What are Cervical Myomas?
Cervical myomas (also known as 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 while intramural fibroids grow within the wall of the uterus, and subserosal fibroids grow on the outside of 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 an excess of estrogen, a hormone involved in cellular growth. Myomas may also develop with an imbalance between estrogen and progesterone.
Symptoms of Cervical Myomas
Mild cervical myomas may not cause any problems while moderate to severe myomas may cause one or more of these symptoms:
- Abnormal vaginal bleeding, especially heavy bleeding or bleeding between menstrual periods
- Anemia, as a result of heavy bleeding, accompanied by fatigue
- Painful intercourse
- Vaginal discharge
- Pelvic pain
- Abdominal pain
- A bulge in the abdomen or feeling of heaviness
- Difficulty urinating or incomplete urination, including a urine stream that hesitates to start or dribbles at the end
- Urinary tract infections
Diagnosing Cervical Myomas
If you’re experiencing these symptoms, please make an appointment for a pelvic examination. In most cases, cervical myomas can be diagnosed with a pelvic exam. Your doctor can also use a transvaginal ultrasound to help diagnose the problem.
At your appointment, your doctor may also want to run additional diagnostic tests to evaluate the condition.
Cervical Myomas Treatment
Small myomas that do not cause symptoms may not need to be treated. Your Obstetrics and Gynecology doctor may still want to keep an eye on your condition over time.
Large fibroids/myomas that are causing pain, bleeding or urinary problems can be surgically removed via myomectomy. Depending on the size and location of your cervical fibroid/myomas, your doctor may perform one of three procedures.
Drug therapy may be an option for some women with fibroids/myomas. Heavy bleeding and painful menstrual cycle caused by fibroids/myomas may be controlled with medications. They may not prevent the growth of cervical myomas. Surgery may not be avoidable. Drug treatment for fibroids includes the following options:
- Birth control pills (oral contraceptives) and other types of hormonal birth control methods—These drugs often are used to control heavy bleeding and painful periods.
- Gonadotropin-releasing hormone (GnRH) agonists—These drugs stop the menstrual cycle and can shrink fibroids. They sometimes are used before surgery to reduce the risk of bleeding.
- Progestin intrauterine device (IUD)—An option for women with myomas that do not distort the inside of the uterus. It reduces heavy and painful bleeding. The medication does not treat the myomas.
Laparoscopy
A procedure in which the surgeon conducts the operation through one or more tiny incisions near your belly button. A thin, flexible, lighted instrument, called a laparoscope, helps your doctor to see the surgical site.
Laparotomy
An open surgical procedure in which the surgeon removes the myomas through a larger abdominal incision.
Hysterectomy
Complete surgical removal of the uterus and sometimes the ovaries. If the myomas are very large, this may be the surgeon’s only option. After a hysterectomy, it is no longer possible to become pregnant. You should share your plans for having children with your doctor when discussing your treatment options.