When Do Fibroids Occur
Fibroids are benign (noncancerous) growths that develop in the muscle tissue of a woman’s uterus. They are also called myomas and leiomyomas. Fibroids are very common; it is estimated that 40 to 80% of women may have them at some point in their lives. Although fibroids are sensitive to the hormones estrogen and progesterone, it is unknown exactly why they develop. Fibroids most typically grow and present symptoms during a woman’s reproductive years, when her ovaries are active, but they can occur at any age. In many cases, these tumors may not cause problematic symptoms such as pain or heavy menstrual flow. Consequently, some women may be totally unaware of any uterine fibroids all throughout their reproductive years.
What Happens During Menopause?
Once the ovaries slow down production and eventually stop the synthesis of estradiol (estrogen)—usually during a woman’s mid-50s— she is considered to have entered menopause. The drop in estrogen production that occurs during this stage of life will usually result in gradual shrinkage of any uterine fibroids that may be present. Fibroids and their accompanying symptoms most often spontaneously diminish and disappear on their own during and after menopause. But what if they don’t?
Why You May Have Fibroids After Menopause
Although the menopausal body’s decrease in reproductive hormones is likely to cause existing fibroids to shrink and to prevent new fibroids from forming, this is not always the case. In other words, menopause cannot be considered a guaranteed fibroid cure for every woman. Some individuals may continue to experience fibroids during and after menopause or may even develop them for the first time during this stage of life.
Certain specific risk factors have been found positively associated with fibroid incidence/prevalence in menopausal females. Such factors include the following conditions:
- A family history of fibroids
- Obesity
- High blood pressure, also known as hypertension
- Low vitamin D levels
- No history of pregnancy
- Exposure to long-term, extreme stress
- African-American ethnicity
There are a number of underlying reasons why a woman might continue to struggle with a fibroid tumor during this stage of her life: stimulation from exogenous estrogen (i.e. hormone replacement therapy — HRT), cancerous tumors or malignant uterine/fibroid changes are a few possible causes. Medical experts recommend that “as a precaution, any woman with an increase in uterine growth/size and/or post-menopausal uterine bleeding should be evaluated to rule out malignant uterine/fibroid changes.”
Treatment for Menopausal and Postmenopausal Women
After diagnosis, there are several treatment options generally available to menopausal and postmenopausal women with uterine fibroids. Those most frequently recommended today include:
- Oral contraceptives — Taking birth control pills is one possible method of fibroid management. In this situation, the main goals of oral contraceptives are to decrease heavy bleeding and reduce the size and number of existing fibroids. These hormones might also prevent future fibroid development.
- Uterine fibroid embolization (UFE) — Uterine fibroid embolization (UFE) is a minimally invasive procedure. It is most often considered when fibroids cause pain, heavy menstrual bleeding and pressure on the bladder or bowel. UFE uses a form of real-time x-ray called fluoroscopy to guide the delivery of embolic agents to the uterus and fibroids. These small particles then block the arteries that provide blood to the fibroids and thus cause them to shrink.
- Myomectomy — This type of surgery targets the removal of existing fibroids. It leaves the woman’s uterus intact.
- Hysterectomy — For severe symptoms related to large, recurring fibroids — or as a last resort — a hysterectomy may be the final option. This surgery removes all or some part of the uterus and sometimes the ovaries too.
- Alternative treatments including herbal remedies — some natural food supplements have gained a reputation for effectiveness in managing the symptoms of fibroids without the drastic side effects associated with other treatment options. A combination of herbs from three major categories seems to be especially helpful to menopausal fibroid sufferers: tonics that promote blood flow to the female reproductive organs; detoxifiers and blood purifiers that reduce swelling, ease blood clotting, relieve constipation and calm the nervous system; energy enhancers that boost metabolism and mood, combat fatigue and improve energy level in general.
Always Consult your Physician
Since each woman’s body is unique, it is important to consult with a qualified healthcare team to determine the best approach to the most effective, individualized treatment. Remember to consider the risks and benefits of each option. Ask enough questions to address all of your concerns. And remember that, if you are experiencing fibroids at or after menopause, you are not alone. There are answers to your concerns, and research continues to explore new paths.