I went to the Women’s Empowerment Expo for the first time this year, which I enjoyed immensely. There, I met more than one woman that asked me specifically about fibroids. I also have a good many women in the office that seek counseling regarding this topic often. Fibroids, also known as leiomyomas, are essentially muscle “tumors” of the uterus. They are called tumors, not because they are cancerous, but because they are a collection of cells or muscle that don’t really belong. Fibroids are very common, up to 80% in African‐American women and 70% in Caucasian women. They also appear to be hereditary and occur more often in obese women and those who have never had children.
A fibroid’s growth is affected by the circulation of hormones, namely estrogen and progesterone, which is why they usually diminish after menopause. Fibroids are generally located inside the uterus but can also hang on the outside. Sizes vary and cause enlargement of the uterus. As mentioned above, they can continue to grow up until the time of menopause.
Not all women with fibroids know they have them, or even complain of symptoms. Patients who do have significant fibroids can develop symptoms ranging from increasingly worsened cramping and heavier bleeding during their menses, abdominal pain from pressure of the uterus sitting atop the bladder and pulling the pelvic muscles, more frequent urination or urinary urgency because of the same reason, to increased abdominal girth and weight.
I have felt these muscular masses during physical exams while palpating the uterus and stomach. If and when a woman mentions signs or symptoms that make me suspicious of fibroids, or anytime I feel masses during a pelvic or vaginal exam, the next step is usually to an ultrasound. An ultrasound is a study performed, much like in pregnancy, either on top of the abdomen or through the vagina for visualization of the female organs and abnormalities therein. If a fibroid is found, the size and number can be determined as well, as there is frequently more than one.
In regards to treatments, there are generally 3 categories: those directed only at the symptoms patients complain about, those directed at shrinking the size, and those directed at getting rid of them altogether. But let me also say there is usually a fear once fibroids are diagnosed. There is good news‐‐fibroids do not become cancerous nor are they malignant. So, honestly, one treatment choice is to do nothing at all. If one does want to try something, referring to what was said before, to treat symptoms, we have medicines such as Naprosyn (available over the counter as Aleve) or Ibuprofen. These medicines serve as anti‐inflammatories for pain and heavy menstrual cramping. There are stronger anti‐inflammatories if these don’t work well.
If size reduction is the goal, which can also occur sometimes with the anti‐inflammatories, hormones or birth control can be used. Since fibroids are controlled by our own hormonal cycles, more regulation with things like estrogen and progesterone‐containing pills, help slow growth and even shrink the size of fibroids.
If one doesn’t want to be on hormonal or birth control pills, then there is more definitive treatment involving either removing the fibroid itself with the use of laser or surgery, or even with a hysterectomy. Some women see the surgical options as the last resort, but they are available with OB‐gyn specialists. Feel free to talk to your medical professional if you’re ever worried about any of these things.
Be healthy and be blessed,