for this, the optimal tumor size is 11-12 weeks (with technical capabilities and modern equipment - up to 15 weeks). It is impossible to perform laparoscopy for fibroids for more than 16-18 weeks. In this case, an open abdominal surgery with a full incision on the abdomen.

In case of submucosal or subserous location of the nodes, it allows saving the organ. Sometimes hormone therapy is prescribed to reduce the size of the tumor before surgery. But in some cases, this can lead to a pronounced reduction in the size of the node, and it will move deeper into the tissue, which will make it difficult to find during surgery.

It is important to know

For submucous fibroids, the operation is performed through the vagina, and for subserous fibroids, the operation is performed through laparoscopic access. If the tumor is large, laparotomy is used.

The choice of surgical intervention method also depends on the type of myomatous node.

Non-surgical treatment options

Just a few years ago, contraindications for plastic surgery left no chance for patients with fibroids: doctors in this case were forced to resort to removal of the uterus. On modern stage New methods of non-surgical tumor treatment have been developed that allow a woman to preserve her reproductive function and become a mother.

But not all methods are capable of producing a lasting effect, and some may even be useless.

Traditional methods and homeopathy Many women refuse traditional ways

therapy in favor of herbal treatment. In the article we examined in more detail the issue of the effectiveness of herbal medicine. Most often, traditional healers use the following remedies:
Red brush;
Shepherd's Purse;
Flax seeds;
Potato juice;
Propolis;

Treatment with leeches.

However, all these techniques are largely a placebo effect. In some cases, they are safe, except for the side effects of herbal drugs. But their effectiveness has not been proven. All reviews about the successful removal of fibroids using these means are subjective and not confirmed. For unexplained reasons, the growth dynamics of the node may change, but this is only a temporary effect.

To correctly assess the possibility of treating a disease with the help of herbs or homeopathy, you need to understand that fibroids are a large amount of abnormally overgrown muscle and connective tissue, and its condition can be influenced in only three ways:

Stop the blood flow to the myomatous node and achieve its regression;
Change the hormonal background of a woman’s body and thus eliminate the influence of hormones on growing fibroids;
Remove the node - peel it off within healthy tissue.

No herb, dietary supplement or homeopathic remedy are not capable of this. Some herbs contain phytoestrogens, but they cannot be a complete replacement for the hormones of the female body.

The danger of traditional methods of therapy is that women trust witch doctors, healers, reviews on the Internet, try to treat fibroids on their own and do not visit a doctor. And during this time the nodes manage to become active, accelerate their growth and sometimes lead to complications in the form of prolonged bleeding in the middle of the cycle, dysfunction Bladder or rectum. This is only a small part. In such a situation, non-surgical treatment becomes impossible, and doctors have to resort to radical surgery.

Drug treatment

Uterine fibroids are sensitive to hormonal levels. Therefore, drug therapy can be used for treatment, which can affect the balance of hormones. The choice of drug depends on the size of the tumor.

Progesterone

For a long time, progesterone and Utrozhestan drugs were used to treat small fibroids. It was believed that this hormone is an estrogen antagonist, which means that its use can restrain the growth of nodes when they are small. But this approach turned out to be erroneous and even dangerous.

"Duphaston" and "Utrozhestan" are medications containing progesterone.

Why has the opinion about progesterone changed? Very often, during treatment with Duphaston, fibroids are not large sizes its active growth was soon observed. This was explained by the malignant nature of the tumor and it was proposed to remove it. But pregnancy had the same effect. In 30% of cases in the first trimester, against the background of a rise in progesterone levels in the woman’s body, an increase in nodes occurred. Conversely, by the third trimester their growth had stabilized, and after childbirth small nodes could disappear.

It is important to know

Studies have shown that in myomatous nodes the number of progesterone receptors significantly increases. Therefore, the prescription of Duphaston for the treatment of fibroids is incorrect from the point of view of the mechanism of development of the disease and will only bring harm.

Monophasic drugs are suitable for treatment, in which the concentration of hormones remains constant in all tablets. These are the following medications:

Regulon;
Rigevidon;
Logest;
Novinet;
Femoden.

For small myomatous nodes, a positive effect in the treatment of pathology is given by combined oral contraceptives.

They are prescribed for fibroid sizes of 1-1.5 cm. The peculiarity of the action of these drugs is that they even out hormonal levels. The woman does not ovulate and does not form a corpus luteum. This stops the growth of the node, but does not allow it to be completely removed. Hormonal contraceptives are used as a stage of restorative or stabilizing treatment after myomectomy.

On a note

WHO studies have shown that the use hormonal contraceptives in women of childbearing age it prevents the occurrence of fibroids.

Gonadotropin-releasing hormone agonists significantly reduce the growth of nodes and promote their regression. The mechanism of their action is to inhibit the activity of hormones that stimulate the ovaries. In this case, a condition similar to menopause occurs. The production of estrogen in the female body stops, fibroids do not receive hormonal support and gradually decrease. Representatives of GnRH agonists are the following drugs:

Diferelin;
Goserelin;
Buserelin;
Leuprorelin.

Statistics show that gonadotropin-releasing hormone agonists help reduce fibroid nodes.

They are available in depot form or as injections that need to be given once a day. Depot forms are administered subcutaneously on the third day of the cycle and then once every 28 days.

Statistics say that in more than 52% of cases of treatment with this method, the size of fibroids is reduced by 50-60%. In approximately 5-8% of women, therapy does not have an effect. However, taking GnRH agonists already after 6 months leads to a decrease in therapeutic effect, the fibroid stops responding to their administration, and sometimes it even grows and is restored to 100% of its original size.

An unpleasant aspect of treatment with GnRH agonists is the large amount side effects. While using these drugs, a woman develops signs of menopause:

Demineralization of bones;
Changes in mood;
Depression;
Vaginal dryness;
Dysuric disorders.

A side effect of treatment with gonadotropin-releasing hormone agonists is sudden outbreaks of heat (hot flashes).

They are very painful and cause some women to refuse such non-surgical treatment. To combat such phenomena, various hormone therapy regimens are used:

Treatment is supplemented with small doses of estrogens, to which the tumor does not respond, but side symptoms either go away or decrease;
A course of therapy with a break - 3 months of treatment, then 3 months of rest and another course;
The standard regimen of taking hormones every 28 days is replaced by a gradual increase in the interval between administrations of new doses to 70 and then to 84 days;
In approximately 2 months, a pronounced decrease in the level of estrogen in the patient’s body is achieved, therefore, after this period, the dose of the hormone is sharply reduced to the minimum. Typically this is a jump from 100 mg/day to 5-20 mg/day. In this case, fibroid growth is inhibited, and the production of its own estrogens is restored.

GnRH agonists are used at the stage of regression treatment after removal of the myomatous node. This approach is used in perimenopausal women, and also as a prevention of relapse. At the first stage, Diferelin or its analogues are used, then combined oral contraceptives are prescribed for stabilization. Dosage regimens may be different:

1 tablet from days 5 to 25 of the cycle;
1 tablet continuously for 63 days, followed by a break for 7 days.

This is interesting

Some women prefer to use the Mirena hormonal intrauterine system, which contains a synthetic analogue of the progestogen levonorgestrel.

Mirena - a therapeutic system for treatment gynecological diseases related to hormonal imbalance in a woman's body.

Antiprogestogens

A representative of this class of drugs is Mifepristone. Its effect develops as a result of binding to progesterone receptors in tumor cells. This leads to a slowdown in fibroid growth. But you should not count on a long-term effect of the drug - the effect of taking it is short-term, and it does not allow you to completely overcome the disease. Therefore, Mifepristone is used only as preparation for surgery.

Progesterone receptor modulators

A representative of this group of drugs is. The ulipristal acetate included in its composition has a direct effect on the tumor, suppressing its growth and causing apoptosis, which leads to regression of the node. The drug is prescribed in a short course for 3 months, taken orally daily. Esmya is also used to treat concomitant endometriosis.

Uterine artery embolization

The most modern method of treating fibroids without surgery is uterine artery embolization. The procedure is performed not by a gynecologist, but by a vascular surgeon. There is no abdominal incision made, and the entire operation lasts about 15 minutes.

Embolization is a concept that means closing the lumen of a vessel and stopping blood flow in it. This term originally referred to pathological conditions. You can often hear about a detached blood clot that has blocked the lumen of a vessel in the brain, heart or lungs. Medicine has learned to use this to its advantage.

Uterine artery embolization is one of the newest methods for treating fibroids.

The procedure was originally used to stop massive bleeding. began to be used in 1994, but not as an independent treatment, but as a preparation for surgery to remove the uterus. This made it possible to reduce the amount of blood loss.

French physician Jacques Henri Ravina proposed using this method to treat women with fibroids. The success of the first embolizations led to the widespread introduction of this procedure into medical practice.

The mechanism of action of the technique is extremely simple. If you block a certain branch of the artery that feeds the fibroid, the tumor will not be able to exist. Therefore, the node gradually “dries out” and regresses. In the case of a submucosal location of the formation, due to malnutrition, it separates from the muscles of the uterus. But the node does not remain in the cavity - its birth occurs with characteristic symptoms.

Preparation for the procedure and methodology for performing UAE

To perform uterine artery embolization, hospitalization is not required, as with classical surgery. It is enough for a woman to undergo a minimal examination, as before any other invasive procedure.

On the day of embolization, the woman must come to the clinic where she will undergo treatment. After the registration procedure, she is sent to the operating room. Anesthesia for UAE is not needed, such an intervention is painless and only requires local anesthesia skin.

Stages of the operation:

After the procedure, the woman is transferred to a ward, where she must stay for a day for observation and medical care. The peculiarity of the destruction of myomatous nodes is associated with ischemic processes in them, and this is accompanied by intense pain. Therefore, on the first day after surgery, it is necessary to provide the patient with adequate pain relief.

After the UAE procedure, the patient must stay in a medical facility for 24 hours under the supervision of a doctor.

Embolization of uterine arteries in Moscow is carried out by large medical centers and small private clinics. In some clinics, pain relief begins at the stage of preparation for UAE, in order to saturate the body with drugs, and pain is not a problem. In other cases, anesthesia is performed after UAE. Severe pain is observed for 2-10 hours after the procedure, and then gradually subsides. Those women who discomfort last longer, they can take analgesics at home for a while.

Consequences of the procedure

EMA triggers the irreversible process of node death in the uterus. After the procedure, post-embolization syndrome develops. It is accompanied by the following manifestations:

Pain in the lower abdomen - pulling, cramping;
Bloody discharge from the genital tract;
Increased body temperature;
General weakness and fatigue.

If the node was located under the mucous membrane, then after UAE it may be born in a few days or months. Gradually, the formation “melts”, and unpleasant symptoms appear from the vagina. bloody issues. The temperature may rise. If during menstruation, going to the toilet, or unrelated to them, the pain increases sharply, this indicates expulsion of the node.

If the node is located deep in the muscles (), then it may not completely disappear, especially if it is large. In this case, a process of “drying out” is observed. muscle tissue and preservation of connective tissue. Therefore, as a result, up to 50% of the former volume of education remains. But the growth of the pathological focus will no longer be activated.

Anatomical and morphological changes in the myomatous node after the UAE procedure.

The body recovers completely after removal of fibroids only after a year. All this time, the woman may not feel the changes happening to her. Moreover, if, for example, the tumor grew towards the bladder and already led to dysfunction of urination, then a return to the usual routine of going to the toilet gradually becomes noticeable.

Indications and contraindications for UAE

The UAE technique is universal and can be used for fibroids of almost any size. But in this situation, the question of the feasibility of performing the procedure is resolved. If the formation is up to 1-2 cm in size, it practically does not grow and does not affect general state women, then there is no need for intervention.

When almost the entire body of the uterus is altered tissue, performing UAE is also not advisable. After the procedure, the organ will not return to its original size. In this case, only surgery is necessary.

If the myomatous node has big size, then surgical intervention is necessary. EMA procedure in in this case will not help.

Absolute contraindications for UAE are cancerous and precancerous diseases. No allergic reactions to emboli were recorded. The only exception is iodine, which is used as an antiseptic. When allergic reaction the drug is replaced with another antiseptic solution.

Relative contraindications are inflammatory processes in the pelvis and foci of infection in the body. Therefore, such women are initially treated for inflammation, and only then - UAE.

Complications after UAE are very rare. There is a certain risk of damage to the ovarian artery, which can also be blocked by an embolus. But such complications are rare and are associated with anatomical features blood supply in a particular woman.

The main goal of organ-preserving operations is to allow a woman to become a mother. After the EMA, this is quite possible. However, before planning a pregnancy, doctors recommend waiting at least a year after the procedure. If there were submucosal nodes, then you need to wait for their birth and then wait another 2-3 cycles before conception. But it is known that even in cases where women did not wait until the full term recommended by the doctor had expired, their pregnancy proceeded without complications. Therefore, anyone who wants to get a photo of the unborn child on an ultrasound, and not symptoms of fibroid progression, should take a closer look at modern methods treatment without surgery.

Expert opinion: is it possible to cure fibroids without surgery?

An interesting video about the essence of the uterine artery embolization method

Myoma is a benign tumor that grows from connective tissue on the walls or in the uterine cavity. The incidence rate by age 35 is 35-45% among the entire female population. The peak incidence occurs in age group 35-50 years old.

Uterine fibroids can range in size from a small nodule to a tumor weighing about a kilogram, when it is easily identified by palpation of the abdomen. Signs of the disease may not appear immediately. The more advanced it is, the more difficult the treatment and the greater the likelihood of complications.

Let's take a closer look at what kind of disease this is, what characteristic features and symptoms, as well as what is prescribed as treatment for a woman.

Myoma: what kind of disease is it?

Uterine fibroids (fibromyoma, leiomyoma) are the most common benign tumor of the uterus, hormonal-dependent (develops with an increased content of female sex hormones estrogen).

Myoma certainly has signs of a tumor, but it also differs from it, so it is more correct to correlate it with tumor-like formations. Despite its benign nature, fibroids can cause many problems, including uterine bleeding and complications during pregnancy, so treatment must be approached responsibly.

The occurrence of uterine fibroids usually occurs in her body, but in rare cases it can also occur in the cervix. Fibroids that develop in muscle tissue are considered typical, while those that form in the neck or ligaments are considered an atypical form of the disease.

The myomatous node begins its development from a growth zone located around a thin-walled blood vessel. In size, such growth can range from several millimeters to several centimeters; most often it occurs in women. multiple fibroids when several neoplasms form at once.

Causes

Myoma ranks 2nd in the structure of gynecological diseases. Its frequency in reproductive age averages 16%-20% of cases, and in premenopausal age it reaches 30-35%.

Myoma appears as a result of mutation of a single cell. Its further division and development of the tumor is influenced by changes in hormonal levels in the body, a violation of the ratio of estrogen and progesterone. When the production of female sex hormones decreases, the tumor may disappear on its own.

The following reasons lead to uterine fibroids:

Hormonal disorders – a sharp decline or an increase in estrogen levels, which are clinically manifested by various menstrual disorders.
Irregularity of sexual activity, especially after 25 years. As a result of sexual dissatisfaction, blood flow in the pelvis changes, and stagnation prevails.
Disturbance in the production of sex hormones in ovarian diseases
Prolonged stress, heavy physical work
The presence of chronic infectious diseases such as chronic pyelonephritis, chronic tonsillitis and etc.
Diseases of the endocrine glands: thyroid gland, adrenal glands, etc.
Violations fat metabolism in the body (obesity).
Mechanical damage, difficult childbirth with ruptures, abortions, complications after surgery, consequences of curettage.
Hereditary factor. The risk of developing fibroids increases significantly in those women whose grandmothers and mothers had such a tumor.

It has been proven that women who have given birth are less likely to develop nodes. Often this tumor can appear during pregnancy. Especially if the first pregnancy is late.

Classification

I have several classifications of such formations. Depending on the number of nodes, uterine fibroids can be of the following types:

Single;
Multiple.

According to the sizes there are:

Large;
Average;
Small myomatous neoplasms.

Depending on the size of the myomatous nodes, which are compared with the duration of pregnancy, there are

small fibroids (5-6 weeks),
medium (7-11 weeks),
large sizes (over 12 weeks).

Depending on the size and location of the nodes, there are 3 types of uterine fibroids:

leiomyoma - consist of smooth muscle tissue;
fibroma - consists of connective tissue;
fibroids - consists of connective and muscle tissue.

Based on their location relative to the muscle layer – the myometrium – fibroids are classified as follows:

Interstitial uterine fibroids

It is located in the center of the myometrium, i.e. muscular layer of the uterus. It is characterized by large sizes. It is completely located in the thickness of the muscular layer of the uterine wall (occurs in 60% of all cases of the disease).

Submucosal fibroid

What it is? Submucosal or submucosal - grows in the direction of the endometrium. If such a node is partially (more than 1/3) located in the myometrium, it is called intermuscular with centripetal growth (towards the uterine cavity). It may also have a stem or a wide base. Pedicled fibroids can sometimes “fall out” of the cervical canal, becoming twisted and infected.

Subserosal

Subperitoneal (or subserous) - the node is located under the mucous membrane of the outer layer of the uterus, near the peritoneum. Subserous fibroids are divided into the following types:

"Type 0". A knot on a wide base is 0-A, a knot on a leg is 0-B.
"Type 1". Most of the node is located in the serous membrane.
"Type 2". Most of the tumor is located in the thickness of the myometrium.

Stages

There are three stages of fibroid morphogenesis:

Formation of the rudiment (active growth zone) in the myometrium.
Growth of an undifferentiated tumor.
Growth and maturation of a tumor with differentiated elements.

The rate of development of myomatous nodes depends on many factors:

The presence of chronic gynecological pathologies;
Long-term use of hormonal contraceptives;
Presence in the past large quantity abortions;
Prolonged ultraviolet irradiation;
Absence of childbirth and lactation in women after 30.

With the rapid growth of a myomatous tumor, a woman observes menorrhagic changes (excessive bleeding during menstruation), anemic signs, and hyperplastic tissue changes occur in the uterus.

An increase in tumor size does not always occur unambiguously, so the following is distinguished:

Simple. Slowly growing and asymptomatic uterine fibroids of small size, often single. Often simple fibroids are diagnosed accidentally.
Proliferating. Grows quickly, provokes clinical manifestations. Diagnosed as multiple uterine fibroids or single large ones.

It is usually recommended to treat fibroid nodes in young women, especially if the tumors are bothersome or interfere with pregnancy. Depending on the location of the node and its size, the doctor may first prescribe conservative therapy - taking medications, and if there is no effect, surgery.

The first signs in a woman

A fibroid can only be recognized when it has reached a sufficiently large size. As uterine fibroids grow, the first signs may appear:

The appearance of sharp pain of a cramping nature not associated with menstruation in the lower abdomen;
long, heavy and irregular menstruation;
constipation;
bleeding;
frequent urination;
heaviness and constant pain in the lower abdomen;
bleeding during sexual intercourse;
lower back pain;
abdominal enlargement not associated with significant weight gain;
frequent miscarriages.

All these signs may be present with other gynecological problems. Therefore, they are not enough to make a diagnosis. The presence of a tumor can only be confirmed by a thorough examination and ultrasound.

Symptoms of uterine fibroids

Often, uterine fibroids do not give any symptoms and are found during a routine examination by a gynecologist. Or it happens that the symptoms are quite smoothed out and are often perceived as a variant of the norm.

The growth of uterine fibroids is accompanied by the appearance of symptoms, the most common of which are:

Pain during the intermenstrual period, varying in duration, occurring in the lower abdomen, sometimes radiating to the lumbar region, upper sections abdomen or legs;
Menorrhagia is an increase in menstrual flow. Heavy bleeding is dangerous because after some time it can result. More heavy bleeding indicates that the muscles of the uterus are contracting less well, in which case medical attention is required.
Pelvic organ dysfunction, which are manifested by frequent urge to urinate and constipation. These symptoms occur when the subserous nodes are pedunculated, cervical, or interligamentous, as well as when large volume tumors.
Feeling of heaviness increases, the presence of something foreign in the stomach. Sexual intercourse becomes painful (if the nodes are located on the vaginal side). The belly grows, as during pregnancy. A sprain increases the nagging pain in the abdomen.
Miscarriage, infertility - occur in 30% of women with multiple fibroids.

In the photo below, you can see the fibroid from different sides:

It is impossible to independently determine whether you have the disease. If the above symptoms and signs of uterine fibroids appear, you should definitely undergo an examination by a gynecologist. These signs can also be accompanied by more dangerous diseases, such as uterine or ovarian cancer, endometriosis.

	Symptoms in a woman
For submucosal	manifests itself in various disorders menstrual cycle, heavy and prolonged menstruation, uterine bleeding, which often results in anemia. Pain syndrome is not typical for such fibroids, but if the myomatous node falls from the submucosal layer into the uterine cavity, cramping, very intense pain occurs.
With intramural	appears in the middle layer of muscle tissue of the uterus and is accompanied by cycle disturbances and pain in the pelvic area
For subserous	It often occurs without symptoms, so the pain is minor and appears rarely: pain in the lower back, back pain, as well as urination problems and constipation.

Complications

Uterine fibroids pose a danger to a woman’s health in terms of the development of complications of the disease. With regular monitoring by a gynecologist and careful attention to her health, a woman can significantly reduce the risk of complications.

Complications of uterine fibroids:

necrosis of myomatous node;
birth of a submucosal node;
posthemorrhagic anemia;
tumor malignancy;
infertility;
miscarriage;
postpartum hemorrhage;
hyperplastic processes of the endometrium.

In order to avoid complications, you should begin treating fibroids in a timely manner (immediately after detection). Surgical intervention is rarely required and is more often associated with existing complications of the disease.

Fibroids and pregnancy

Uterine fibroids are found in 8% of pregnant women undergoing pregnancy monitoring. For most women, during pregnancy the size remains unchanged or decreases.

Danger:

development of fetoplacental insufficiency (changes in the structural and functional properties of the placenta, which can lead to impaired fetal development);
threat of miscarriage at various stages.

Most often, women with uterine fibroids are offered to give birth by caesarean section due to the risk of all sorts of complications, such as:

untimely rupture of amniotic fluid (this occurs due to increased tone of the muscular layer of the uterus or incorrect location fetus);
risk of heavy postpartum bleeding;
risk of premature placental abruption (most often this occurs if the fibroid is located behind the placenta).

During a caesarean section, a woman may have the tumor removed immediately so that she can plan another pregnancy in the future.

Diagnostics

The first signs of fibroids are very similar to the symptoms of other gynecological pathologies. Therefore, to make a correct diagnosis, it is necessary to conduct a series of laboratory instrumental studies. Only a correct and timely diagnosis can become a guarantee successful treatment and a speedy recovery.

Diagnostics include:

Gynecological examination. It is carried out on a gynecological chair using necessary tools. The size of the uterine body, the location of the ovaries, the shape and mobility of the cervix, etc. are taken into account;
Ultrasound of the pelvic organs using a vaginal probe. For better visualization, the study is performed with a filled bladder. The method is highly informative and allows you to identify the size of the tumor and its shape;
Laparoscopy - used only when myoma cannot be distinguished from an ovarian tumor;
Hysteroscopy is an examination of the cavity and walls of the uterus using an optical hysterocope. Hysteroscopy is performed for both diagnostic and therapeutic purposes: identification and removal of uterine fibroids in certain locations.
Biopsy. In some cases, during hysteroscopy or laparoscopy, a small sample of tissue is taken, which is then examined in more detail under a microscope.
Diagnostic curettage of the uterine cavity: indicated for all identified uterine fibroids in order to establish endometrial pathology and exclude uterine cancer.

How to treat uterine fibroids?

How to treat uterine fibroids? The main goal of treating fibroids is to eliminate the cause of the disease and harmful effects tumors on the surrounding tissues of the uterus, reduction in its size, growth arrest. Both medical and surgical methods are used.

As a rule, treatment tactics are chosen depending on the size, location and clinical and morphological variant of the tumor, the hormonal status of the patient, the state of her reproductive systems, etc. Some experts believe that there is no need to rush into surgery, but it is wiser to monitor the woman’s health before the onset of menopause.

Unfortunately, conservative treatment fibroids are effective only under certain conditions, namely:

relatively small size of the node (the size of the uterus does not exceed a 12-week pregnancy);
asymptomatic course;
the patient’s desire to preserve the uterus and, accordingly, reproductive function;
inertial or subserous arrangement of nodes having an exceptionally wide base.

With a confirmed diagnosis of uterine fibroids, the following groups of drugs are used:

Combined oral contraceptives containing desogestrel and ethinyl estradiol. These medications help suppress and alleviate the first symptoms of fibroids in women. However, drugs in this group do not always help to reduce tumors, so they are used only when the size of the node does not exceed 1.5 cm.
Androgen derivatives: Danazol, Gestrinone. The action of this group is based on the fact that androgens suppress the synthesis steroid hormones ovaries. As a result, the size of the tumor decreases. Use for up to 8 months continuously.
Antiprogestogens. Helps stop tumor growth. Treatment can last up to six months. The most famous drug in this group is Mifepristone;
Antigonadotropins (Gestrinone)– prevent an increase in the size of uterine fibroids, but do not help reduce existing sizes.

FUS ablation. One of modern methods fight against fibroids. In this case, the tumor is destroyed by ultrasound under the control of a magnetic resonance imaging scanner.

A woman receiving conservative treatment for uterine fibroids should be examined at least once every 6 months.

A set of recommendations has been developed for such patients:

It is strictly forbidden to lift heavy objects, which can lead to prolapse of the uterine body and other complications;
Stress that negatively affects hormonal levels is unacceptable;
Increase the consumption of fruits, berries, herbs, vegetables, as well as fish and seafood;
Walk more often (this helps improve blood flow);
Refuse from sports in which the load is aimed at abdominal muscles(you can do free swimming and yoga);
It is also worth noting that patients with diagnosed fibroids should avoid thermal effects. This means that you need to give up long sunbathing, visiting the bathhouse, sauna and solarium, as well as hot showers.
Undergo restorative treatment with vitamins 4 times a year (select the complex together with your doctor).

Surgical treatment: surgery

Mandatory indications for invasive therapy are:

the size of the tumor is more than 12 weeks and it puts pressure on nearby organs;
myomatous formations provoke heavy uterine bleeding;
there is an acceleration in the growth of fibroids (by 4 weeks in less than a year);
necrotic changes in the tumor;
twisting of the pedicle of the subserous node;
nascent submucosal myoma (emergency laparotomy is indicated);
combination of myomatous nodes with.

There are different options for surgical treatment of uterine fibroids. Among them, three main areas can be distinguished:

removal of the entire uterus and nodes;
removal of myomatous nodes while preserving the uterus;
surgical disruption of blood circulation in fibroids, which leads to their destruction.

Depending on the type of fibroid, its location, and size, the doctor chooses the type of surgery to remove the fibroid. Myomectomy today is performed in 3 ways:

Laparoscopy - through small holes in the abdomen
During hysteroscopy, a special instrument is inserted into the uterus through the vagina.
Strip surgery through an incision in the lower abdomen is performed very rarely.

Rehabilitation after surgery

Rehabilitation of the female body depends on a variety of factors:

For example, if the operation was performed using an open method, then recovery process passes more slowly.
The patient is offered a restriction physical activity, not forgetting that measured walking can only bring benefits and will contribute to accelerated healing.

Maintaining proper nutrition

There is no special diet, you just need to stick to a healthy diet.

First of all, it is diverse and balanced diet, corresponding to the energy needs of a woman, with the inclusion of vitamins and microelements.
Food is taken 5 times a day; overeating and long breaks between meals are not allowed.
A healthy diet involves eliminating frying and using baking, stewing or boiling when preparing dishes.

Allowed products for fibroids

Prohibited Products

The basis of the diet should be the following products:

vegetable oil – sunflower, flaxseed, rosehip, corn, etc.;
any fruits, herbs, vegetables, berries;
dark varieties of bread, with the addition of coarse flour and bran;
cereals, legumes;
fish products, mainly sea fish;
fermented milk products (fresh);
nuts, seeds, seeds;
high-quality varieties of green and black tea, herbal tea;
compote or jelly based on berries or fruits.

Undesirable foods should be excluded from the diet:

margarine, oil mixtures (spreads), limited butter;
fatty meat, lard;
sausages, smoked products;
hard cheese with a high percentage of fat, processed cheese, sausage cheese;
baked goods and baked goods made from white flour;
sweets, including cakes, ice cream, cream pies.

Folk remedies

Before you start using folk remedies If you have fibroids, be sure to consult your doctor.

Tampons with burdock root juice are applied topically. Add honey, sea buckthorn and St. John's wort oil, mumiyo to the juice and mix thoroughly. The tampon is placed overnight for 21 days.
Sea buckthorn berry oil. To do this, make cotton swabs, soak them in oil and place them in the morning and evening. The course lasts 2 weeks. If necessary, it can be repeated.
Take 4 tsp. flax seeds, pour half a liter of boiling water and simmer over low heat for 10 minutes. At this time, stir the broth. When it cools down, drink half a glass, 4 times a day. The course lasts 15 days, then take a break for 15 days, and repeat the course.
Tincture of partitions walnut . You can buy it ready-made at the pharmacy and use it according to the instructions, or you can prepare it yourself: pour 30 grams of partitions with vodka (1 glass) and leave in a dark place for 3-4 weeks. Take 30 drops 30 minutes before meals with a glass of water. The course is 1 month, 2 weeks break and can be repeated.
Prepare an infusion of several flowers by brewing them with a glass of boiling water for 10 minutes. You need to drink it in the morning before breakfast, for a long time. The duration of admission is determined by the herbalist. Calendula infusions are used for douching. This plant can be used internally in the form of a pharmaceutical tincture.
Finely chopped boron uterus grass(50 g) pour 500 ml of vodka. Leave for ten days in a dark place, shaking regularly. The first ten days take the infusion one teaspoon once a day, the next ten days - one tablespoon. Then take a break for ten days and repeat the treatment.
Using tampons gives good results, soaked in medicinal liquids. Shilajit should be diluted with water in a ratio of 2.5:10. Soak a cotton pad in the prepared solution and place it in the vagina. At the same time, mumiyo should be taken orally at a dose of 0.4 g. Therapy should last 10 days, after which a break of 1 week must be taken. Afterwards you can repeat the course.

Forecast

With timely detection and proper treatment of uterine fibroids, the further prognosis is favorable. After organ-preserving operations in women in reproductive period pregnancy is likely. However fast growth uterine fibroids may require radical surgery to exclude reproductive function, even in young women.

Prevention

Main preventive measures boil down to the following:

proper nutrition with a predominance of fresh vegetables and fruits;
taking vitamins and microelements that contribute to the normal synthesis of sex hormones;
active lifestyle, playing sports;
regular sexual intercourse;
annual preventive examinations with a gynecologist with ultrasound.

We found out what uterine fibroids are and what treatment is most effective. Remember, when regularly visiting a doctor, if a tumor occurs, it will be found at the very beginning, while its size is small and the woman does not even suspect the presence of fibroids. Timely detection of a tumor will allow it to be cured without the use of surgical means and maintain the ability to bear children.

Myoma is a hormonal-dependent neoplasm, so in most cases these tumors occur over the age of 35-40 years. It may not manifest itself in any way if it grows at a slow pace and may disappear spontaneously after menopause. But in some cases, intensive growth of this tumor can be observed, the size of which doctors measure in the same way as for weeks. When its value reaches 12-13 weeks and after Last year for 4-5 weeks, this may be a symptom of the onset of cancerous degeneration. In this case, there is no point in wasting time on treatment and the only correct option becomes.

It is also indicated when the myomatous node is located in the cervix or there is heavy menstruation, which may not begin on time and is accompanied by pain and heavy bleeding. In this case, there is a danger of anemia, so there is simply no time left for treatment. The operation is also indicated in cases where the tumor compresses neighboring organs, disrupting their normal functioning. In other cases, fibroids can be treated without a surgeon’s scalpel.

The technique of FUS therapy for fibroids is successfully used even in cases that most recently resulted in the removal of the uterus.

Non-surgical treatment of fibroids

In the vast majority of cases, fibroids can be removed without surgery. For this purpose, focused ultrasound (FUS) pulses are used, which exert a targeted effect under the control of magnetic resonance imaging (MRI) on the fibroid cells inside the tumor and literally “evaporate” them. Ultrasound pulses heat small areas of the tumor to a specific temperature that destroys cells. This effect is called ablation.

The Federal Budget provides quotas for the treatment of reproductive diseases in women.

So that you can take advantage of this opportunity and cure fibroids without surgery, you should contact the Clinic reproductive medicine at your place of residence. It is necessary to undergo a gynecological examination, examinations and tests so that the Clinic doctor can give his opinion that in your case you can use FUS therapy for fibroids under MRI control, which is carried out in Moscow at the Treatment and Rehabilitation Center of the Federal Service for Health. As a rule, the ablation procedure is performed within one day and after it there is no need to receive additional treatment in the hospital.

For most women, the diagnosis of uterine fibroids sounds very threatening. After all, firstly, the word tumor is immediately associated with surgical treatment. And, secondly, some women heard stories from the older generation - their mothers and grandmothers - that such diseases were always treated with surgical intervention.

But at present, this disease does not pose such a danger. And if you have fibroids, treatment without surgery is possible.

Description of the disease

All researchers who study this pathology still cannot reliably say what is the direct cause of the development of this benign tumor. However, in most cases, to trigger pathological cell proliferation, an imbalance of sex hormones and a hereditary predisposition must be present.

But the combination of these two factors does not necessarily lead to the development of fibroid nodes. Risk factors also include being overweight. But again, there is a relationship between the production of sex hormones and fat deposits in the body. After all, estrogen production can also occur in adipose tissue.

Also, any operations and interventions in the integrity of the reproductive system can provoke the development of a tumor. These are abortions, curettage, inflammation and trauma during childbirth. Doctors also note in their reviews that a sedentary lifestyle or problems in intimate life can provoke stagnation of blood in the reproductive system, which, in turn, can contribute to the development of fibroids.

Myoma can grow into a single node or present as multiple nodes. Moreover, the latter are a little more difficult to cure.

The disease is classified depending on the location of the nodes and can be submucosal, subserous, itramural, interstitial. With multiple myoma nodes, a mixed type of disease can be diagnosed.

Depending on their size, fibroids are divided into large, medium and small. Small fibroids almost never show symptoms. Medium-sized nodes most often cause menstrual irregularities, and if the node has grown to a large size, it can cause pain in the lower abdomen and disturbances in the functioning of organs adjacent to the uterus.

Diagnosis of the disease

Before prescribing treatment, the gynecologist must conduct a diagnosis to determine the number, location and size of the nodes. To do this, the doctor interviews the patient, examines her in a gynecological chair, and prescribes ultrasonography and, if necessary, other examination methods.

Depending on the indicators, therapy will be determined. For example, for submucous fibroids, surgical treatment is prescribed. The operation is also prescribed for:

excessive tumor growth
large node sizes,
when nodes are localized in the cervical area,
with heavy bleeding caused by fibroids.

In all other cases, the doctor tries to avoid surgery and prescribes conservative treatment. This is especially true for multiple nodes, when it is very difficult to remove all tumors at once.

Conservative treatment

If you have fibroids, the prescribed treatment without surgery can vary. There are three main methods, each of which has its own advantages. But a doctor must prescribe one or another treatment method based on the diagnosis.

Uterine artery embolization

Enough new method treatment of fibroids without surgery. But, despite its novelty, it has many positive reviews that indicate the high effectiveness of this method.

This treatment involves blocking blood vessels, feeding the tumor with the help of special microparticles – embolus. They are made from body-safe plastic. Emboli are introduced into the artery using a catheter and an intravenous injection. The patient is not given anesthesia, since the entire procedure is painless and lasts about half an hour.

Blood supply to the uterus occurs through four arteries - two uterine and two ovarian. The main role in this is played by the uterine cells, they also feed the neoplasm. But since the blood supply to the tumor is inadequate, if the uterine arteries are blocked, it will suffer first. And healthy uterine tissue will be nourished by the ovarian arteries.

After the tumor stops feeding, it begins to decrease in size, as if “shrinking out”. After just a few months, fibroid nodes are reduced by 40–50 percent. Therefore, for uterine fibroids, this treatment without surgery has positive reviews. The main advantage of the uterine artery embolization method is the absence of disease recurrence. It can also sometimes be used to treat submucous fibroids, which are difficult to treat without surgery.

FUS ablation

With this method of treating uterine fibroids without surgery, the tumor is exposed to ultrasound. The patient is placed in a special preparation - a magnetic resonance imaging scanner, where the entire procedure takes place.

If this method is used, then the fibroid under the influence of this treatment without surgery is, as it were, evaporated by an ultrasound beam. Patients who have undergone this treatment talk about the following advantages of the method in their reviews:

the treatment occurs without surgery, so there are no stitches left on the abdominal wall and uterus,
the risk of bleeding is minimal,
general anesthesia is not required, which reduces the overall burden on the body,
well suited for the treatment of multiple fibroids,
there are practically no relapses,
Long-term hospitalization is not required, so most often the woman goes home on the same day.

Contraindications to the use of this technique are pregnancy, excess weight, too small nodes, pedunculated submucous fibroids, strokes, heart attacks and some other restrictions.

Drug treatment

When diagnosed with uterine fibroids, this treatment without surgery is immediately remembered and the reviews about this technique are quite good. With the right selection medicines The therapy is quite effective, and the woman begins to notice an improvement in her condition in the near future.

Hormonal drugs are almost always used to treat uterine fibroids.
Combined oral contraceptives. The most popular tablets are Zhanine, Novinet, Diane-35. These medications affect the hormonal balance and, in addition to their main function - preventing conception, help stop the growth of fibroids.
GnRH agonists. These are drugs such as Diferelin, Buserelin, Lucrin-Depot. Tablets of this group put the body into a state of artificial menopause, which affects hormonal levels. Under the influence of such changes, the level of estrogen in the blood decreases, and this stops the growth of fibroids, and sometimes leads to its reduction. But when taking these pills, side effects such as drowsiness, mood swings and other signs of menopause are possible.

Progestins. These medications affect the production of estrogen. And a decrease in the concentration of these hormones leads to a halt in the growth of nodes.

The disadvantage of treating uterine fibroids with medications is that often when you stop taking them, the nodes often begin to grow again.

Folk recipes

Treatment of uterine fibroids without surgery using folk remedies is quite controversial.

The most popular folk remedy for treating fibroids without surgery is hog queen. A tincture of this plant can be purchased at a pharmacy. This infusion should be taken one teaspoon at a time for 10 days. Then a ten-day break and the course of treatment is repeated. You can prepare this infusion yourself from dried boron uterus grass and vodka. For 50 g of herb, take 500 ml of liquid and infuse it for 10 days, then take it according to the same scheme.

Another popular folk remedy is celandine. From this herb you can prepare an infusion similar to that prepared from the boron uterus, only the dry herb and vodka are taken in a ratio of 1 to 10. But the regimen for taking the tinctures differs. On the first day, add a drop of the product to half a glass of water. The next one - two. And so on until it reaches 15 drops, and then start decreasing one drop at a time.

You can also use freshly picked herbs, the juice of which is diluted with alcohol and honey in proportions 1:1:2. Everything is left in the refrigerator for 5 days, and then 2 teaspoons are taken before meals.

You can also use various traditional methods, which activate the work immune system, increase the body’s resistance and generally improve the human condition.

But before using any folk remedies, you should talk to your gynecologist. The fact is that although herbs contain small amounts active substance, uncontrolled use may lead to side effects. It should also be remembered that some herbs in large doses are poisonous to humans, so you should strictly follow the dosage recommended by your doctor.

Any folk remedies should be taken as part of complex treatment, since if they are taken individually, the treatment will not be effective.

In order for the treatment of uterine fibroids without surgery to be effective, the gynecologist must accurately understand the size of the nodes, how many there are and how they are located. Also, the sooner therapeutic measures are started, the easier the treatment will be and the greater the chance of no relapse.

Myoma is a benign formation that forms from the muscular layer of the uterus. The disease is a common pathology among women reproductive age. According to statistics, 20% of women over 35 years of age have fibroids, so many are interested in whether it is possible to treat uterine fibroids without surgery.

Myoma cells are structurally similar to connective tissue and muscle cells body, which indicates their benign origin. But sometimes a tumor can transform into a malignant one, that is, become malignant, so the disease must be treated, and the sooner the therapy is carried out, the better.

Treatment without surgery is possible.

Indications for alternative ways surgical treatment are:

enlargement of the uterus to the size of a 12-week pregnancy (treatment of large uterine fibroids without surgery is impossible);
the diameter of the nodes is no more than 2 cm;
the functional significance of the organs located near the uterus is not changed;
the clinical picture of the disease is not expressed;
myomatous nodes are located subserous or intramural;
there are no contraindications to conservative therapy used as an alternative to surgery;
Myomatous nodes grow slowly.

It is important to note that the above states are observed only in initial stage diseases. As practice shows, most women learn about the diagnosis much later, when the symptoms of the pathology are pronounced and the fibroids increase to large sizes.

To prevent this, it is important to regularly undergo preventive examinations with a gynecologist and promptly treat any problems with women’s health at the initial stage.

The earlier the disease is diagnosed, the higher the chances of using alternative methods of treating uterine fibroids without surgery.

Conservative therapy

If the disease is detected at the initial stage of development, the attending physician may temporarily postpone surgery and try to use conservative treatment of the tumor using the following methods:

embolization of uterine arteries;
hormone therapy;
FUS ablation of fibroids.

Embolization of the uterine arteries

This is a relatively new method of treating the disease, which answers the question of whether uterine fibroids can be cured without surgery. This is a minimally invasive technique that allows you to avoid surgical intervention on the reproductive organ. It is based on the introduction of an intravascular non-cohesive substrate - emboli into the vessels of the uterus, resulting in selective occlusion or blockage.

Clogged arteries stop “feeding” the fibroid, therefore, it stops its growth and development and after some time simply dies. Usually a couple of hours are enough for this. Embolization of the uterine arteries is performed by an x-ray surgeon. Unfortunately, this technique is not widespread in our country due to the lack of special equipment and X-ray rooms.

FUS ablation

This is also a relatively new non-invasive technique. During the procedure, the doctor removes the fibroid using a focused beam of ultrasound waves. During the medical procedure, the woman is placed in a magnetic resonance imaging scanner, which will help the specialist monitor own movements. Ultrasound signals will have a targeted effect on the fibroid, and at this moment its cells will be destroyed.

Hormonal treatment

With the help of complex influence hormonal drugs Treatment of uterine fibroids without surgery is most often performed.

For conservative therapy the following are used:

Agonists . The action of these drugs is aimed at artificially creating menopausal conditions. The fact is that during menopause the tumor stops growing, and over time it tends to shrink. 3 months after treatment with agonists, the first signs of positive dynamics should appear - the fibroids may decrease in size. But agonists have side effects such as a tendency to depression, osteoporosis, and hot flashes. An example of agonist drugs is Buserelin.
Progestins . These drugs block the synthesis of estrogens by the ovaries, which nourish fibroids and promote their active growth. But treatment with progestins is not considered highly effective, since in most cases myomatous nodes do not disappear completely. Examples of progestin drugs are Norkolut.
19-norsteroids . These drugs are prescribed not only for uterine fibroids, but also have increased antigonadotropic activity and also block estrogen-sensitive receptors in the mucous layer of the uterus. An example of 19-norsteroids is Gestrinone.
Androgens . Inhibits the functional activity of a woman's gonads. They are rarely used to treat fibroids, as they have many side effects. Examples of androgens are Tetrasterone, Testenate.

How to treat uterine fibroids without surgery using conservative methods and achieve a positive result?

During treatment, it is important to avoid any stress factors, since emotional upheavals provoke hormonal changes in the body, and therefore the growth of myomatous nodes can accelerate;
you cannot lift or carry heavy things that weigh more than 3 kg;
It is not recommended to overheat the body; to do this, you need to avoid visiting bathhouses, saunas, beach tanning and much more;
massage should be avoided;
it is important to carefully, which during treatment will become a serious hormonal surge, and its interruption - even more so.

Treatment with traditional methods

Treatment methods traditional medicine can give positive result only at the initial stage of development of uterine fibroids. It is important to combine conservative treatment with folk recipes, since herbal medicine can enhance drug therapy, but it can be used independently as the main therapeutic method can not.

How can uterine fibroids be cured without surgery using traditional therapy methods?

Herbs will help, namely:

Plants with antitumor effects . Such herbal preparations help remove tumors in any part of the uterus; for example, they can cure submucosal uterine fibroids without surgery. Antitumor plants are marsh cinquefoil, white mistletoe, chitotel, tartar, hog queen.
Plants with immunomodulatory and adaptogenic effects . With uterine fibroids, improving the body's defenses will not be superfluous, since the body needs to be adjusted to fight the disease. Natural adaptogens and immunomodulators are eleutherococcus, pennyweed, radiola rosea, and Manchurian aralia.
Plants that normalize