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June 28th 2016

Fibroids 101

Fibroids are a common gynecological diagnosis, often misrepresented yet rarely ignored.

Fibroids (also known as myomas or leiomyoma) are benign (non-cancerous) growths in the uterus (womb). They can be attached to the wall of the uterus by a stalk, may grow into the wall of the uterus, jut out into the cavity of the uterus or appear on the outside of the uterus.

Growth of fibroids fluctuates with hormone levels. Unfortunately, no one really knows what will cause a fibroid to grow or shrink in a particular person so much of the scientific information is just dogma.

Studies have shown that estrogen makes fibroids grow, thus as we age and make less estrogen, fibroids should hypothetically shrink. However, I’ve seen women with low estrogen levels with large fibroids and women with high estrogen levels with small or no fibroids. Balancing hormones must always be our main goal because optimum hormone balance eliminates troublesome symptoms and even reduces fibroids.

Fibroids are diagnosed by ultrasound. Young women in the early 40s, around menopause are those most bothered by them. Stress and fear cause them to grow while taking it easy and listening to your body, waiting and not reacting, limits their growth.

Many experienced gynecologists and internists easily diagnose a fibroid during pelvic examination. Regardless, the doctor will recommend an ultrasound to determine the size and location in the uterus and then follow its behavior over time.

If you suffer with fibroids and bleed a lot, are anemic in spite of religious iron supplementation, have significant discomfort due to its size leaving you bloated all the time, you may want to do something about them.

First line of treatment should be natural bioidentical progesterone and iron supplementation along with lifestyle changes. (Bioidentical hormones are identical to the sex hormones -estradiol, progesterone, testosterone- our bodies make. They are extracted from soy and yam oils and have undergone extensive pharmaceutical processes of concentration and purification to create the hormone molecules our bodies recognize as our own). Improving your diet with more protein, dark leafy green vegetables, minimal processed foods, limited in alcohol and caffeine are key. Avoiding high altitude travel, strenuous workouts, listening to your body and getting a minimum of 7-8 hours of sleep at night will improve your body’s chances of eliminating the fibroid problem.

If the fibroids continue to grow or cause bleeding in spite of conservative and gentle treatment, you can opt to have a myomectomy where the fibroids are removed from the uterus, or an arterial embolization which cuts off the blood supply to the fibroid eliminating it over time. These are both surgical procedures with associated pain but short recovery time if you slow down for a week or two.

Only if the bleeding cannot be controlled, the fibroid keeps growing, if the diagnosis of cancer of the uterus is made independent of the fibroid, then and only then should you consider a hysterectomy.

Some gynecologists will have you believe that once you’re past childbearing age you now longer need your uterus. Nothing could be further from the truth. Your uterus is part of your body so keep it intact. Hysterectomy is major surgery. Even with the preservation of the ovaries, you will still experience significant hormone changes that may lead to menopause. So don’t allow anyone to be cavalier with your body.