A leiomyoma is a growth that appears within the lining of the uterus. Nearly all leiomyomas are noncancerous, and most do not cause adverse physical symptoms. If a gynecologist notices a growth, however, he or she will usually conduct a series of diagnostic tests to ensure that the tumor is indeed benign. Small, asymptomatic leiomyomas do not typically need to be treated, though a doctor may decide to surgically excise a large or suspicious-looking tumor.
Doctors are unsure why leiomyomas form, but they have been associated with inheritable genetic factors and hormonal imbalances. A leiomyoma begins as a small group of abnormal smooth muscle cells within the lining of the uterus grow and replicate, eventually forming a hard mass. Many tumors are too small to be seen or felt, though it is possible for a leiomyoma to grow large enough to put pressure on the uterus and irritate surrounding tissue. Growths appear most frequently in women between the ages of 30 and 50.
While most leiomyomas are asymptomatic, it is possible to experience abnormal menstruation patterns and heavy bleeding. Some women suffer from frequent cramps, chronic pelvic pain, constipation, and frequent urges to urinate. Any unusual or painful symptoms should be reported to a gynecologist as soon as possible so the doctor can check for leiomyomas or other reproductive tract disorders.
If a leiomyoma is large enough, a gynecologist may be able to make a diagnosis simply by inspecting and feeling the tumor. He or she may take ultrasound images of the uterus to confirm the presence of smaller growths. In order to rule out cancer, blood and tissue samples are usually collected and analyzed in a laboratory. The doctor can determine the best course of treatment after making an accurate diagnosis.
Women who do not experience painful symptoms may not need to be treated. Instead, they are encouraged to schedule regular checkups to ensure that tumors do not grow larger or turn cancerous. A patient who experiences pelvic pain or heavy bleeding may be prescribed oral contraceptives, hormones, or anti-inflammatory drugs to reduce adverse symptoms. Surgery is generally reserved for an abnormally large tumor or a growth that the doctor suspects might become cancerous in time.
A skilled surgeon has several options for treating a leiomyoma. Many growths can be shrunk by cutting off their blood supply, a procedure called uterine artery embolization. Large growths are often treated by applying liquid nitrogen to freeze and kill them or physically excising them from the lining of the uterus with a scalpel. Rarely, a hysterectomy is needed to remove part or all of a damaged uterus. Most women experience full recoveries following surgical procedures, though it is possible for growths to reemerge.