[Health Tip] 1 in 3 Women of Reproductive Age Has 'Jagugeunjong'... Preserving Fertility Is Key to Treatment

One in three women of reproductive age in Korea is diagnosed with 'uterine fibroids.' Most cases are asymptomatic, leading to many instances where fibroids are not treated in time and progress to infertility and other complications.

Uterine fibroids are benign tumors that develop in the smooth muscle of the uterus, where the muscle cells abnormally proliferate and form lumps. Depending on their location, they are classified as submucosal fibroids, intramural fibroids, or subserosal fibroids. Since they are heavily influenced by female hormones, they are found in 25-35% of women of reproductive age and 40-50% of women over 35 years old.

The number of patients with uterine fibroids is increasing annually. According to the Health Insurance Review and Assessment Service, the number rose from 440,000 in 2019 to 590,000 in 2021. By age group, the distribution was 40s (37.7%), 50s (30.9%), and 30s (17.3%), with patients in their 20s also increasing by about 40% over three years to approximately 18,000. Common symptoms of uterine fibroids include ▲excessive menstrual bleeding ▲severe menstrual pain ▲infertility ▲indigestion ▲frequent urination, and bleeding outside of the expected menstrual period or blood clots may also raise suspicion.

However, most cases are asymptomatic, and many patients live without treatment until abnormalities are detected. If fibroids are not treated promptly, they can cause infertility or, if large, compress surrounding organs and impair their function, making early diagnosis and treatment essential. In cases with mild symptoms, the fibroids' condition is monitored through regular examinations without separate treatment. When menstrual pain is severe, anti-inflammatory painkillers are prescribed to observe the progress.

For those with heavy menstrual bleeding and irregular cycles, contraceptive pills may be taken. Although it is inconvenient to take them daily throughout the month, this is the most effective way to reduce menstrual bleeding and alleviate menstrual pain. Professor Yeonji Lee of Myongji Hospital's Department of Obstetrics and Gynecology said, "Even fibroids larger than 10 cm may cause almost no symptoms, making them unnoticeable," adding, "Women who have started menstruating should have their uterus and ovaries examined by ultrasound at least once a year."

Professor Lee Yeon-ji of the Department of Obstetrics and Gynecology at Myongji Hospital is examining a patient.
[Photo by Myongji Hospital]

Treatment for uterine fibroids depends on the size of the fibroids, presence of symptoms, and pregnancy plans, and includes hormonal drug therapy and surgical treatment. Drug therapy involves oral medications and injections. Oral medications are mainly used to control bleeding or pain, while injections aim to reduce fibroid size by suppressing female hormones.

However, since drug therapy cannot remove fibroids, radical treatment through surgery is necessary. Surgical treatment involves either removing the entire uterus or only the fibroids, depending on their location, shape, and size. If the fibroids are smaller than 3 cm² and asymptomatic, they are monitored without separate treatment. However, if the fibroids grow or cause pain and bleeding, treatment is essential.

Since surgery is performed directly on the uterus, minimizing damage to tissues and nerves to preserve fertility is crucial. It is also important to reduce the risk of infection and bleeding and minimize incisions to enhance cosmetic outcomes. Recently, robotic surgery, which offers these advantages, has gained attention. Robotic surgery is performed through only 1 to 4 small incisions, reducing the risk of bleeding and infection and leaving significantly smaller scars. Additionally, the robotic arms operate inside the body with precision similar to human hands, allowing safe removal of even large fibroids while preserving the uterus to maintain fertility.

Professor Yeonji Lee explained, "The exact cause of uterine fibroids is unclear, but the number of patients is increasing annually due to various factors, making regular gynecological check-ups necessary," adding, "Especially for women of reproductive age diagnosed with fibroids, it is important to consider surgical methods that minimize damage to the uterus and preserve fertility when receiving treatment."