Fibroids – tumors made of muscle tissue that grow in the uterus – are the number one cause of hysterectomy. Up to 80 percent of women live with fibroids, but in the majority, the condition is undiagnosed. Fibroids are non-cancerous but cause symptoms like menstrual pain, heavy bleeding, bleeding between periods, lower back pain, frequent urination and abdominal enlargement.
The Causes of Fibroids
The precise cause of uterine fibroids is still mostly unknown. Since fibroids grow during pregnancy when hormone levels are high and shrink after menopause when hormone levels are lower, we know that fibroids are greatly influenced by the hormones estrogen and progesterone. We also know that fibroids are more common in women in their 30s and 40s and that there is a strong genetic component to the risk of developing fibroids. Women with a family history are more likely to develop fibroids, and approximately sixty percent of African-American women will have a fibroid by the time they are 35 years old. Obesity and diets high in meats and low in green vegetables are also risk factors.
Living With Fibroids
Many women suffer for years from heavy bleeding, painful sex, painful periods, frequent urination and general discomfort caused by uterine fibroids. Living with fibroids can also take an emotional toll that affects your sexual health, career and personal relationships. A good number of experts holds that fibroids are underreported due to embarrassment, lack of education on what fibroids are, lack of knowledge about how fibroids can be successfully treated, or lack of access to treatment. Consequently, fibroids are widely thought to be under-treated, though educational campaigns for women’s health may be correcting this.
Treatments for Fibroids
Fibroids often exist asymptomatically. Since they are benign, no treatment is recommended in those cases. If fibroids are causing bleeding, discomfort, or any other symptom that negatively impacts a woman’s quality of life, treatment is recommended. Treatment options include:
- Medication. Pharmaceutical treatments may slow bleeding by helping the blood clot, but they will not remove the fibroids themselves.
- Hysterectomy. Hysterectomy results in the complete removal of fibroids and prevents their return, but the removal of the uterus means women can no longer have children.
- Myomectomy. A myomectomy preserves the uterus by surgically shaving off the fibroids. This option may be right for women who want to preserve their childbearing ability, but there is risk of fibroids returning.
- Uterine artery embolization (UAE). Requiring a minimally invasive surgery, a UAE procedure injects small particles into the uterine arteries, essentially starving the fibroids of their nutrient source and causing them to die. While women have successfully become pregnant after UAE treatment (and fertility is thought to have improved in some women), anyone considering pregnancy should speak with their doctors before undergoing a UAE.
- Hormonal treatment. The hormone progesterone may reduce the effect of fibroids and can be delivered by birth control measures such as pills, patches, vaginal rings, intrauterine devices (IUDs), or injection.
Many of us ask the question: “How do you define decreased quality of life? How many work days or play dates do I have to cancel due to fibroid symptoms? At what point can I justify to myself–or even to an insurance company–a fibroid intervention?” The answer, of course, varies from woman to woman. But judging from the number of patients who tell us they wished they had taken care of the problem sooner, MIRI encourages all women to take these questions seriously. Despite their high prevalence, fibroids should not be considered “normal,” and minimally invasive, quick-healing and aesthetically-preserving treatment is available.
We will create a plan designed just for your unique symptoms and goals.