Treatment of uterine leiomyoma by obstetrician-gynecologist Irina Ivanovna Kulbach in the city of Dnipro

When visiting a doctor, patients are often concerned about lower abdominal pain, menstrual cycle irregularities, a feeling of pressure in the pelvis, or anxiety caused by detected lumps.

The doctor conducts a thorough clinical evaluation, reviews the complaints and medical history, and, if necessary, orders additional tests to clarify the condition.

The patient receives a clear and understandable action plan: what to do immediately, which examinations to undergo, and how to monitor changes over time.

Special attention is given to differential diagnosis and dynamic observation, which helps to timely adjust the treatment strategy and minimize the risk of complications.

When to See a Doctor

The appearance of discomfort in the pelvic area or disturbances in reproductive health require specialist attention. If you notice changes in how you feel or in your health condition, it is important not to delay a visit to an obstetrician-gynecologist. You should make an appointment with an obstetrician-gynecologist if, in the case of uterine leiomyoma, you observe:

• Constant or intermittent lower abdominal pain
• Irregular, excessively heavy, or very light menstrual periods
• A feeling of pressure or heaviness in the pelvic area
• Abdominal enlargement not related to pregnancy
• Menstrual cycle disturbances that interfere with plans and daily life
• Symptoms that recur or worsen over time
• Lack of improvement after attempts to self-relieve the condition
• Anxiety due to previously detected nodules or lumps
• The appearance of unusual discharge
• Difficulties during sexual intercourse
• Symptoms affecting the quality of sleep or work performance
• The need to monitor the condition during pregnancy or family planning

If you experience these symptoms, consulting a specialist will help determine the cause of the changes and decide on the next steps. It is important not to ignore persistent or worsening unpleasant sensations in order to receive support and recommendations at all stages of observation.

Emergency Conditions or When You Need to See a Doctor Immediately

• Sudden onset of severe lower abdominal pain that rapidly intensifies
• Heavy vaginal bleeding that does not stop for a prolonged period
• Combination of severe pain with fever and general weakness
• Abrupt deterioration of overall condition, difficulty breathing, or dizziness
• Feeling of pressure or pain that interferes with movement and daily activities

If you experience these symptoms, do not wait for a scheduled appointment—seek emergency medical care. Our clinic offers the option to call a doctor to your home for a quick assessment and to arrange the necessary support.

Causes and Risk Factors

This section discusses the possible causes of uterine leiomyoma and the factors that may increase the risk of its development. Understanding this will help you talk to your doctor about which examinations are necessary to assess your condition.

Main Causes / Mechanisms (briefly)

• Hormonal imbalance, especially elevated estrogen levels
• Genetic predisposition and hereditary traits
• Structural features of the uterine muscle tissue that affect the growth of nodules
• Chronic inflammation or stress factors influencing metabolism
• Age-related changes in the female reproductive system

Risk Factors

• Female gender and reproductive age (more common in women aged 30 to 50)
• Family history of similar conditions in close female relatives
• Excess body weight and obesity affecting hormonal balance
• Lack of pregnancy or late childbirth
• Frequent menstrual disorders and hormonal imbalances
• Presence of other gynecological diseases
• Harmful habits such as smoking and poor nutrition
• Stress and regular overwork

Reversible Causes That Should Be Excluded

• Inflammatory processes in the pelvic organs
• Hormonal disorders that can be corrected
• Metabolic and endocrine disorders

Uterine leiomyoma develops under the influence of a complex of factors, and an accurate understanding of the cause requires a medical examination. Even when risk factors are present, it is important to monitor your condition and seek medical help promptly.

Diagnosis

The diagnosis of uterine leiomyoma is aimed at a thorough assessment of the patient's symptoms and condition in order to develop an optimal plan for examination and treatment. The physician will carefully review the medical history and conduct necessary studies to understand the situation.

Diagnostic Approach

• Taking a detailed medical history, including complaints and specifics of the menstrual cycle
• Examination of the pelvic organs to assess the condition of the uterus and surrounding tissues
• Ordering basic laboratory tests as indicated
• Performing ultrasound (US) as the primary imaging method
• If necessary, additional examinations such as MRI or Doppler ultrasound
• Analyzing the results and forming a plan for further action
• Discussing the observation or treatment strategy with the patient

Typical Examinations as Indicated

• Ultrasound examination of the pelvic organs
• Magnetic resonance imaging (MRI) for complex cases
• Laboratory tests to assess hormonal status
• Hysteroscopy if evaluation of the uterine cavity is needed
• Doppler ultrasound to study blood flow around the fibroid nodules

What to Bring to the Appointment

• Previous discharge summaries and examination results
• Images and reports from ultrasound, MRI, or other tests
• A list of current medications and supplements
• A symptom diary, if maintained

The diagnostic process helps to understand the condition in uterine leiomyoma and determine the next steps, taking into account the patient’s individual characteristics and the clinical situation.

Treatment

Treatment of uterine leiomyoma is aimed at improving the condition and reducing unpleasant symptoms. The therapy plan is tailored individually, taking into account the patient's characteristics and the clinical situation.

Therapy Goals

• Reduce symptoms associated with leiomyoma
• Slow down the growth of nodules and prevent complications
• Preserve reproductive system function and improve quality of life
• Control and correct factors influencing the course of the disease

Main Treatment Approaches

• May include medication methods to normalize hormonal balance
• Possible use of non-drug methods to support overall condition
• Surgical and minimally invasive interventions considered as indicated
• Regular assessment and monitoring of disease progression are important
• Therapy is individualized and combined considering comorbidities

What the Doctor Does

• Selects and adjusts the treatment regimen depending on changes in condition
• Takes into account possible side effects and metabolic features
• Explains therapy effectiveness criteria and monitoring timelines
• Controls concomitant conditions and coordinates with other specialists
• Evaluates the need for changes in the plan in case of insufficient effect

What to Expect: Plan and Monitoring

• Condition assessment and possible documentation updates are assigned individually
• The doctor focuses on regular follow-up and therapy adjustment based on results
• The treatment plan is revised as needed considering symptom dynamics
• Follow-up visits are necessary to monitor effectiveness and safety of the procedure

To develop an individual plan, please schedule a consultation with Dr. Irina Ivanovna Kulbach.

Prevention

Prevention of uterine leiomyoma helps reduce the risk of developing and progressing the disease. The prevention plan is tailored individually, taking into account health characteristics and medical recommendations.

Main Primary Prevention Measures

• Weight control and maintaining a healthy lifestyle
• Quitting smoking and reducing the impact of other harmful habits
• Timely treatment and monitoring of hormonal balance as indicated
• Managing stress and maintaining emotional balance
• Prompt consultation with a doctor in case of menstrual irregularities or pain

Screening and Secondary Prevention / Regular Monitoring

• Regular gynecological examinations according to the doctor’s recommendations
• Performing pelvic ultrasound examinations as indicated
• Monitoring hormonal status if there are accompanying conditions
• Discussing with your doctor the need for additional examinations on an individual basis

Practical Tips

• Increase physical activity to the level recommended by a specialist
• Monitor your diet and try to avoid excessive fat intake
• Discuss medication adjustments with your doctor if you have chronic illnesses
• Follow doctor-recommended measures to strengthen your overall health
• Keep a symptom diary for timely communication with your doctor

Preventive measures make an important contribution to maintaining health with uterine leiomyoma but require regular monitoring and communication with a healthcare professional.

Important to Know

The treatment of uterine leiomyoma requires a comprehensive approach and timely assessment of the condition. It is very important to identify possible causes and factors that influence the development of the disease, rather than merely addressing the symptoms. Early consultation helps to choose the optimal strategy and reduce the risk of complications. Often, dynamic monitoring with subsequent adjustment of the treatment plan is necessary. The course of the disease is affected by general factors such as stress levels, quality of sleep, and the presence of comorbidities. Self-medication can mask symptoms, cause side effects, and delay accurate diagnosis.

• Identifying causes helps to effectively control the condition and plan treatment
• Early assessment reduces the risk of progression and the need for complex interventions
• Dynamic monitoring allows timely adjustments to therapy
• Overall health and lifestyle influence the manifestations of leiomyoma
• Self-medication can obscure the clinical picture and complicate diagnosis
• Clinic doctors provide support at all stages of treatment and follow-up

For detailed information on diagnosis and treatment options, it is recommended to review the main page on the topic or schedule a consultation with a specialist.

Self-care before the appointment: what to do and what to avoid

Before seeing a doctor for uterine leiomyoma, it is important to take safe measures that will not cause harm and will help you better prepare for the consultation. If your condition worsens, urgently seek help from Dr. Irina Ivanovna Kulbach.

What you can do before the appointment

• Write down when symptoms appeared, their nature, and what worsens or eases your condition
• Bring a list of all medications and supplements you are taking
• Measure and record your temperature, blood pressure, and pulse rate if you know how
• Keep a symptom diary: note the time, intensity, and possible triggers
• Reduce physical activity and ensure rest until your visit
• Drink enough water to avoid dehydration
• Monitor your general well-being and any changes in your condition
• Avoid severe stress before the consultation

What you should not do before the appointment

• Do not stop or change any chronic medications without your doctor’s approval
• Do not start using new medications without a specialist’s recommendation
• Do not trust unverified folk remedies or “quick” recipes
• Do not try to interpret tests and examination results on your own
• Do not ignore symptoms if they worsen or new ones appear
• Do not delay seeing the doctor if your condition gets worse
• Do not take strong painkillers without consent, as this may mask important signs
• Do not self-medicate even if symptoms temporarily improve

If signs of an emergency appear, immediately seek help from Dr. Irina Ivanovna Kulbach.

How I Can Help as a Doctor Regarding Uterine Leiomyoma

During a consultation on uterine leiomyoma, I offer a comprehensive approach focused on understanding your condition and selecting the most appropriate strategy. It is important not only to identify the causes of symptoms but also to consider all accompanying factors for safe and effective management. In a consultation about uterine leiomyoma, I can assist you with the following:

• Analyze symptoms and medical history to identify potential causes
• Assess the severity of symptoms and possible risks
• Review current treatments and their tolerability
• Develop a plan for next steps: examinations, treatment, and monitoring
• Take into account comorbidities and current medications when choosing a management plan
• Provide recommendations on lifestyle and regimen based on individual indications
• Discuss criteria for treatment effectiveness and timing of follow-up visits
• Conduct initial diagnostics with differential diagnosis considerations
• Adjust treatment in case of insufficient effect or adverse reactions

Thus, the consultation covers not only symptom evaluation but also treatment planning and follow-up. This comprehensive approach helps reduce the risk of complications and tailor recommendations that consider your individual characteristics and condition dynamics.

What Questions Can You Ask a Doctor About Uterine Leiomyoma

During a consultation regarding uterine leiomyoma, you can discuss the following issues with Irina Ivanovna Kulbach:

• Lower abdominal pain and its causes
• Menstrual cycle irregularities and heavy bleeding
• Feeling of pressure or abdominal enlargement
• Recurring symptoms or worsening condition
• Lack of effect from the prescribed treatment
• Questions about pregnancy planning and childbirth with leiomyoma
• Monitoring your condition after treatment or surgery
• The impact of comorbidities on treatment

In case of sudden severe pain, heavy bleeding, or a sharp deterioration in your condition — urgent medical help is required; do not wait for a scheduled appointment.

Common Questions You Can Discuss During the Consultation

• What is happening to me, and what could it be?
• Why have the symptoms appeared now?
• How to distinguish symptoms of leiomyoma from other issues?
• What examinations are necessary in my specific case?
• Which tests and investigations are mandatory?
• How to properly prepare for examinations and the consultation?
• What treatment or management options are available for my condition?
• Is it possible to manage without surgery or medication?
• Why is the prescribed treatment not effective, and what should I do next?
• How long does treatment usually last, and how often is follow-up needed?
• What signs indicate improvement or worsening of my condition?
• What should I do if my condition suddenly worsens or an exacerbation occurs?

If you have questions or concerns related to uterine leiomyoma, scheduling a consultation will allow you to discuss your situation in detail and determine the most appropriate plan of action. In case of emergency symptoms, seek immediate medical assistance.

How the Consultation Proceeds

A consultation for uterine leiomyoma involves a detailed review of complaints and condition, as well as the creation of a plan for further action. The extent of examinations is determined individually, taking into account the specific indications of each patient. A preliminary assessment is made during a single visit, while a precise decision requires monitoring and additional studies.

1. Clarifying complaints and the purpose of the visit: determining what exactly is troubling the patient, when symptoms appeared, what worsens or alleviates the condition, as well as the patient’s expectations from the appointment.
2. Collecting medical history and risk factors related to gynecological health and past illnesses.
3. Discussing previous examinations and treatments — the patient may bring documents, test results, and a list of medications.
4. Performing a gynecological examination and, if necessary, additional tests based on indications to assess the condition of the uterus and pelvic organs.
5. Formulating a preliminary conclusion, including possible causes of complaints and what needs further clarification, without making a final diagnosis.
6. Assigning an individualized plan of examinations as indicated — this may include ultrasound (US), magnetic resonance imaging (MRI), or laboratory tests.
7. Discussing management and treatment options — explaining the choices and principles of therapy without naming specific medications or details.
8. Planning follow-up and monitoring: recommendations on timing of repeat visits, criteria for evaluating effectiveness, and situations warranting earlier consultation.

If this is your first consultation, the main focus is on clarifying symptoms and identifying possible causes. If previous treatment was ineffective, the consultation helps to thoroughly analyze the situation and adjust the approach.

This approach allows you to feel confident and understand each stage of examination and treatment under specialist supervision, taking individual characteristics into account.

Preparation for the Appointment

Preparing for your appointment with an obstetrician-gynecologist for uterine leiomyoma will help speed up diagnosis and treatment planning. Follow these simple recommendations to make your visit as productive as possible.

• Bring a list of all current medications with their names and dosages, if known
• Bring the results of previous examinations, including ultrasound, MRI, and laboratory tests
• Write down your main complaints: when and how symptoms begin, what worsens or relieves them
• Do not stop taking prescribed medications without consulting your doctor
• Arrive 10–15 minutes before your appointment to complete paperwork
• Do not apply makeup or creams on your abdomen and groin before the examination
• If you have specific questions or concerns, prepare them in advance for discussion
• If in doubt, clarify the requirements for your visit when making the appointment

If you have been advised to come fasting, do not eat or drink for 8–12 hours before the appointment (unless otherwise specified; confirm when booking).

For optimal preparation, you can always clarify details by calling the clinic and avoid changing medications without consulting a specialist.

About the Doctor

Irina Ivanovna Kulbach is a highly qualified obstetrician-gynecologist with over 40 years of experience. She works with patients with uterine leiomyoma, including cases of initial diagnosis, chronic conditions, and patients who have not responded to previous treatments. In her practice, Irina Ivanovna pays special attention to the differential diagnosis of causes and dynamic monitoring, which allows for adjustment of treatment strategies as needed. Patients receive a thorough analysis of their situation and a clear plan for the next steps, taking into account individual characteristics and their condition.

Why Patients Choose Dr. Irina Ivanovna Kulbach

Choosing a doctor for uterine leiomyoma is crucial to receiving a clear strategy and reliable care. In her work with patients, Irina Ivanovna focuses on a comprehensive analysis of symptoms and thorough diagnostics to determine the optimal plan. Patients appreciate her step-by-step approach, clear explanations, and attentive monitoring over time. Unlike other specialists, she pays special attention to adjusting therapy when there is no effect and takes into account all accompanying conditions.

• Clear treatment plan divided into stages: current measures, monitoring, and follow-up visits
• Examinations prescribed strictly based on indications, without unnecessary procedures
• Consideration of all comorbid diagnoses and medications for safe treatment
• Monitoring condition dynamics with plan adjustments in case of side effects or lack of improvement
• Review of already completed examination results and integration into the strategy
• Explanation of treatment goals and possible risks in an accessible language
• Emphasis on preventing exacerbations and complications for long-term control
• Experience in managing complex and chronic cases with an individual approach

Irina Ivanovna helps patients understand the causes and symptoms of leiomyoma, which allows them to feel more confident. This approach ensures comfortable support and timely adaptation of the plan depending on changes in the condition.

Case Studies

Diagnostic search at the initial visit

A middle-aged female patient presented with persistent lower abdominal pain and menstrual cycle disturbances. It was important to exclude other gynecological causes and clarify the nature of the uterine mass. The examination included a review of complaints, physical inspection, and ultrasound investigation, which helped determine the probable origin of the problem. Over time, the pain decreased and the menstrual cycle became more regular. The patient continues to be monitored for control and treatment plan adjustment if necessary.

Treatment strategy adjustment after ineffective therapy

A woman of reproductive age came with complaints despite having received previous therapy without improvement. The physician needed to assess the reasons for the lack of effect. An analysis of current prescriptions and concomitant factors was conducted, and the treatment approach was revised considering individual characteristics. At the follow-up visit, stabilization of the condition and reduction of symptom severity were noted. The plan includes ongoing observation and possible therapy adaptation.

Chronic course with comorbidities

A mature-aged patient presented with a long-term illness course and other gynecological problems. It was crucial to take all concomitant factors into account to choose a safe and effective strategy. A comprehensive approach was applied, with thorough anamnesis analysis, treatment adjustment, and monitoring of drug interactions. Improvement in quality of life and symptom reduction were observed over time. Continuation of monitoring and maintenance therapy was recommended.

Exacerbation — control and prevention of complications

A woman presented with worsening symptoms and discomfort requiring prompt modification of the treatment plan. Special attention was paid to the timely exclusion of severe complications and organizing condition monitoring. Following the initial stage of exacerbation management, stabilization was forecasted. A regular plan for prevention and dynamic follow-up was subsequently established to prevent recurrent exacerbations.

Recurrent symptoms and the need for a second opinion

A patient with periodic symptoms causing concern despite treatment sought case review and a second opinion. The physician conducted a thorough review of complaints and medical history, assessed prior examination results, and suggested options for further management. Follow-up showed improvement and greater clarity in the treatment plan. Dynamic monitoring and timely adjustment of therapeutic interventions were advised.

How long does the consultation last?

On average, a consultation lasts 30–60 minutes; please confirm the exact time when booking.

How should I prepare for the appointment?

It is recommended to write down your symptoms, questions, and bring the results of previous examinations.

What should I bring to the appointment?

Bring ultrasound (US), MRI results, laboratory tests, discharge summaries, and a list of current medications.

Do I need to come on an empty stomach?

Usually not, unless the doctor advises otherwise; please check when booking.

How many visits are usually required?

The number of visits depends on the situation and treatment plan, usually several are needed.

When can I expect the first results of the treatment?

This is individual and depends on the chosen approach and the body’s characteristics.

What should I do if I feel worse before the appointment?

If your condition worsens, contact the doctor immediately, especially if you experience severe pain or bleeding.

Can the treatment be used together with current medications?

This is discussed during the appointment; do not stop or add medications on your own.

Is it possible to have an online consultation?

Yes, online consultations are available for initial questions and condition monitoring.

Can I come with already completed examinations?

Yes, bring all relevant examination results for assessment of your condition.

Do I need to come back for follow-up visits and how often?

Follow-up visits are scheduled based on results and condition dynamics, individually.

Can I get a second medical opinion?

Yes, you can seek a second opinion on any treatment or examination issues.

What should I do if symptoms return after improvement?

Contact the doctor to adjust the plan and evaluate the cause of recurring symptoms.

What examinations are needed for uterine leiomyoma?

Examinations are selected individually based on symptoms and initial examination results.

What does the treatment plan for uterine leiomyoma include?

Therapy depends on the size, symptoms, and accompanying factors; prescribed by the doctor after examination.

Can I stop taking medications on my own?

Do not stop taking medications without consulting your doctor; this is important for your safety.

How long does recovery take after treatment?

Recovery times vary depending on the chosen method and individual factors.

What should I do if examinations cause anxiety?

Discuss all concerns with your doctor, who will explain the necessity and purpose of the prescribed tests.