Diagnosis of fibroids

Non-symptomatic polyps are often discovered as incidental findings, e.g. as part of gynecological screening examinations. In women with Complaints The doctor can specifically look for possible polyps.

How do doctors recognize fibroids?

The most important diagnostic steps for uterine fibroids:

History of illness

In the history of the patient’s illness, the doctor takes note of the patient’s current and past medical conditions. He or she asks about current and past physical complaints. A regularly kept diary helps the doctor to get an overview of the occurrence of menstrual complaints, the length of the bleeding and the intermenstrual bleeding. In addition, the doctor inquires about previous treatments and the use of medication (e.g., the pill). The family history is also important, for example whether the mother or sisters have already suffered from menstrual complaints or fibroids.

Palpation examination

During the bimanual palpation, the gynecologist feels the small pelvis and assesses the size, position, mobility, consistency, and tenderness (painfulness) of the uterus and appendages.

Ultrasound examination

Ultrasound examination of the vagina (vaginal sonography) or the abdomen (abdominal sonography) is a very effective method for examining the female reproductive organs. In the presence of fibroids, the gynecologist can more accurately determine the number and location of the fibroids and measure their size. This technique also allows for monitoring fibroids over an extended period of time and, using Doppler ultrasonography, assessing the patterns of blood flow.

In particularly severe cases, additional methods for diagnosing uterine fibroids can help:

Uterine ultrasound

The hysteroscope was initially developed as a method to examine the inside of the uterus. Later, it was adapted to the operative hysteroscope, which can be used to remove submucosal myomas. Much depends on the size and location of the myomas as well as the experience of the surgeon.

CT/MRI

Myomas are sometimes discovered as a side effect when a CT scan or MRI was performed for other reasons. An MRI should be performed if necessary, due to better tissue specificity and the lack of radiation exposure.

Uterine myomatous disease
Uterine myomatous tumors on CT (© Prof. Ebert, Berlin 2014)

What are fibroids?

The term "myoma" was first used by the German pathologist Rudolf Virchow. Uterine myomas are benign tumors of the uterus. They consist of connective tissue, blood vessels, and smooth muscle.

What kind of complaints do myomas cause?

Often, fibroids cause no symptoms and are often diagnosed as a random finding during an ultrasound examination or CT scan.

Diagnosis of fibroids

Non-symptomatic polyps are often discovered as a random finding, for example during gynecological check-ups. If symptoms occur, the doctor can specifically look for possible polyps.

Involuntary childlessness and myomas

Due to the demographic development in Germany, the topic of "uterine myomas" also affects many women seeking fertility treatment, as fertility often only becomes an issue for women after the age of 30.

Therapy of fibroids

Medication treatment options are used to reduce bleeding, control pain, stop the growth of the fibroids, and/or reduce the size of the fibroids.

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