Fibroid Awareness Month

Woman in bed with abdominal pain

Fibroids – What You Need to Know

According to the Office on Women’s Health (OWH), up to 80% of women develop fibroids by the time they reach age 50. While fibroids are most common in women during their 40s and early 50s, not all women diagnosed with fibroids experience noticeable symptoms.

Women with fibroids and associated symptoms often face other health issues that impact quality of life. Some women experience greater monthly pain and heavy menstrual bleeding. Still others experience constant pressure on the bladder, causing frequent urination. Some women have constant pressure within the rectum, causing persistent rectal pressure. Finally, fibroids can impact reproductive health in rare instances as cause of female infertility and can lead to problems during pregnancy and delivery.

Fibroids are the leading cause of hysterectomies. More than 200,000 hysterectomies are performed each year in the U.S. due to uterine fibroids. African American women are especially susceptible to fibroids and are 2 to 3 times more likely to have them.

If not removed, fibroids can continue to grow and cause the abdomen to enlarge, which can lead to an array of additional health concerns.

July is designated Fibroids Awareness Month. Your local Capital Women’s Care team of health professionals shares important information about fibroids and their symptoms, causes and treatments to help you understand how they may impact your body and overall health.

What Are Fibroids?

Fibroids are muscular tumors that typically grow within the uterine wall. Fibroids are almost always non-cancerous (benign.) According to the OWH, cancerous fibroids are rare, occurring in fewer than 1 in 1,000 cases.

Uterine fibroids are the most common benign pelvic tumors in women, although prevalence may be underestimated due to asymptomatic women. There are 4 types:

  • Submucosal fibroids grow into the uterine cavity.
  • Intramural fibroids grow within the uterine wall and are the most common form.
  • Sub serosal fibroids grow on the outside of the uterus.
  • Pedunculated fibroids grow on stalks that grow out from the surface of the uterus or into the cavity of the uterus and look like mushrooms.

Fibroids may either grow as a single tumor or as many grouped within the uterus. They may range in size from being as small as an apple seed or as big as a grapefruit. In unusual cases fibroids can become very large.

There are several factors that can increase fibroids risk:

  • Age. Fibroids become more common as women age, especially during the 30s and 40s through menopause. After menopause fibroids usually shrink.
  • Family history. Having a family member with fibroids increases your risk. If a woman's mother had fibroids, her risk of having them is about 3 times higher than average.
  • Ethnic origin. African American women are more prone to fibroids than white women.
  • Obesity. Women who are overweight face higher fibroids risk. For very heavy women, the risk is 2 to 3 times greater than average.
  • Pregnancy. During pregnancy, production of estrogen and progesterone (which may trigger and initiate fibroid growth) increases in a woman’s body. Fibroids may develop and grow rapidly while you’re pregnant.
  • Eating habits. Consuming a large amount of red meat (e.g., beef) and ham is linked with higher fibroid risk. A diet with plentiful green vegetables seems to protect women from developing fibroids.

Researchers have yet to determine what causes fibroids to form and grow but think more than 1 factor could play a role, including:

  • hormonal (affected by estrogen and progesterone levels)
  • and genetics (fibroids found within families.)

Since researchers have yet to identify what causes fibroids, it’s also unknown what causes them to grow or shrink. Researchers have identified fibroids grow rapidly during pregnancy when hormone levels are high; they shrink when anti-hormone medication is used; and they also stop growing or shrink once menopause commences.

Fibroid Symptoms

Most fibroids don’t cause any symptoms, yet some women with fibroids can experience:

  • heavy bleeding with blood clots (which can be heavy enough to cause anemia) or painful periods
  • periods lasting longer than usual
  • feeling of fullness or pressure in the pelvic area
  • swelling or enlargement of the lower abdomen
  • frequent urination
  • pain during sex
  • persistent lower back, leg or pelvic pain
  • complications during pregnancy and labor, including a 6-time greater risk of having cesarean section. Other potential problems include breech positioning of baby, labor that fails to progress, placental abruption and preterm delivery
  • and reproductive problems, such as infertility.

If you experience any of the above symptoms, schedule a visit with your local Capital Women’s Care team.

Speak with your doctor if you expect to become pregnant and have fibroids, as some treatments permanently erase all opportunity for future pregnancy.

If you’re pregnant and diagnosed with fibroids, or become pregnant and have fibroids, your Capital Women’s Care practitioner will carefully monitor your condition. In most scenarios, fibroids don’t cause problems during pregnancy.

Fibroid Diagnosis

Getting a regular pelvic exam that checks the uterus, ovaries and vagina are a starting point for determining fibroid presence.

If your practitioner feels a lump or mass, they distinguish its size and proceed to do imaging tests for fibroid confirmation. These tests might include:

  • ultrasound
  • magnetic resonance imaging (MRI)
  • x-rays
  • cat scan (CT)
  • hysterosalpingogram (HSG) involves injecting x-ray dye into the uterus and taking x-ray pictures.
  • or sonohysterogram involves injecting water into the uterus and making ultrasound pictures.

Surgery may also be required to properly diagnose fibroids. There are 2 diagnostic-based surgery types:

  • laparoscopy is when your doctor inserts a long, thin scope into a tiny incision made in or near the navel. The scope has a bright light and camera, allowing your doctor to see the uterus and other organs on a monitor during the procedure and produce pictures.
  • hysteroscopy is when your practitioner passes a long, thin lit scope through the vagina and cervix into the uterus. There are no incisions. Your doctor can look inside the uterus for fibroids and other problems, like polyps. A camera can also be used.

Fibroid Treatment

There are several treatments available to eliminate and remove fibroids, including:

  • Medications to regulate hormone levels may be prescribed to shrink fibroids

    Gonadotropin-releasing hormone (GnRH) agonists cause estrogen and progesterone levels to drop eventually stopping menstruation and shrinking fibroids. GnRH antagonists also help to shrink fibroids. They work by stopping the body from producing follicle-stimulating hormone (FSH) and luteinizing hormone (LH). GnRH agonists are a short-term option usually instituted prior to surgery.

    Nonsteroidal anti-inflammatory drugs, like ibuprofen, can reduce fibroid pain, but they don’t reduce bleeding.

    Hormonal birth control like oral contraceptives help to regulate the ovulation cycle and they may help reduce the amount of pain or bleeding during periods. Low dose hormonal birth control doesn’t make fibroids grow.

    Women may also use a progesterone intrauterine device or progesterone-like injections.

  • Abdominal myomectomy is a surgical procedure that involves making a large incision in the abdomen to access the uterus to remove fibroids. The surgery can also be performed laparoscopically, using a few small incisions into which surgical tools and a camera are inserted. There is no guarantee this procedure avoids fibroid regrowth.

  • A newer, completely noninvasive surgical procedure is forced ultrasound surgery (FUS). High-energy, high-frequency sound waves in conjunction with MRI are directed at fibroids to ablate (destroy) them.

  • Myolysis procedures shrink fibroids using heat sources like an electric current or laser, while cryomyolysis freezes fibroids.

  • Endometrial ablation involves inserting a special instrument into the uterus to destroy the uterine lining using heat, electric current, hot water or extreme cold.

  • Uterine artery embolization is a nonsurgical procedure where small particles are injected into the uterus to cut off blood supply to fibroids.

  • Hysterectomy, the surgical removal of the uterus, is used as a last resort should fibroid condition worsen or if no other previous fibroid treatment yields favorable results. Hysterectomy permanently eliminates opportunity for future pregnancy.

Researchers are continually striving toward new fibroid treatment options, including a recently FDA-approved surgery-free treatment via oral combination therapy in May 2021. Options such as this eliminate requirement for hospitalization and prolonged surgical recovery time while preserving fertility.

Reduce Fibroid Effects & Risk

Certain home remedies and natural treatments can have a positive effect on fibroids, including: acupuncture, yoga, massage or applying heat for cramps (avoid heat if you experience heavy bleeding.)

Avoid meats and high-calorie foods. Instead, opt for foods high in flavonoids: green vegetables, green tea and cold-water fish like tuna or salmon.

Managing stress levels and losing weight if overweight or obese also benefits women with fibroids.

Your Capital Women’s Care team of professionals is here to address your concerns or questions about uterine fibroids or any women’s health issue. Our knowledgeable women’s health experts offer you comprehensive care and treatment, so you achieve and enjoy optimal health plus a long quality life.

Sources:

https://www.womenshealth.gov/a-z-topics/uterine-fibroids
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3342149/
https://www.statnews.com/2021/07/08/uterine-fibroids-overlooked-far-too-...
https://www.wndu.com/content/news/Fibroid-facts-up-to-70-percent-of-wome...
http://www.idph.state.il.us/about/womenshealth/factsheets/ufibroids.htm
https://www.healthline.com/health/uterine-fibroids
https://www.medicalnewstoday.com/articles/151405
https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms...
https://www.hopkinsmedicine.org/health/conditions-and-diseases/uterine-f...
https://my.clevelandclinic.org/health/diseases/9130-uterine-fibroids
https://www.everydayhealth.com/uterine-fibroids/study-discovers-promisin...
https://www.verywellhealth.com/the-fda-approves-myfembree-for-treatment-...

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