Pain in the lower abdomen, heavy periods, bleeding mid cycle ... Uterine fibroids become troublesome as soon as they start to grow or to be too numerous.

Their location may vary: some develop outside the uterus (subs serous fibroids), others in the uterine muscle (interstitial fibroids) and others still in the uterine cavity (submucosal fibroids).

Their exact causes remain unknown, but we know that a hormonal imbalance, overweight and early rules promote their appearance.

Heredity also plays: the risk is increased by 40% for a woman whose mother, aunt or sister is affected.

Signs that must alert

Unexplained pelvic pain, haemorrhagic bleeding and / or bleeding in the middle of the cycle should lead to consultation.

The gynecologist then checks if the uterus has grown in size and asks questions that might put him on the track: is the sex uncomfortable? Do you feel heaviness in the lower abdomen? Is the urge to urinate more common? Is constipation associated?

All these symptoms signify the presence of fibroids because they can exert pressure on the intestine, bladder or vagina . A pelvic ultrasound will complete his suspicions.

From classical treatments to new techniques

Only fibroids that interfere with daily life should be treated. Depending on their size and location, as well as the age and life plans of the patient, the proposed treatments differ.

Medications can be offered to channel fibroids and reduce bleeding source of anemia. But these induce temporary artificial menopause, resulting in hot flashes, weight gain and dry skin.

A myomectomy (removal of fibroids) is also often recommended if the fibroids are few. Performed vaginally or by laparoscopy, it preserves the uterus, but does not guarantee the absence of recurrence.

A more radical solution is considered when the disability is important and the patient has no plans for pregnancy: hysterectomy (removal of the uterus) . Reserved for women over 40, this operation is effective, but heavy and irreversible.

To avoid hysterectomy, embolization develops more and more. Conducted by interventional radiologists, this treatment consists in asphyxiating fibroids by blocking the arteries that nourish them.

"A catheter is inserted into the artery located at the level of the crease of the groin, under local anesthesia, then we go to the uterine arteries under angiographic control," explains Professor Marc Sapoval, head of the Department of Vascular Interventional Radiology and Oncology from the Georges Pompidou European Hospital, Paris, where microbeads are injected and will be lodged at the entrance of fibroids ".

This method, now available in most large hospitals, is effective in 95% of cases. But it does not prevent the occurrence of other fibroids.

Isolated fibroma of medium size (maximum 10 cm) can also benefit from ultrasound eradication. Heated at 70 ° C, it degenerates in about 3 hours. But this technique, which requires the use of an MRI, remains uncommon.