There is a lot to learn about sanitary napkins! The health status of women with dialysis based on the amount of use

Introduction: Last month, 39-year-old Ms. Zhao felt her belly growing bigger and bigger. She could even feel a lump on her belly. Her colleagues all teased her that she was pregnant. When she went to the hospital for a check-up, she was shocked - she had 27 uterine fibroids of various sizes, the largest of which weighed 4 kilograms. Recently, Ms. Zhao successfully underwent "minimally invasive abdominal transverse incision myomectomy + uterine plastic surgery". She was able to become pregnant normally two years after the uterine plastic surgery.

Experts remind that not every patient with uterine fibroids needs to undergo tumor removal surgery or even hysterectomy. If the diameter of the fibroid is larger than 5 cm, or the fibroid grows under the mucosa or in the uterine cavity, and there are symptoms such as excessive menstrual flow, secondary anemia, compression of the bladder causing frequent urination, or compression of the rectum causing constipation or difficulty in defecation, which affects normal life, surgery is recommended. If there is no desire to have children or if the tumor is suspected to have become malignant, a hysterectomy will be performed. If the diameter of the fibroid is less than 3 cm, you can observe it for a period of time before making a decision.

Uterine fibroids

"Favoring" unmarried women

Dr. Wan Lan, director of the Department of Obstetrics and Gynecology at the 458th PLA Hospital, said that it is very rare for someone like Ms. Zhao to not feel any symptoms. The following symptoms generally indicate the possibility of uterine fibroids: heavy and spotty menstrual flow. Generally, no more than 2 packs (10 pieces) of sanitary napkins are used in each menstrual cycle. If more than 3 packs are used and the sanitary napkins are almost soaked, it is menorrhagia; short, frequent and urgent urination; lower abdominal distension and discomfort, and constipation; in severe cases, anemia may occur. In addition, uterine fibroids may also cause female infertility. Wan Lan introduced that the high-incidence age group for uterine fibroids is 28 to 45 years old. Normally, if menopause occurs, uterine fibroids will also shrink as hormone levels decrease. "In the past, women rarely suffered from uterine fibroids, which was related to the high number of births. Because the ovaries do not ovulate during the ten months of pregnancy and the six months of breastfeeding, hormone secretion is at a low level, which plays a role in protecting the uterus." In addition, factors such as genetics, diet, obesity, and emotions can also affect the occurrence of uterine fibroids.

Do I need surgery for uterine fibroids?

Wan Lan said that not every patient needs surgery. According to research results, 10% of women in the population suffer from uterine fibroids, but most of them are asymptomatic. It is necessary to evaluate the size, location, number, deformation, and impact on life of uterine fibroids, and then develop a personalized plan based on the evaluation results.

For women with uterine fibroids who have not given birth, if the fibroids grow in the uterine cavity, it will affect pregnancy and may cause abnormal uterine morphology, infertility or miscarriage. Therefore, the fibroids should be removed before pregnancy. Generally, pregnancy can be achieved about half a year to a year after the operation. If the fibroids grow under the uterine serosa or between the uterine muscle walls, the number is small and the shape is small, pregnancy can be achieved first and then removal without affecting pregnancy. However, "pregnancy with tumor" has certain risks. If the fibroids undergo red degeneration, the patient will need to undergo a uterine myomectomy during pregnancy.

Having uterine fibroids after childbirth or during pregnancy. Wan Lan said that if the diameter of the fibroids is larger than 5 cm, or the fibroids grow under the mucosa or in the uterine cavity, and there are symptoms such as excessive menstrual flow, secondary anemia, compression of the bladder causing frequent urination, or compression of the rectum causing constipation or difficulty in defecation, which affects normal life, surgery is recommended. If the diameter of the fibroid is less than 3 cm and grows under the uterine serosa or between the uterine muscle walls, you can observe for a period of time to see whether the fibroid shrinks; this is especially true for women approaching menopause, because usually if menopause occurs, uterine fibroids will also shrink as hormone levels decrease.

Wan Lan also mentioned that uterine fibroids are a slow-growing benign tumor, but they can also degenerate. Wan Lan said that generally if uterine fibroids undergo degeneration, patients may feel abdominal distension and discomfort, and B-ultrasound examination can reveal that the fibroids are more than 5 cm in diameter and have an uneven texture. "Once degeneration occurs, it must be treated immediately, because degeneration means that the growth of the fibroid changes from slow to fast, and may be accompanied by bleeding, infection, necrosis, etc."

Gynecological examination once a year for those over 25 years old

"The occurrence of uterine fibroids is positively correlated with the increase of estrogen in the body, but because the estrogen level in women fluctuates every day, it is not very meaningful to test estrogen. B-ultrasound examination can promptly detect whether there is a tumor in the uterus, and the current detection level is very mature." Wan Lan said that the general international practice is to recommend that women over the age of 25 undergo a gynecological examination once a year, and if conditions permit, it is best to do it once every six months, so as to promptly detect gynecological diseases such as uterine fibroids and cervical cancer. Gynecological examination items include vulvovaginal examination, leucorrhea examination, cervical examination, uterine B-ultrasound examination, etc.

Wan Lan said that there is still no drug treatment that can prevent or treat uterine fibroids. Although some drugs, such as GnRH-a and gestrinone, can shrink uterine fibroids before surgery to facilitate surgery, they will immediately increase in size after the drug is stopped, so these drugs are not recommended as routine treatment. There are many Chinese medicines on the market that claim to be able to treat uterine fibroids, but there is currently a lack of evidence-based medicine.