1. Women’s Health Issues

Fibroids

Fibroids are benign tumors made mostly of muscle tissue. They are in the wall of the uterus. Sometimes they are on the cervix. They range in size from that of a pea to that of a cantaloupe or larger. With larger fibroids, the uterus can grow to the size of a pregnancy more than 20 weeks along. About 20 to 25% of women over age 35 get fibroids.



Signs & Symptoms

When symptoms occur, they vary due to the number, size, and locations of the fibroid(s). Symptoms include:

  1. •Swelling in the abdomen.

  2. •Heavy menstrual bleeding. Bleeding between periods or after sex. Bleeding after menopause.

  3. •Backache. Pain during sex. Pain with periods. Pressure on the internal organs causes the pain.

  4. •Feeling pressure in the pelvis. Passing urine often. Pressure on the bladder causes this.

  5. •Chronic constipation. Pressure on the rectum causes this.

  6. •A lot of bleeding can lead to anemia.

  7. •Infertility.

  8. •Miscarriage. If the fibroid is inside the uterus, the placenta may not implant the way it should.



Causes

The exact cause is not known, but fibroids need estrogen to grow. They may shrink or go away after menopause.


Reasons a Woman Is More Likely to Get Fibroids

  1. •She has not been pregnant.

  2. •She has a close relative who also had or has fibroids.

  3. •She is African American. The risk is 3 to 5 times higher than it is for Caucasian women.



Treatment

  1. •“Watchful waiting.” A doctor will “watch” for any changes and suggest “waiting” for menopause. Why? Fibroids often shrink or go away after that time. A woman may choose to get treatment for the fibroids, if she has problems. These include: Too much pain; too much bleeding; an abdomen that gets too big; the need to take daily iron to prevent anemia; and other abdominal problems.

  2. •Medication. One type is called GnRH agonists. These stop the body from making estrogen. This is not a cure. The fibroids return when the drug is stopped. Taking the drug shrinks the fibroids. This might allow a minor surgery (with less blood loss) to be done instead of a major one. GnRH agonists are taken for a few, but not more than six months. Why? Their side effects mimic menopause and may lead to osteoporosis. In some cases, GnRH agonists can be used longer with “Add Back Therapy.” This uses low dose estrogen to make side effects milder.

  3. •Surgery. There are many methods:

  4. -Myomectomy. The fibroids are removed. The uterus is not. This method may allow fibroids to grow back. The more fibroids there are to begin with, the greater the chance they will grow back.

  5. -Procedures to destroy the uterine lining. These do not remove fibroids or the uterus, but stop or lighten menstrual flow from then on. The uterine lining can be destroyed using a laser, heat, or ultra cold.

  6. -Uterine artery embolization. A catheter is inserted in a large blood vessel in the groin and sent to the level of the uterine arteries. A substance is given that blocks blood flow to the uterine arteries that nourish the fibroids. This treatment shrinks the fibroids.

  7. -Hysterectomy. This surgery removes the uterus and the fibroids with it. This method is advised when the fibroid is very large or when other treatments don’t stop severe bleeding. It is the only way to get rid of fibroids for sure. A women can no longer get pregnant after the surgery. This treatment is also advised if the fibroid is cancer. This occurs rarely.

Self-Care / Prevention

  1. •Maintain a healthy body weight. Follow a diet low in fat. The more fat you have, the more estrogen your body is likely to have. This promotes fibroid growth.

  2. •Get regular exercise. Doing this may reduce your body’s fat and estrogen levels.

Do you have any of these problems?

  1. •Heavy menstrual bleeding. Is a pad or tampon saturated in less than an hour?

  2. •Bleeding between periods, after sex, or after menopause.

  3. •Paleness. Weakness. Fatigue.

  4. •Pain during sex or with menstrual periods.

  5. •Pain in the lower back, not due to a strain or any other problem.

  6. •Feeling pressure on your bladder or rectum or you pass urine often.

Do you have severe abdominal pain?

Questions to Ask