Uterine fibroids are one of the most common benign tumors in women, affecting a significant number of reproductive-age and perimenopausal females. They can occur as a single tumor (solitary uterine fibroid) or multiple tumors (multiple uterine fibroids), meaning several tumors can grow in the uterus simultaneously. The classification of uterine fibroids is based on their location relative to the uterine wall:
Subserosal fibroids grow outward, close to the surface of the uterus; intramural fibroids develop in the middle layer of the uterine wall; and submucosal fibroids grow toward the uterine cavity. Some fibroids may have a stalk (pedunculated fibroids), but most are sessile (without a stalk). Uterine fibroids vary greatly in shape and size, which can distort the normal shape of the uterus and make it irregular.
Fibroids located at the cornua of the uterus can block the openings of the fallopian tubes or compress the fallopian tubes, leading to obstruction and affecting fertility. Additionally, fibroids that alter the shape of the uterine cavity can interfere with the implantation of fertilized eggs. For these reasons, patients with uterine fibroids are often complicated by infertility, a condition commonly described as "having tumors and being unable to have children."
However, not all women with uterine fibroids are infertile. If the size and location of the fibroids have little impact on the uterus, pregnancy is still possible. Nevertheless, such pregnancies are associated with higher risks, including an increased likelihood of miscarriage, preterm birth, abnormal fetal position, and difficult labor. Postpartum complications, such as postpartum hemorrhage and secondary infection, are also more common in these patients.
Therefore, for women with uterine fibroids who already have children, it is crucial to adopt effective contraceptive measures and not be negligent. The preferred contraceptive methods include male condoms and diaphragms. Oral contraceptives are generally not recommended, as the hormones in them may stimulate the growth of uterine fibroids, exacerbating the condition.
It is worth noting that the choice of contraception should also be based on the individual’s specific situation, such as the size, location, and number of fibroids, as well as overall health. Patients are advised to consult with their gynecologists to select the most suitable contraceptive method, ensuring both effectiveness and safety while avoiding any adverse effects on the fibroids.