Common Questions from Fibroid Patients

Will I be able to get pregnant if I have fibroids?

Many women will be able to become pregnant, even with fibroids; however, fibroids sometimes may cause complications and can prevent pregnancy. The location of the fibroids themselves is the largest problem when it comes to conceiving with fibroids.

If the fibroids are the kind that bulge into the uterine cavity or the kind that grown in the muscular wall of the uterus they may cause trouble.  The good news is that many times these fibroids can be successfully treated to boost the chance of fertility.


What are possible complications with pregnancy and fibroids?

With even one fibroid, your pregnancy could be classified as high -risk. Again, the type of fibroid and its location will likely have an effect on pregnancy. Some  common complications include spontaneous miscarriage, preterm labor, placental abruption, malpresentation, labor dystocia, cesarean delivery, and postpartum hemorrhage (1).


Do I have to have a hysterectomy?

While each women’s individual health situation will be the deciding factor for surgery,  hysterectomy is not necessary to treat every case of fibroids. Hysterectomy is unfortunately offered to soon as the first solution to many cases of fibroids. Functional fibroids will often resolve on their own, while others may be treated with alternative methods, such as Traditional Chinese Medicine(TCM herbs). Some patients may be benefit from a minimally invasive fibroid removal surgery which spares the uterus.

Although hysterectomy is often suggested before any other treatment, fibroid sufferers should carefully consider the long-term effects of the surgery.


What type of diet should I follow to help shrink the fibroids?

Diet may help with combating fibroids. Since the exact cause of fibroids is unknown, it’s not easy to recommend specific preventative or other holistic options. Since hormone imbalance may be the cause of fibroids, it’s thought that foods which support the liver could be helpful. That’s because the liver helps to regulate some of the hormones in the body. Some liver-supporting foods include:

Beets

Carrots

Broccoli

Cabbage

Walnuts

Citrus Fruits

Dandelion root herb

Turmeric

Milk thistle seed

Avoiding or reducing red meat and dairy intake is also advised. Eating whole foods and exercising regularly may be helpful in preventing and relieving the symptoms of some fibroids cases. New studies come out each year with conflicting views on which foods are best for fibroids. A healthy diet and lifestyle change are  good ideas for everyone,  but may not remove or dissolve existing fibroids. Fibroids should be considered on a case by case basis. How large is your fibroid? Are you truly having hormone imbalance? A combination of lifestyle changes, herbal support and close monitoring by a healthcare professional will offer the best likelihood for improvement.

Why are my fibroids causing frequent urination and/or constipation?

Fibroids can sometimes enlarge the uterus. The uterus may become as big as a woman who is pregnant!  The enlargement of the uterus will put pressure on the bladder and urethra. It could even cause constipation due to pressure on the colon.


Why are my periods so heavy and long?

One reason that fibroids may cause heavy and prolonged menstrual periods (also known as menorrhagia) is that they can increase the surface area of the uterus. A larger uterus will simply have more tissue to shed each month- causing heavier periods. It might be possible that the fibroids within the uterine muscle may increase blood flow to the uterus. The extra blood flow may cause imbalance in the normal function of the uterus- causing extra bleeding or longer periods. It’s also thought that  hormone imbalance causing the fibroids may also affect the length and heaviness of the menstrual cycle.

What is the difference between endometriosis, PCOS and having fibroids and cysts?

Fibroids are composed of muscular material that form in the muscle cells and can build within a short amount of time. They’re firm, compact and grow within the fibrous connective tissue in the uterus. Fibroids usually go away on their own after a women has gone through menopause.  An obvious difference between fibroids and cysts is that only cysts are filled with fluid. Ovarian cysts are filled with water, blood, or another liquid that usually form during ovulation. They can grow on one or both of a woman’s ovaries. Cysts tend to go away on their own, or sometimes they can also rupture. This type of growth is common most  among women of reproductive age.

Endometriosis occurs when the tissue that makes up the uterine lining grows on other organs in the body. Endometriosis is usually found in the lower abdomen, or pelvis, but can appear anywhere in the body. Having symptoms from endometriosis is more common than having symptoms of fibroids or cysts though, not everyone has them.  While people most often have no symptoms of either growth, when they do have symptoms they are similar to endometriosis. It is common for people to have lower abdominal pain, pain with periods, or pain with sexual intercourse.

PCOS stands for Polycystic Ovary Syndrome. It is the most common hormone abnormality among1 reproductive-aged women and up to 10% of women have it. PCOS is when the body produces too much androgen testosterone. This hormone abnormality does not cause cysts but does produce other symptoms including menstrual abnormalities preventing ovulation. PCOS then can cause ovaries to become enlarged and prevent pregnancy.

Are the fibroids and cysts cancerous?

Most fibroids are noncancerous, fewer than 1 in 1,000 cases, what was thought to be a uterine fibroid may be a cancerous mass.  Fibroids rarely require medical treatment. Only a small portion of women may need to have their fibroids removed if they experience chronic symptoms. In most cases cysts are also benign, but  occasionally they can be malignant. Malignancy is not common with only 1.3% of women receiving the diagnosis at any point of during their life. Though ovarian cancer is not common. Ovarian cancer can affect one or both ovaries. It occurs when cells begin to grow abnormally.

Why do some women continue to have fibroids after menopause while others are relieved from the issue?

Menopause is not a cure for fibroids, but it does decrease the chances of developing them. Many, but not all, fibroids also shrink or disappear after menopause. Women who have fibroids after menopause may suffer from their symptoms which include frequent spotting, menstrual-like cramping, abdominal swelling and more. There are some conditions that can increase the risk of a women having fibroids after menopause.

High blood pressure, low vitamin D levels, obesity, no history of pregnancy, long-term, and extreme stress can all increase the risk of postmenopausal fibroids.

Sometimes women who go through hormone replacement therapy(HRT) after menopause continue to develop or have symptoms of fibroids. Though estrogen levels generally decrease during perimenopause they are doing so irregularly and sometimes those levels can increase.  Fibroids’ growth correlates to estrogen levels in the body, so when estrogen increases so does fibroids growth.  Certain substances in fat cells can mimic the effects of estrogen, which result in fibroid growth. Time between perimenopause and menopause varies for each woman and it could take years to see reduction of fibroid size and symptoms.

 

 

 

 

References:

1. http://obgyn.ucla.edu/endometriosis

2. http://obgyn.ucla.edu/pcos

3.Contemporary Management of Fibroids in Pregnancy Hee Joong Lee, MD, PhD,1 Errol R Norwitz, MD, PhD,2 and Julia Shaw, MD, MBA2

4.https://www.healthline.com/health/menopause/fibroids-after-menopause

Will Fibroids Shrink After Menopause?

https://rmob.coloradowomenshealth.com/health/fibroids-polyps-cysts

 

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