Uterine fibroids are common. As many as one in five women may have fibroids during their childbearing years (the time after starting menstruation for the first time and before menopause). Half of all women have fibroids by age 50. They are rare in women under age 20. Black women are three times more likely to get fibroids than other women.
The cause of uterine fibroids is unknown. However, their growth has been linked to the hormone estrogen. As long as a woman with fibroids is menstruating, a fibroid will probably continue to grow, usually slowly.
Fibroids can be so tiny that you need a microscope to see them. However, they can grow very large. They may fill the entire uterus, and may weigh several pounds. Although it is possible for just one fibroid to develop, usually there are more than one.
Fibroids are often described by their location in the uterus:
- Myometrial – in the muscle wall of the uterus
- Submucosal -- just under the surface of the uterine lining
- Subserosal -- just under the outside covering of the uterus
- Pendunculated -- occurring on a long stalk on the outside of the uterus or inside the cavity of the uterus
Fibroids are usually benign (not cancerous). Having them does not increase a woman’s risk of developing cancer. In fewer than 1 in 1,000 cases a cancerous fibroid will occur.
Most women with uterine fibroids have no symptoms. However, abnormal uterine bleeding is the most common symptom of a fibroid. If the tumors are near the uterine lining, or interfere with the blood flow to the lining, they can cause heavy periods, painful periods, prolonged periods or spotting between menses. Women with excessive bleeding due to fibroids may develop iron deficiency anemia. Uterine fibroids that are deteriorating can sometimes cause severe, localized pain.
Fibroids can also cause a number of symptoms depending on their size, location within the uterus, and how close they are to adjacent pelvic organs.
Even though most fibroids cause no symptoms, women who do have symptoms often find fibroids hard to live with. These symptoms can include:
- Bleeding between periods
- Heavy menstrual bleeding, sometimes with the passage of blood clots
- Menstrual periods that may last longer than normal
- Need to urinate more often
- Pelvic cramping or pain with periods
- Sensation of fullness or pressure in lower abdomen
- Pain during intercourse
- Feeling of fullness in the lower stomach area
- Enlargement of the lower abdomen
- Lower back pain
- Complications during pregnancy and labor
- Pressure on the rectum with pain during defecation.
Treatment for the symptoms of fibroids may include:
- Birth control pills (oral contraceptives) to help control heavy periods
- Intrauterine devices (IUDs) that release the hormone progestin to help reduce heavy bleeding and pain
- Iron supplements to prevent or treat anemia due to heavy periods
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naprosyn for cramps or pain
- Short-term hormonal therapy injections to help shrink the fibroids
Surgery and procedures used to actually treat fibroids include:
- Hysteroscopic resection of fibroids: Women who have fibroids growing inside the uterine cavity may need this outpatient procedure to remove the fibroid tumors.
- Uterine artery embolization: This procedure stops the blood supply to the fibroid, causing it to die and shrink. Women who may want to become pregnant in the future should discuss this procedure with their health care provider.
- Myomectomy: This surgery removes the fibroids. It is often the chosen treatment for women who want to have children, because it usually can preserve fertility. More fibroids can develop after a myomectomy.
- Hysterectomy: This invasive surgery may be an option if medicines do not work and other surgeries and procedures are not an option.
Uterine fibroid tumors are estrogen dependent — they thrive on estrogen. In fact, uterine fibroid tumors never develop before the onset of menstruation when the female body begins producing estrogen. During pregnancy, fibroid tumors often grow extremely fast due the extra estrogen produced by the body during pregnancy. Most women who have fibroid tumors and who are able to wait until after menopause, discover their uterine fibroid tumors shrink and disappear once estrogen production stops in the body.
Because of estrogen’s affect, both women who currently have fibroid tumors and those who’ve had uterine fibroids in the past need to pay particular attention to the potential side effects of estrogen-containing medications.
Many studies have already been made even in the earlier times linking tumors/fibroids with a diet rich in animal protein/fat (meat, eggs and most esp. milk) and chemicals like pesticides and additives/preservatives in processed food which flood the body with excessive amounts of estrogen. On the other hand, there are also supporting studies linking significantly lower rates of fibroids in countries with diet rich in vegetables and fruits which in contrast, flood the body with enzymes that eat up/melt excessive fibrin in the system which is basically what makes up abnormal growths like tumors, fibroids, and keloids.
Look for alternatives when buying substitutes for dairy, such as low-fat, organic products, or omega-rich foods. Dairy products contain calcium, which is important, so when removing the high-fat dairy products, try these foods still rich in calcium; soybeans, beans, peas, soy milk, goats milk, nut milk, sesame seeds, and green leafy vegetables. These foods easily pass through the liver, which results in less estrogen in the body.
Remember: The more estrogen in the body, the higher the risk for fibroid tumors or aggravating current tumors.
Alcohol is a major toxin to the liver. Alcohol prevents the liver from performing properly. If the liver isn’t functioning properly, it will not metabolize hormones. This will lead to increasing estrogen levels, which is bad for fibroid tumors. Also causing the same problem as alcohol, are caffeinated beverages, as well as drinks like fruit juices and sodas containing large amounts of sugar. Consume drinks that are caffeine -free, low in sugar and without alcohol. Water is the best thing you can drink.
On an interesting note, a recent study in the American Journal of Epidemiology links hair relaxers to uterine fibroids.
Scientists followed more than 23,000 pre-menopausal Black American women from 1997 to 2009 and found that the two- to three-times higher rate of fibroids among Black women may be linked to chemical exposure through scalp lesions and burns resulting from relaxers.
The study also links hair relaxers to early puberty in young girls:
Women who got their first menstrual period before the age of 10 were also more likely to have uterine fibroids, and early menstruation may result from hair products black girls are using, according to a separate study published in the Annals of Epidemiology.
Three hundred African-American, African-Caribbean, Hispanic and white women in New York City were studied. The women’s first menstrual period varied anywhere from age 8 to age 19, but African Americans, who were more likely to use straightening and relaxers, hair oils, also reached menarche earlier than other racial/ethnic group.
The number of fibroids, their size and how fast they grow varies among women. Female hormones encourage fibroids to grow, so they continue growing until menopause. Smaller fibroids will often shrink after menopause. However, larger fibroids may change little or become slightly smaller in size. If a woman has had fibroids removed surgically, new fibroids can appear any time before she enters menopause.
Remember, I’m not a doctor. I just sound like one. Take good care of yourself and live the best life possible!
The information included in this column is for educational purposes only. It is neither intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan.
Glenn Ellis is a health advocacy communications specialist. He is the author of “Which Doctor?” a health columnist and radio commentator who lectures and an active media contributor nationally and internationally on health related topics.
His latest book is “Information is the Best Medicine.” For more good health information, visit: www.glennellis.com.