Experts Still Dont Know What Causes Fibroids
Its not clear yet what causes fibroids, but we can point to a few factors that can increase your risk of developing these growths, which may include:
- Family history of fibroids
- Early menarche
- A diet which includes a high amount of red meat and few green vegetables
- Alcohol use
While they develop from the muscular tissue of your uterus, fibroids have a very different genetic profile than normal uterine muscle tissue, and they contain more estrogen and progesterone receptors. These two hormones stimulate your uterine lining to prepare for pregnancy during your menstrual cycle each month and seem to promote uterine fibroid growth.
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.
A Note About Smoking And Diet
Eating brightly colored fruits and vegetables is good for your general health. Consuming a variety of red, yellow, and orange foods will provide rich antioxidants. Dark greens are also nutrient dense and will provide healthful benefits. These nutrients may help protect you from disease, including some cancers.
However, a study found that beta carotene found in red, yellow and orange foods didnt lower the risk for fibroids. In smokers, beta carotene may even increase risk. Further research is needed on why this might happen. In any case, smoking is harmful to your health and may increase your risk of fibroids.
Diet alone cant treat fibroids. However, a balanced diet may also help ease some fibroid symptoms and complications. Certain foods may help slow fibroid growth in some cases.
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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.
How Are Uterine Fibroids Diagnosed
In many cases, fibroids are first discovered during a regular exam with your womens health provider. They can be felt during a pelvic exam and can be found during a gynecologic exam or during prenatal care. Quite often your description of heavy bleeding and other related symptoms may alert your healthcare provider to consider fibroids as a part of the diagnosis.There are several tests that can be done to confirm fibroids and determine their size and location. These tests can include:
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Can Fibroids Turn Into Cancer
Fibroids are almost always benign . Rarely a cancerous fibroid will occur. This is called Doctors think that these cancers do not arise from an already-existing fibroid. Having fibroids does not increase the risk of developing a cancerous fibroid. Having fibroids also does not increase a woman’s chances of getting other forms of cancer in the uterus.
Other Tests For Uterine Fibroids
In special circumstances or if doctors cant identify the source of your pain, you may need additional testing:
- Hysterosalpingogram : Doctors typically use an HSG for women having trouble getting pregnant. It checks the inside of the uterus and fallopian tubes. After a doctor places a catheter in the uterus, the doctor slowly injects a special dye for contrast and takes X-rays.
- Hysterosonogram: Doctors use a hysterosonogram to see the inside of the uterus. After they place a small catheter inside the uterus, they inject water while taking a series of ultrasound images. The test can confirm the presence of uterine polyps or intracavitary fibroids that can cause heavy bleeding.
- Laparoscopy: For laparoscopy, a doctor makes tiny incisions in or near the navel. The doctor then inserts a long, thin instrument into the abdomen and pelvis. The laparoscope has a bright light and a camera. It allows your doctor to see the uterus and surrounding structures. The view can help your doctor determine if you have a condition such as endometriosis, which can cause pelvic pain.
- Hysteroscopy: For suspected abnormalities inside the uterus, a doctor uses a long, thin instrument with a camera and light. The doctor passes the instrument through the vagina and cervix into the uterus. No incision is needed. The doctor can look for fibroids or endometrial polyps within the cavity of the uterus with this approach. Your doctor may also remove some types of fibroids during this procedure.
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How Does Menopause Change Fibroid Symptoms
After menopause, fibroids cause similar symptoms to pre-menopausal fibroids. Since women dont have periods after menopause, they dont experience the intense menstrual cycles associated with fibroids. However, they can experience intermittent bleeding, cramps, a protruding belly, and frequent urination. If you have post-menopausal fibroids, you could also have symptoms like:
- Inability to empty bladder fully
- Pain during intercourse
Rare Cases Of Postmenopausal Fibroids
Oindi et al presented a case of a 47-year-old African-American woman, with a growing abdominal mass accompanied by menorrhagia and dysmenorrhea for three years prior to presentation. Her past medical history included a diagnosis of UFs for which she underwent a laparoscopic myomectomy with power morcellator six years prior. The physical examination revealed an anterior abdominal wall mass in the left iliac fossa region. As part of further evaluation and to relieve her symptoms, she received a total abdominal hysterectomy and abdominal excision of the mass. Histological examination of the mass revealed benign smooth muscle fibers with characteristics of UFs. Her postoperative recovery was uneventful . The use of power morcellator has significant benefits including decreased blood loss, shorter hospital stay, and faster recovery. One of the disadvantages of the power morcellator is the fragmentation of UFs, which may lead to peritoneal seeding and future growth of parasitic fibroids, as mentioned in the case above. Although this is a late and rare complication of this technique, precaution should be taken to prevent seeding when using the power morcellator . If a uterine leiomyosarcoma is mistaken as a benign uterine fibroid, the patient is at risk of seeding of the sarcoma throughout the abdominal cavity through the use of a power morcellator, and thus great precaution should be used.
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A Hysterectomy Is Not The Only Option For Treating Fibroids
Fibroids were once the leading reason for performing hysterectomies. Advances in medical technology and treatment techniques allow us to choose less drastic measures for treating these benign growths these days.
We may recommend medications that manipulate your hormones enough to control excessive bleeding due to the fibroids. These medications can shrink your fibroids but wont eliminate them. Birth control pills can also control bleeding but have little effect on the size of your fibroids.
If fibroids are interfering with your ability to become pregnant or maintain a pregnancy, we can consider surgical removal of the fibroids while leaving your uterus and other reproductive organs intact. This type of surgery can often be done laparoscopically, which requires just a few small incisions and offers a faster healing time than traditional, open surgery.
At Womens Healthcare of Princeton, we care for all aspects of your health, including diagnosis and treatment of uterine fibroids. Call or click to set up an appointment.
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Fibroids And Menopause: Do I Have To Get Fibroids Removed
In the past, the only fibroid treatment available was surgery. This would remove either part or all of a womans uterus. This influenced a lot of women to do the watch and wait method. Its important to remember that fibroids will not go away without treatment. When left untreated, they will continue to cause uncomfortable or painful symptoms. Over time, this chronic pain may decrease from fibroids after menopause, but this is not a guarantee.With the recent development of new technologies, removal of fibroids is unnecessary for symptom relief. Hysterectomy is still the only true cure for fibroids, however it is now only used for very serious, rare cases.Uterine Fibroid Embolization is a treatment method that uses x-ray technology to deliver a medical agent to the uterus and fibroids. This blocks the blood flow to the fibroids and eventually causes them to shrink. UFE is done as an outpatient procedure, does not require a long recovery, and allows for preservation of fertility.
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Urinary And Bowel Problems
Fibroids can press and squeeze the bladder, leading to frequent need for urination.
Large fibroids that press against the bladder occasionally result in urinary tract infections. If the urethra is pressured or blocked, urinary retention may occur. Pressure on the ureters may cause urinary tract obstruction and kidney damage.
Pressure on the bowels may result in constipation.
Fibroids Come In Different Shapes And Sizes
Fibroids may be tiny and described as seedlings or grow large enough to alter the shape and size of your uterus. Those that grow on the outer wall of your uterus, which is called the serosa, can develop on a narrow stem that supports the larger growth. We call these pedunculated fibroids.
We also classify uterine fibroids according to their location in your uterus. Those that grow within the uterine wall are called intramural fibroids. Submucosal fibroids protrude into the uterine cavity, and subserosal fibroids project outward from the uterus.
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What Does Uterine Fibroid Pain Feel Like
There are a variety of feelings you might experience if you have fibroids. If you have small fibroids, you may feel nothing at all and not even notice theyre there. For larger fibroids, however, you can experience discomforts and even pains related to the condition. Fibroids can cause you to feel back pain, severe menstrual cramps, sharp stabbing pains in your abdomen and even pain during sex.
Postmenopausal Fibroids And Bone Health
The menopause transition is a critical period of change in bone strength in women, which sets the stage for development of osteoporosis and fracture susceptibility in older ages. Several prospective cohort studies have documented declines in bone mineral density over the menopausal transition. BMD begins to decline at approximately 1 year prior to the final menstrual period . Conversely, certain hyperestrogenic states such as obesity have been shown to have protective effects on BMD even after factoring in mechanical load on bones. Randell, K.M. et al., stated that perimenopausal and early menopausal women who underwent hysterectomies for symptomatic UFs had lower risk for fractures . This finding suggests that higher levels of estrogen in women with symptomatic UFs may have a protective effect on osteoporosis .
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Can Fibroids Shrink And Go Away
Are uterine fibroids causing pain and frustration in your life? Fibroid symptoms like heavy periods, intense cramps, and frequent urination can impact your career, relationships, self-esteem, and ability to perform your daily tasks.
Not surprisingly, many of our patients want to know if fibroids shrink on their own. For some individuals, this is a possibility. For instance, post-pregnancy or menopause hormonal changes can sometimes cause fibroids to shrink, thereby alleviating symptoms over time. The bad news is that this type of relief may be years, or even decades, away.
In the meantime, lifestyle factors can play an important role in fibroid management. Maintaining a healthy Body Mass Index , exercising regularly, and eating an appropriate fibroid diet can help you better manage your symptoms and even prevent additional fibroid growth.
While these are potential ways to improve your symptoms, they cant effect the cause of the issue. A minimally-invasive fibroid treatment called Uterine Fibroid Embolization is an effective, outpatient procedure that can shrink your fibroids, preserve your uterus, and resolve your painful, uncomfortable, and inconvenient symptoms.
Heres what you need to know.
Who Is Most Likely To Get Fibroids
As mentioned earlier, the cause of fibroids is very unpredictable. Fibroids affect women of all ages and you may even have symptoms of fibroids after menopause.
Common patterns of fibroid development include being of reproductive age being overweight, high blood pressure, family history of fibroids, or being African-American.
There has also been research that shows Vitamin D deficiency is a main factor in the development of uterine fibroids. This is important if you are approaching menopause because the risk for vitamin deficiency increases with age.
If you would like to know more about the relationship between vitamin D and uterine fibroids, check out our blog article : Vitamin D and Fibroids: Does Vitamin D Deficiency Cause Fibroids?
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The Following Patients With Uterine Fibroids After Menopause Should Cause Oncological Alertness:
- with large sizes of myomatous nodes
- with submucous localization of uterine fibroids
- with recurrent and atypical endometrial hyperplasia
- with a combination of uterine fibroids and adenomyosis
- with the severe neuroendocrine syndrome
- in the absence of regression of uterine fibroids after menopause against the background of age-related extinction of ovarian function.
In addition, the likelihood of activation of fibroids with menopause is increased in those women whose family history has had cases of this pathology. This is important to consider when treating uterine fibroids.
Q& a: Understanding Fibroid Pain
You may be able to manage symptoms with over-the-counter medications and home remedies. This is especially true if you only have minor symptoms that arent affecting your day-to-day life.
Home remedies include:
- heating pads or warm compresses
There are also some home remedies that may help reduce other symptoms of fibroids:
- eat a healthy diet rich in fruits, vegetables, whole grains, and lean meats, and avoid red meat, refined carbohydrates and sugary foods as these may worsen fibroids
- consume dairy products, such as milk, yogurt, and cheese, at least once a day
- limit alcohol
- take vitamin and mineral supplements, including iron and B vitamins, to help prevent anemia caused by heavy bleeding
- exercise regularly and maintain a healthy weight
- limit your intake of sodium to reduce your risk of high blood pressure
- find ways to reduce stress, such as yoga or meditation
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Can Fibroids Go Away After Menopause
Fibroid pain may lessen after menopause, but it may not completely go away. If you choose to have surgery to remove fibroids, your pain will likely be relieved shortly after surgery, but its possible for the fibroids to return later on depending on your age. If youre close to menopause, you may be less likely to have recurring problems.
Approach Of Uterine Fibroids In Perimenopause
UFs are very common and their symptoms have significant impact on womens quality of life, however, the assumption that they will resolve with the onset of menopause is simplistic and not always valid . It is important to consider that AUB accounts for more than 70% of all gynecological consultations in perimenopause and postmenopause . Considering the broadness of AUB and the multitude of conditions that may mimic it, a thorough evaluation is important to exclude serious pathology such as carcinoma or complex atypical hyperplasia and to identify the cause of bleeding for proper treatment .
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Causes Of Uterine Fibroids Appearance
Currently, scientists are forced to admit defeat the causes of myomatous nodes are unknown. There are two main theories, but none of them has strong evidence:
- Embryonic theory suggests that abnormalities occur during fetal development. The smooth muscle cells of the uterus of the embryo do not finish their development for a long time, until the 38th week of pregnancy, and are in an unstable state , due to which there is a higher risk occurrence of defects in them.
- Based on the traumatic theory, a defect in the cells of the myometrium occurs due to repeatedly repeated menstrual cycles, inflammatory processes, abortions, curettage of the uterus, the inaccurate performance of obstetric manual methods during childbirth, and a small number of pregnancies.
The uterine fibroids after menopause nods always arise from a single cell. Due to damage, this cell begins to divide and forms a node.
Uterine fibroids are a disease that no woman is safe. Since the causes of the occurrence are unknown, effective methods of prevention do not exist, except for regular visits to the gynecologist twice a year. The doctor may pay attention to nonspecific signs and schedule an examination.