Fibroids can be a major issue with women who are waiting to conceive. What are Fibroids? Fibroids are abnormal growths that develop in or on a woman’s uterus, they are also the most frequently seen tumors of the female reproductive system. Other names for fibroids are uterine myomas, leiomyomas, or fibromas, are firm, compact tumors that are made of smooth muscle cells and fibrous connective tissue that develop in the uterus.
How many people have them?
According to UCLA Health, although not all are diagnosed, it is estimated that between 20 to 50 percent of women of reproductive age have fibroids. They aso state that during childbearing years, some estimates state that between 30 – 77 percent of women will develop fibroids. Fibroids come in many different sizes, from the size of a pea to the size of a softball or small grapefruit, with about one-third of those fibroids being large enough to be detected by a health care provider during a physical examination.
UCLA Health has stated that 99% of the time, fibroid tumors are benign (non-cancerous), they’re not associated with cancer and do not affect a woman’s risk for uterine cancer.
Who is at risk for fibroid tumors?
Women who are approaching menopause are at the greatest risk for fibroids because of their long exposure to high levels of estrogen. However, once menopause is reached, the risk of fibroids decreases, fibroids shrink and sometimes disappear completely.
According to the American Society for Reproductive Medicine, uterine fibroids will affect 8 in 10 African American women and 7 in 10 Caucasian women before menopause. The reasoning behind this is still unknown. The National Uterine Fibroids Foundation states that African-American women are 2-3 times more likely to present with symptomatic uterine fibroids and are usually diagnosed at a younger age than the rest of the population of women with uterine fibroids.
The National Uterine Fibroid Foundation reports that women who are overweight are at a greater risk of fibroids, although the reasons for this are not clearly understood. A common perception on this matter is that obesity is linked to higher estrogen levels.
What causes fibroid tumors?
It is believed that each tumor develops from an aberrant muscle cell in the uterus, which multiplies rapidly because of the influence of estrogen. However, it is not clearly known what causes fibroids.
What are the symptoms of uterine fibroids?
- Heavy and/or prolonged menstrual periods
- Low back pain
- Pain during intercourse
- A firm mass, often located near the middle of the pelvis, which can be felt by the physician
- Abnormal bleeding between menstrual periods
- Pelvic pain (caused as the tumor presses on pelvic organs)
- Frequent urination
Keep in mind that some women who have fibroids have mild symptoms, or no symptoms at all. Other women may experience more severe, disruptive symptoms.
Can fibroids cause infertility?
Fibroids in the cavity of the uterus can cause infertility by preventing implantation. This is what occurs when the embryo (the egg and the sperm combined) attaches to the endometrial lining.
Submucosal fibroids can prevent implantation, and can cause problems with conception or can result in miscarriage.
Intramural fibroids (fibroids in the muscle) can also prevent conception. Fibroids can also obstruct the fallopian tubes, resulting in difficulty in becoming pregnant. Fibroid blockage of the tube will not allow the embryo to pass into the uterine cavity, and implant on the endometrial lining.
Fibroids can also cause problems during pregnancy. These include:
- Placental abruption – detachment of the placenta, causing bleeding and loss of pregnancy.
- Abnormal growth of the pregnancy – this happens when fibroids affect the blood flow or the size of the fibroids prevent the baby from growing properly.
- Pre-term labor and birth – preventing normal growth leading to contractions and early labor. Early labor may lead to an early delivery of the baby and possible developmental problems.
Treatment for fibroids
Since most fibroids stop growing or may even shrink as a woman approaches menopause, the health care provider may simply suggest monitoring the woman’s symptoms carefully to ensure that there are no significant changes or developments and that the fibroids are not growing.
In women whose fibroids are large or are causing significant symptoms, treatment may be necessary. Treatment will be determined by your healthcare provider(s) based on:
- Your overall health and medical history
- Extent of the disease
- Your tolerance for specific medications, procedures, or therapies
- Expectations for the course of the disease
- Your opinion or preference
- Your desire for pregnancy
According to UCLA Health, treatment options for fibroids may include:
- Hysterectomy: Fibroids are the number one reason for hysterectomies in the United States. Hysterectomies involve the surgical removal of the entire uterus.
- Conservative surgical therapy: Using a procedure called a myomectomy, in which, physicians remove the fibroids, but leave the uterus intact to enable a future pregnancy.
- Gonadotropin-releasing hormone agonists (GnRH agonists): This approach lowers estrogen levels and triggers a “medical menopause.” Sometimes GnRH agonists are used to shrink the fibroid, making surgical treatment easier.
- Anti-hormonal agents. Certain drugs oppose estrogen (such as progestin and Danazol), and appear effective in treating fibroids. Anti-progestins, which block the action of progesterone, are also sometimes used.
- Uterine artery embolization. Also called uterine fibroid embolization, uterine artery embolization (UAE) is a newer minimally-invasive technique. The arteries supplying blood to the fibroids are identified, then are embolized (blocked off), this eventually shrinks the fibroids.
- Anti-inflammatory painkillers. This type of drug is often effective for women who experience occasional pelvic pain or discomfort.
Overall, fibroids are not an easy thing to deal with. Eating a more plant-based diet has shown to help decrease the size of fibroids and also taking supplements such as fish oils, vitex or b-complex have proven to help as well. Exercising regularly and reducing exposure to environmental toxins may help as well.