What to Know About Uterine Fibroid Complications

These growths can develop in and on the uterus, often in women of childbearing age, and range widely in size from about as small as a pea to as large as a grapefruit or watermelon, explainsKelli Burroughs，医学博士，德克萨斯州休斯敦的纪念赫尔曼·糖土地医院的妇科医生。您可以有一个肌瘤，即20个或更多。Burroughs博士说，超声是诊断肌瘤的关键手段，相关的大小和位置。该信息很有帮助，因为并发症和不舒服的症状通常与肌瘤的大小和位置相关。

“When fibroids are close to or within the cavity of the uterus, it can cause heavy menstrual bleeding,” explainsLatasha Murphy, M.D., a gynecologist and surgeon with the Gynecology Center at Mercy Medical Center in Baltimore, MD. Exactly why is unknown:Researchers cite包括肌瘤在内的理论增加了子宫内膜的表面积，Engorge血管和撞击子宫收缩。什么时候寻求医疗帮助？墨菲博士说，如果您经常流动异常沉重，连续七天或之间出血，您会感到骨盆不适/疼痛或经历痛苦的​​性交，请与您的医生接触。

沉重的出血不仅不舒服，而且会导致iron-deficiency anemia。Along with blood loss, there’s a drop in hemoglobin, the component of red blood cells that transports oxygen. The body needs iron to produce hemoglobin, but scrambles to find enough iron to keep up with the need for rapidly-depleting hemoglobin. And if you don’t have enough hemoglobin to deliver oxygen throughout your body, you can feel excessive fatigue. In that case, have your iron levels checked by your doctor, says Dr. Murphy. If your levels are low, taking iron supplements and eatingiron-rich foodscan help to boost energy levels.

Fibroids can cause a distortion of the uterus, posing further complications. “Imagine filling a sock with various size balls,” says Dr. Burroughs. “The original shape and size of the sock will be directly impacted by the number, size, and position of the balls.” If the enlarged uterus presses on the bladder in front of it, the bladder may not be able to store much urine. Therefore, patients need to urinate more frequently, explains Dr. Murphy. (Fibroids can also press against the tubes which transport urine from the kidney to the bladder, causing potential kidney dysfunction, although such cases很少见）

同样，当肌瘤位于子宫后壁上时，它们可以对位于子宫后面的直肠施加额外的压力。根据加州大学旧金山健康的说法，这可能会导致在排便过程中排便和/或疼痛的困难。您的医生可能会推荐泻药或其他方法来帮助您constipation。With both bladder and bowel complications, surgical fibroid removal should be considered when less invasive treatment to shrink fibroids doesn’t work, says Dr. Burroughs.

The location and size of the fibroids can affect a woman’sfertility。例如，肌瘤可能会阻塞输卵管，以便精子无法伸到卵以首先施肥。另外，“如果肌瘤占据子宫内腔，患者的流产风险更高，因为肌瘤可以防止适当地植入胚胎，” Burroughs博士说。至于治疗选择，一个studyfound 80% of women with fibroids were able to get pregnant within a year undergoing a腹腔镜肌瘤切除术to remove the fibroids.

It is also possible for fibroids to grow during pregnancy. This can potentiallyincrease the riskof premature delivery or pregnancy loss, according to the University of Chicago Medicine. During delivery, a fibroid may also block the birth canal, which can lead to the need for your doctor to perform a Cesarean section. If you are considering becoming pregnant, it’s best to speak with your doctor about what, if any, impact your fibroids may have, notes Dr. Murphy: Many women with fibroids successfully have vaginal births, and fibroids outside the uterine wall may not present added complications.

On top of birth control, there are other medications your doctor can prescribe to manage your fibroid symptoms. TheseincludeGonadotropin-releasing hormone (GnRH) agonists, to prevent menstruation and shrink fibroids, and tranexamic acid which reduces the blood loss during menstruation. Another minimally invasive surgery option is called uterine fibroid embolization (UFE), a procedure that interrupts blood supply to the uterus. Typically, fibroids start to shrink within three months, with a reduction in heavy bleeding and cramping. A hysterectomy can be performed as a last resort but it is not an option if you want to preserve fertility, says Dr. Murphy.

如果您对这些潜在的并发症（或与之打交道）有担忧，请向您的医疗保健提供者讨论您的选择。尽管可以在检查期间感觉到肌瘤，但可能会进行超声检查，以确定大小和位置如何影响您的身体。Burroughs博士说，您的治疗计划将集中在您的症状上，并考虑到生育能力的问题。尽管子宫切除术是完全摆脱肌瘤的唯一方法，但仍有other non-surgical waysto find the relief you need.