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Women’s bodies are complicated and at the same time, it’s important to be on top of our health. If you’re experiencing a change in the regularity or flow of your menstrual period, or feeling pain or pressure in your abdominal region, it’s important to consult your doctor.
In collaboration with obstetrician gynecologist Dr. Michelle Tsui 徐行悅醫生, we explain the difference between fibroids, cysts and polyps – their causes, symptoms, and treatments available in Hong Kong.
Uterine fibroids, also known as leiomyomas or myomas, are benign growths in the smooth muscle of the uterus. They usually appear during childbearing years and are very rarely cancerous. They range in size from undetectable to the eye to more than 10 centimeters in diameter.
Many women will have uterine fibroids without any symptoms – they will be discovered during a routine examination. Uterine fibroids are either submucosal (bulging towards the inside of the lining of the uterus), intramural (growing within the muscular uterine wall), or subserosal (bulging towards the outside of the uterus.
It’s important to note that most uterine fibroids will not require treatment.
Symptoms of uterine fibroids vary based on the size, location and number of fibroids. The most common symptoms of fibroids include:
Treatment of fibroids depends on their size, location and extent to which they are affecting the body’s ability to function normally. The following treatments are used to treat uterine fibroids:
Women planning to conceive in the future
Women actively trying to conceive
Women who no longer wish to conceive
Endometrial polyps, also known as uterine polyps, are an overgrowth of cells in the endometrial lining of the uterus. Uterine polyps are usually benign, though they do occasionally develop into cancer. They are attached to the uterine wall by a large base or a thin stalk and range from several millimeters to a few centimeters.
Risk factors include a history of cervical polyps. Scientists are not entirely sure what causes uterine polyps but it’s clear that they grow in response to estrogen. Individuals taking tamoxifen or hormone replacement therapy are at a higher risk of uterine polyps.
Like fibroids, often endometrial polyps will be asymptomatic and are picked up during routine screening. The most common symptoms include:
If a woman is symptom-free and not at-risk for cancer, she may wait and see if the polyp continues to grow larger. Asymptomatic polyps are usually found during routine examinations.
Symptomatic (bleeding) polyps and polyps in older women are more at risk of abnormal cells and should be removed. If a woman is experiencing symptoms or advised so by her physician, a gynecologist will use a hysteroscopy to remove the polyps. A hysteroscopy is a tube and camera inserted through the vagina and cervix used to remove the polyps non-invasively. The removed polyps will be tested for cancerous or pre-cancerous cells.
An ovarian cyst is a fluid-filled sac located within or on the surface of the ovary. Women have two ovaries - one on each side of her uterus. Cysts can appear on either or both ovaries. Many ovarian cysts are asymptomatic. There are multiple types of cysts depending on their relation to menstruation/ovulation. Cysts related to ovulation are known as follicular and corpus luteum cysts. These are normal physiological changes and do not require intervention as they come and go with the cycle.
Benign but non-physiological ovarian cysts will not disappear on their own. Benign ovarian cysts that are not related to normal menstruation include:
Symptoms of an ovarian cyst can include:
It’s important to note that large ovarian cysts are at-risk of rupture or torsion (twisting). This can cause serious symptoms. Symptoms as a result of a complication from an ovarian cyst can include:
Many ovarian cysts are actually functional or physiological and will resolve on their own. If an asymptomatic cyst is found during a routine examination, your physician may advise a waiting period with monitoring using periodic pelvic ultrasounds. If surgery is recommended, your cyst will be removed in a surgery known as cystectomy leaving the ovaries and other organs intact. Cystectomy is almost always done by laparoscopic or ‘keyhole’ surgery and is associated with minimal pain and short hospital stays. In rare severe cases if the cyst is cancerous or the woman is menopausal, removal of one or both ovaries will be required (oophorectomy).
Dr. Michelle Tsui 徐行悅醫生 received her medical training at University of Queensland, Australia. She is currently working as a private obstetrician and gynecologist in Hong Kong.
This article was independently written by Healthy Matters. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.
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