A Pocket Guide To Uterine Fibroids And Menopause
Can you have fibroids after 50? While they may shrink once you enter menopause, they can also continue to cause symptoms. Learn more about menopause and fibroids as well as discover your treatment options below.
Fibroids are very unpredictable, which makes it very difficult to prevent and determine the cause, especially when it comes to information regarding uterine fibroids and menopause. However, research suggests that fibroid growth is linked to hormones specifically estrogen and progesterone.
For many women, fibroids grow during times when hormone levels are high, such as during pregnancy. On the other hand, fibroids tend to shrink when hormone levels are reduced, such as after menopause. Therefore, the risk of getting fibroids after menopause decreases.
Does A Fibroid Ever Go Away On Its Own
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What Treatments Are Available For Fibroids
If you have small fibroids, some health care providers recommend simply treating the symptoms, such as cramps, pain, or increased monthly blood loss, rather than treating the fibroids.
To control the fibroids growth, your health care provider may suggest you stop taking medication that contains estrogen and may suggest alternatives. However, some health care providers may even prescribe certain hormonal birth control options to help with the heavy periods.
Until recently, health care providers often recommended hysterectomy for women with fibroids that caused excessive bleeding. Fibroids are the reason given for an estimated one-third of the 60,000 hysterectomies performed in Canada each year.
Hysterectomy means removing the womb and sometimes the ovaries as well.
However, there is a growing belief in medicine that hysterectomies are not appropriate for treating fibroids and there are now other options for treating fibroids, such as:
- Medicated Intra-Uterine Device is sometimes used to help with the heavy periods and to shrink the fibroids, as a way to avoid more invasive procedures.
- Uterine fibroid embolization is a process to shrink the fibroids. The doctor uses fibre optics to guide a tube to troublesome fibroids, and injects small plastic or gelatin particles into the blood vessels that serve the fibroids. This blocks the blood supply to the fibroids. Although UFE is less invasive than surgery, little is known about its long-term effects, especially on future fertility.
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What If Your Fibroids Are Growing Postmenopause
Although the vast majority of fibroids cause no problems post-menopause, its important to note that your fibroids should not be growing at this time. If your abdomen is swelling, or if you notice increased pelvic pressure and an increased need to urinate, you should check with a doctor.
Fibroids are benign and do not grow into cancer however, a very rare cancer, known as uterine sarcoma does cause an increase in the size of the uterus, which can mimic the symptoms of post-menopausal fibroids. Uterine sarcomas tend to occur in women aged over 55.
Fortunately, its relatively simple for your doctor or gynocologist to rule out uterine sarcoma, but you should get the situation checked out, for your own peace of mind.
So, to return to the original question: are fibroids still a problem, post-menopause?
Typically no. If you are lucky, any fibroid symptoms you have had will start to decrease and will eventually fade away completely. However, taking HRT may prolong your fibroid symptoms, and if your sense that your uterus is growing at all, its important to seek medical advice post-menopause.
What New Treatments Are Available For Uterine Fibroids
The following methods are not yet standard treatments, so your doctor may not offer them or health insurance may not cover them.
- Radiofrequency ablation uses heat to destroy fibroid tissue without harming surrounding normal uterine tissue. The fibroids remain inside the uterus but shrink in size. Most women go home the same day and can return to normal activities within a few days.
- Anti-hormonal drugs may provide symptom relief without bone-thinning side effects.
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Fibroids After Menopause: Will They Go Away
As the most common tumor of the female reproductive tract, fibroids affect more people than you might expect. In fact, approximately 33 percent of women develop them during their childbearing years and 70-80% of women will have developed them by the age of 50.
Because fibroids are noncancerous, many people experience a few problematic symptoms, and some may not know they have fibroids at all.
If you already have fibroids and youre approaching the stages of perimenopause, youre probably wondering if you can delay treatment and let them resolve on their own. Although fibroids are not cancerous, they can cause serious complications if left untreated. In some cases, these complications can impact the uterus long term, causing unpleasant symptoms of fibroids after menopause.
If you have uterine fibroids, its best to get them treated right away. Thankfully there are treatments available today that dont require surgery for removal of the fibroids.
How To Detect Fibroids After Menopause Symptoms And Methods Of Diagnosis
The medical literature describes many symptoms of fibroids after menopause, but, most often they are talking about three of them:
- Increased profuse menstrual bleeding.
- Large fibroids can put pressure on the bladder or rectum, leading to impaired urination, problems with stool.
- Stomach enlargement. Many women ignore this symptom because they believe that they just gained weight.
Other possible manifestations: pain in the lower abdomen, lower back, legs, pain during intercourse. Although you need to remember that these signs are nonspecific and can often indicate other diseases
Who Can Have Fibroids
- Many women may have fibroids and not know it or feel any symptoms.
- About 20-25% of all women have symptomatic fibroids.
- Fibroids are rare in women under 20 years old.
- Fibroids are more common in women over 30.
- Women over the age of 35 have between a 20 and 40 % chance of having fibroids.
- Black women are 3 times likelier than other women to have fibroids.
- Fibroids are more common in women who are significantly overweight and in women who have never had children.
- Fibroids are more common in women towards the end of their reproductive years, and they often shrink after menopause.
How Do Doctors Diagnose Bleeding After Menopause
To find the cause of abnormal vaginal bleeding, your doctor will perform a physical exam and ask about your family and health history. He or she may also order a transvaginal ultrasound or an endometrial biopsy.
Transvaginal ultrasonography allows your doctor to assess your uterine cavity and endometrial thickness. He or she can also examine your fallopian tubes and ovaries. During this procedure, your doctor or an ultrasound technician will place an instrument into the vagina to examine the uterine cavity and endometrial lining. This instrument will emit sound waves that bounce off the pelvic organs. These sound waves get sent to a nearby computer and create a picture called a sonogram.
Endometrial biopsy, or endometrial sampling, involves removing a small piece of the endometrial lining. After taking the sample, the doctor will send it to the lab. There, the scientists will look for anything abnormal, including signs of infection or cancer.
What Questions Should I Ask My Doctor If I Have Fibroids
- How many fibroids do I have?
- What size is my fibroid?
- Where is my fibroid located ?
- Can I expect the fibroid to grow larger?
- How rapidly have they grown ?
- How will I know if the fibroid is growing larger?
- What problems can the fibroid cause?
- What tests or imaging studies are best for keeping track of the growth of my fibroids?
- What are my treatment options if my fibroid becomes a problem?
- What are your views on treating fibroids with a hysterectomy versus other types of treatments?
A second opinion is always a good idea if your doctor has not answered your questions completely or does not seem to be meeting your needs.
Ruling Out Other Conditions That Cause Heavy Bleeding
Almost all women, at some time in their reproductive life, experience heavy bleeding during menstrual periods.
A number of conditions can cause or contribute to the risk:
- Menstrual disorders
- Having late periods or approaching menopause
- Uterine polyps
- Copper intrauterine device contraceptive
The intrauterine device shown uses copper as the active contraceptive others use progesterone in a plastic device.
- Bleeding disorders that impair blood clotting, Von Willebrand disease, some coagulation factor deficiencies, or leukemia.
- Uterine cancer.
- Pelvic infections.
- Adenomyosis. This condition occurs when glands from the uterine lining become embedded in the uterine muscle. Its symptoms are similar to fibroids, but there is usually more pain with adenomyosis.
- Medical conditions, including thyroid problems and systemic lupus erythematosus.
- Certain drugs, including anticoagulants and anti-inflammatory medications.
- Often, the cause of heavy bleeding is unknown.
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Causes Of Uterine Fibroids
Experts donât know exactly why you get fibroids. Hormones and genetics might make you more likely to get them.
Hormones. Estrogen and progesterone are the hormones that make the lining of your uterus thicken every month during your period. They also seem to affect fibroid growth. When hormone production slows down during menopause, fibroids usually shrink.
Genetics. Researchers have found genetic differences between fibroids and normal cells in the uterus.
Other growth factors. Substances in your body that help with tissue upkeep, such as insulin-like growth factor, may play a part in fibroid growth.
Extracellular matrix . ECM makes your cells stick together. Fibroids have more ECM than normal cells, which makes them fibrous. ECM also keeps growth factors in it and causes cells to change.
What Causes Bleeding After Menopause
Imagine this scenario:
Youve been in menopause for three years, and instead of menstrual cramping and PMS, you seek treatment for the inconvenience of hot flashes and night sweats. Then one day, you start bleeding again, just like you did when you had your period. You wonder why it is happening and if its the indicator of something more serious.
To be clear, any bleeding after menopause is not normal, said Dr. Miller. This is a clear indicator that you need to schedule an appointment with us so we can determine the cause. While most causes of postmenopausal bleeding are not life-threatening, it can be an indicator of serious diseases such as various cancers, including endometrial cancer.
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What Makes Fibroids Shrink And Go Away
Although the causes behind fibroid growth are not entirely understood, it is believed that hormones such as estrogen and progesterone play a major role. Fibroids tend to develop when hormone levels are higher, such as during the childbearing years. Notably, many women experience fibroid growth during pregnancy. By age 50, 70 to 80 percent of women are affected.
Conversely, fibroids tend to shrink when hormone levels are reduced, such as after childbirth or menopause. In some cases, they can shrink enough to alleviate your fibroid pain and discomfort. Unfortunately, theres no way to know whether this will happen for you or not.
We dont think you should wait around to see if your fibroids will shrink on their own. Instead, look into Uterine Fibroid Embolization to shrink your fibroids, keep your uterus, and quickly reduce or eliminate your symptoms.
Treating Fibroids After Menopause
There are several treatment options available for women with uterine fibroids including:
- Oral contraceptives. With this option, your bodys estrogen levels drop, so your body may stop producing hormones, since we believe theres a link between hormones and fibroids.
Many of these treatments are the same for all women, regardless of age. Still, menopause may make a more permanent surgical option, like a hysterectomy, more attractive since your childbearing years are over. Younger women that still plan to have children typically prefer to take oral contraceptives or undergo a minimally invasive procedure like UFE.
Even if youve experienced menopause, a hysterectomy is a very invasive procedure. Thats why it is important to discuss all of these options with your womens health specialist. Together, we can help you reach a decision based on your current health and outlook on potential treatments. with one of the fibroid specialists of Houston Fibroids, or please contact our office today at 575-3686.
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How Do I Know For Sure That I Have Fibroids
Your doctor may find that you have fibroids when you see her or him for a regular pelvic exam to check your uterus, ovaries, and vagina. The doctor can feel the fibroid with her or his fingers during an ordinary pelvic exam, as a lump or mass on the uterus. Often, a doctor will describe how small or how large the fibroids are by comparing their size to the size your uterus would be if you were pregnant. For example, you may be told that your fibroids have made your uterus the size it would be if you were 16 weeks pregnant. Or the fibroid might be compared to fruits, nuts, or a ball, such as a grape or an orange, an acorn or a walnut, or a golf ball or a volleyball.
Your doctor can do imaging tests to confirm that you have fibroids. These are tests that create a “picture” of the inside of your body without surgery. These tests might include:
- Ultrasound Uses sound waves to produce the picture. The ultrasound probe can be placed on the abdomen or it can be placed inside the vagina to make the picture.
- Magnetic resonance imaging Uses magnets and radio waves to produce the picture
- X-rays Uses a form of radiation to see into the body and produce the picture
- Cat scan Takes many X-ray pictures of the body from different angles for a more complete image
- or An HSG involves injecting x-ray dye into the uterus and taking x-ray pictures. A sonohysterogram involves injecting water into the uterus and making ultrasound pictures.
Can You Have Uterine Fibroids After Menopause
Fibroids Cramps Menopause Fibroid symptoms such as heavy periods, severe cramps, period cramps but no period, frequent urination, and low energy levels can cause individuals to regularly miss work, cancel social engagements, avoid intimacy, and have low self-esteem. When your quality of life is impacted in these ways, we usually recommend treatment. Oct 21, 2021 · After menopause,
Fibroids left untreated in post-menopausal women can have the following.
fibroid re-growth or persistent symptoms after menopause.10 However, if you wait.
Uterine polyps are also known as endometrial polyps and refer to small growths in the inner lining of the uterus in women. The polyps resemble flat bumps or small mushrooms. You could have one of several polyps at a time. The polyps vary in size and could range from a few.
Uterine fibroids are growths in or on the uterus.They are not cancer. Fibroids can grow on the inside of the uterus, within the muscle wall of the uterus, or on the outer surface of the uterus.They can change the shape of the uterus as they grow. This can make it hard for you to get pregnant.
Uterine fibroids are the most common tumor found in female reproductive organs. Age. Fibroids are most common in women from their 30s through early 50s. About 20% to 40% of women age 35 and older have fibroids of significant enough size to cause symptoms. Race and Ethnicity
They usually shrink after the menopause when your.
After the procedure I was taken to the recovery.
Where Can I Find More Information
- The first year: fibroids: an essential guide for newly diagnosed by Johanna Skilling, Marlowe & Company 2002
- Fibroids: the complete guide to taking charge of your physical, emotional, and sexual well-being by Johanna Skilling, Marlowe & Company 2006
- The UNhysterectomy: Solving Your Painful, Heavy Bleeding Without Major Surgery by Holly Bridges, Self-published 2012 – Book review
This FAQ may provide medical information, but is not meant to be a substitute for medical advice. When you have questions about your health, it is always advisable to ask a health care practitioner.
Revised March 2013.
Clinical Studies Of Ht Effect On Postmenopausal Fibroids
The natural regression of UFs in menopause is due to the lower levels of circulating estrogen and progesterone. Many clinicians are concerned about HT because of UFs regrowth. Research on this subject remains inconclusive. Several prospective clinical trials have shown that UF growth peaked within the first two years of HT and it then decreased after the third year . Another study suggested that transdermal estrogen and high doses of medroxyprogesterone acetate may put patient at more risk for increase in UF size . Consequently, if HT includes progestin, a lower dose should be used to avoid the UF growth. Chang et al., states that women who benefit from HT should have ultrasound follow up every three months. If the size of UFs is increased, HT should be discontinued .
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Role Of Hormones And Uterine Fibroids
A staggering feature of UFs is their dependency on ovarian hormones. The role of estrogen and progesterone has been critical in understanding the pathogenesis and treatment of UFs. Fibroids express more estrogen receptors and progesterone receptors as compared to adjacent normal myometrial tissue . Recent findings have shown that estrogen increases the expression of PRs, and their sensitivity on respective tissues including UFs .
Studies have shown that UF growth has been suppressed when treated with continuous gonadotropin releasing hormone agonist for a period of 3 months. This is due to the decreased release of estrogen and progesterone in response to downregulation of GnRH receptor at the pituitary gland, thus mimicking menopause . These findings verify the critical role of ovarian steroid hormones in the pathogenesis of UFs .