A short entry on a common problem often misrepresented and rarely ignored.
Fibroids (also called myomas) are benign (non cancerous) growths in the uterus (womb). They can be attached to the wall of the uterus by a stalk, like in polyps, may grow into the wall of the uterus, or just jut out of the wall into the cavity of the uterus.
Fibroid growth or shrinkage is hormonally dependent. Unfortunately no one really knows for sure what will cause a fibroid to grow or shrink in a particular person.
Hypothetically we know that too much estrogen makes the fibroid grow, and as we age and we make less estrogen, fibroids tend to shrink. However, I’ve seen women with severe hormone imbalances who experienced irrational fibroid growth or shrinkage. Having said this, balancing your hormones should always be a goal since the better the hormone balance, the less likely you are to be troubled by fibroids.
Fibroids are not reserved for older women. Young women have them and depending on when you have an ultrasound done, you may have a fibroid at one time and not at another. Stress causes them to grow and relaxation and dealing with stress makes them shrink. (see The Wisdom of Menopause- Christiane Northrup, MD)
From my extensive experience I can only tell you that fibroids are a good thing to ignore for the most part. Your own body will make them disappear or shrink to totally insignificant sizes most of the time if left alone.
Fibroids are diagnosed by ultrasound. Many experienced gynecologists and internists will be able to diagnose a sizeable fibroid during a pelvic examination, but they will then send you for an ultrasound to determine the size and location anyway.
When should you do something about a fibroid?
Only if it bleeds a lot and you have become anemic in spite of taking iron supplementation religiously, or you have a lot of discomfort because it has grown so much you feel pregnant and bloated all the time.
When should you have a hysterectomy for fibroids?
Only if the doctor has tried to control the bleeding unsuccessfully, has tried to shrink it with natural hormone methods (stay away from Lupron), the fibroid is so big you cannot fit in your usual clothes and if there is any reason to believe you have any sign of cancer in your uterus independent of the existence of the fibroid (I will write another Blog entry on the topic of endometrial biopsies soon).
Hysterectomy happy physicians will have you believe that the sooner you get rid of the pesky fibroid the quicker you will feel better. While you may feel gutted out, you will NOT FEEL BETTER. Hysterectomy is a major surgery. Even with the preservation of the ovaries, you will still experience significant hormone changes and may even be thrown into premature menopause. You are best advised to steer clear of any surgery that you don’t absolutely have to have, that certainly includes hysterectomy.
There are a few surgical procedures that specifically address the fibroid and those are milder and more likely to be helpful at least temporarily. They include myomectomy (they take out the fibroid and leave the uterus behind) and embolization of the fibroid (they cut off the blood supply to the fibroid and then it shrinks on its own). Both these procedures are okay in the short run and will help control the bleeding and discomfort caused by fibroids. However, they are by no means permanent and if your hormone balance is not addressed, in time the fibroids will recur. But these surgical procedures are better options then using synthetic hormones like Lupron or birth control pills.
Final words on fibroids
For all we know, fibroids are normal expression of hormonal changes that occur in our bodies and if they are small and do not bother you, they may not represent abnormality at all.
Get your hormones balanced, make sure you eat hormone healthy foods, exercise and deal with stress honestly and gently. If you are diagnosed with a fibroid by chance do nothing about it. Do not react with fear or allow the doctor to intimidate you about it.
Take your time and do nothing when it doubt. Let your body handle the fibroid the way it sees fit. Most likely it will be a better way then the aggressive and permanent surgical or medication procedure offered by the gynecologist.
Enjoy life and do not make fibroids another reason to live in fear and under a cloud of doom.
Now you know what you REALLY need to know about fibroids.