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What are cervical myomas?
Cervical myomas (or cervical fibroids) are smooth, round, benign tumors composed mostly of muscle tissue. These myomas are present in the cervix, the lower part of the uterus, and are rare. When they do, they are usually accompanied by uterine myomas, also known as uterine fibroids, in the larger upper part of the uterus. Submucosal fibroids grow into the uterine cavity, intramural fibroids grow within the uterus wall, and subserosal fibroids grow outside the uterus.
Myomas are benign tumors, meaning they are not cancerous. However, they can cause serious problems in some cases, especially if they are large. They may block part of the urinary tract or prolapse through the cervix and into the vaginal canal. Prolapsed myomas may develop ulcers, which could cause abnormal bleeding or infection.
What causes cervical myomas?
Myomas are thought to be caused by high levels of estrogen and progesterone. These hormones cause the lining of the uterus to thicken during the menstrual cycle and can also cause myomas to grow. Myomas contain more cells that estrogen and progesterone bind to than typical uterine muscle cells.
Other risk factors for cervical fibroids include:
- Genetics: Experts believe there is a genetic component to fibroid development. People with a family history of cervical or uterine fibroids are more likely to develop them themselves.
- Age: Fibroids are most common in women in their 30s and 40s. After menopause, fibroids typically shrink due to a decrease in hormone production.
- Ethnicity: African-American women are more likely to develop fibroids at a younger age and might experience larger and more numerous fibroids compared to women of other ethnicities.
What are the symptoms of fibroids?
Mild cervical myomas may not cause any problems, while moderate to severe myomas may cause one or more symptoms, including:
- Heavy menstrual bleeding or bleeding between menstrual periods
- Anemia, as a result of heavy periods and vaginal bleeding
- Painful intercourse
- Vaginal discharge
- Pelvic pain
- Abdominal pain and cramping
- A bulge in the abdomen or a feeling of heaviness
- Difficulty urinating or incomplete urination, including a urine stream that hesitates to start or dribbles at the end
- Urinary tract infections
- Constipation
How do we diagnose cervical myomas?
If you’re experiencing fibroid symptoms, please make an appointment for a pelvic exam. In most cases, cervical myomas can be diagnosed during a regular exam. We can also use a transvaginal ultrasound to help diagnose the problem.
At your appointment, your doctor may also want to run additional diagnostic tests, including MRI (magnetic resonance imaging), to evaluate the condition. Other diagnostic tests include:
- Hysteroscopy: During this procedure, Dr. Aliabadi will insert a hysteroscope (a thin, flexible tube with a camera on the end) into your vagina to look at the fibroids on your cervix.
- Laparoscopy: Using a small incision near your belly button, our gynecologist inserts a thin, flexible, lighted instrument (laparoscope) to see inside the area surrounding your uterus, including the ovaries and fallopian tubes. This tool is useful for detecting additional fibroids that would otherwise have been missed.
What are cervical fibroid treatment options?
Small myomas that do not cause symptoms may not need to be treated. Dr. Aliabadi will want to monitor your myomas to make sure they don’t start to cause problems.
Anti-inflammatory medications like ibuprofen or naproxen can lessen bleeding during menstruation and alleviate pain caused by fibroids. This conservative approach is advised for women who experience intermittent pelvic pain or discomfort from fibroids.
Drug therapy may be an option for some women with fibroids/myomas. Drug treatment for fibroids includes the following options:
- Birth control pills — Low doses of hormonal contraceptives are often used to control heavy bleeding and painful periods.
- Gonadotropin-releasing hormone agonists — GnRH agonists stop the menstrual cycle and can shrink fibroids. Because of their side effects, GnRH agonists are generally only used for short periods, often for a short while before surgery to reduce the risk of bleeding.
- Progestin intrauterine device (IUD) — An option for women with myomas that don’t distort the inside of the uterus. While progestin won’t treat myomas, it can help treat heavy bleeding.
Surgical treatment options for cervical myomas
Heavy bleeding and painful menstruation caused by fibroids/myomas may be controlled with medications. However, large fibroids that are causing pain, bleeding, infertility, or urinary problems can be removed or treated with surgery.
Myoma surgical treatments could include:
Uterine fibroid embolization
Despite being named after the uterus, UFE could be a suitable treatment for cervical fibroids, depending on their size and location. This non-surgical procedure blocks the blood supply that sustains a fibroid’s growth.
However, although UFE has a high success rate of 90% for fibroids located throughout the uterus, early outcomes for cervical fibroids have shown less success.
Laparoscopic myomectomy
Dr. Aliabadi is an expert in minimally invasive outpatient surgeries. A laparoscopic myomectomy allows for the surgical removal of your fibroids through a few small incisions. A laparoscope allows the surgeon to see the area they’re working on.
Laparotomy
Traditional “open surgery” occurs when the surgeon removes myomas through a larger abdominal incision.
Hysterectomy
Complete surgical removal of the uterus and sometimes the cervix. If the myomas are very large, this may be the surgeon’s only option.
Have questions about your health? Talk to Dr. Aliabadi
Dr. Aliabadi and her compassionate team are experts in women’s health care. When treated by Dr. Aliabadi, you’re guaranteed to feel safe, heard, and well cared for. A highly regarded healthcare provider in the gynecological and obstetric fields, Dr. Aliabadi can handle just about any women’s health issue, from menstruation and menopause to childbirth.
We invite you to establish care with Dr. Aliabadi. Please make an appointment online or call us at (844) 863-6700.
The practice of Dr. Thais Aliabadi and the Outpatient Hysterectomy Center is conveniently located for patients throughout Southern California and the Los Angeles area. We are near Beverly Hills, West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.
Cervical myomas are almost always benign. In fact, fewer than one in 1,000 fibroids turn out to be cancerous. To prevent any rare complications from a potentially cancerous cervical fibroid, it is crucial to get a proper diagnosis and consult with a fibroid specialist. Although extremely uncommon, fibroids are slightly more likely to be cancerous in women who have undergone menopause.
Cervical fibroids can potentially cause infertility, although it is less common than with fibroids located elsewhere in the uterus. These growths may interfere with the natural functions of the cervix, including sperm entry or the ability to sustain a pregnancy.
Fibroids are classified based on their location. Submucosal fibroids grow into the uterine cavity while intramural fibroids grow within the wall of the uterus, and subserosal fibroids grow on the outside of the uterus. Some submucosal or subserosal fibroids may be pedunculated. This means they hang from a stalk inside or outside the uterus.
Ultrasounds detect cervical fibroids by using sound waves to produce detailed images that highlight abnormal growths within the cervical tissue.
Yes, Childbearing is associated with a lower risk of developing fibroids.
Sources
Effectiveness of pericervical tourniquet by Foley catheter reducing blood loss at abdominal myomectomy. Clinical and experimental obstetrics & gynecology, Alptekin, H., & Efe, D. (2014).
Kaump GR, Spies JB. The impact of uterine artery embolization on ovarian function. J Vasc Interv Radiol. 2013;24(4):459–67. doi:10.1016/j.jvir.2012.12.002.
Kohn JR, et al. Pregnancy after endometrial ablation: A systematic review. BJOG. 2018; doi:10.1111/1471-0528.14854.
