Fibroid Facts

What are fibroids?

Fibroids are tumors which grow within the normal muscle of the uterus (womb) Single or multiple fibroids may be present and may vary in size from a grape (1cm) to a grapefruit (10 cm) or even larger. Fibroids are usually benign (not cancerous).

What causes fibroids?

The cause of fibroids is not known. It is known however, that the female sex hormones estrogen and progesterone are involved in fibroid growth as are a number of other growth factors.

Who gets fibroids?

Fibroids occur during a woman?s reproductive years and affect at least 50% of women over the age of 35. With the decrease in production of estrogen at menopause,fibroids stop growing and symptoms tend to disappear.

Will my fibroids turn into cancer?

Some women fear that fibroids may turn to cancer. This is no longer thought to occur. Cancerous fibroids (leiomyosarcomas) begin as cancer and these account for only one in 2-400 women with fibroids.

What are the symptoms?

Most often, fibroids cause no problems at all. However, for some women fibroids produce troublesome symptoms which may leave them feeling tired and lethargic and cause disruption to lifestyle and relationships. You may experience one or more of the following symptoms:

• Heavy Bleeding

This is the most common symptom and may vary from bleeding for a longer period of time, passing clots, episodes of “flooding” or irregular periods.


• Pain

Moderate to severe period pain may be experienced which may feel sharp, cramp-like or may produce a constant dull ache in the abdomen or lower back. This last type of pain is related to the fibroid placing pressure on the surrounding organs within the pelvis.


• Pressure Symptoms

fibroid uterus is placing forward pressure onto the bladder. Difficulty passing bowel motions, constipation or feeling as though you need to open your bowels more frequently may also indicate that there is backward pressure onto the bowel.


• Infertility

Infertility, or failure to achieve pregnancy may occur when certain types of fibroids block the fallopian tubes (preventing the sperm and egg from meeting) or distort the cavity of the uterus (interfering with the embryo embedding in the lining of the uterus) Fibroids in the wall of the uterus (intramural- see diagram) may also cause infertility and some of the symptoms resulting from fibroids: excessive bleeding or pain may also reduce the chance of conceiving.

Types of fibroids

Submucosal

These fibroids protrude inwards into the cavity of the uterus. They may grow on a stalk, which if long enough may protrude through the cervix. These are called fibroid polyps.

Intramural

These begin as little lumps in the muscle of the uterus. As they grow, the shape of the uterus becomes distorted.

Subserosal

These vary greatly in size and may be multiple. They grow and protrude outwards from the uterus, sometimes on a stalk, which may twist and cause pain.

Cervical

Some fibroids (about 2%) occur in the cervix.

Some more facts:

• Most women with fibroids do not require treatment


• The presence size and position of fibroids should be confirmed by a gynaecologist before beginning any treatment.


• Shrinkage of fibroids by drugs, embolisation or surgery may avoid major surgery in women, particularly those over 40.


• Myomectomy (fibroid removal) can usually be done laparoscopically or from the vagina and is most suitable for those wishing to become pregnant.


• Second opinions are important before consenting to major surgery.


• The choice of a specialist gynaecologist may provide surgery with a shorter stay in hospital and a decreased risk of complications.

Will progesterone help with fibroids?

Is it the heavy bleeding that creates the fibroids or the fibroids that create the heavy bleeding? From observation, our website has found that many women who suffer fibroid problems come to us as a last resort before a hysterectomy. And with serious management, progesterone use and a commitment to their health and patience, the fibroids usually come into control.

If you look at it another way, when a woman goes through menopause and her estrogen levels drop to the degree that her periods stop altogether, her fibroids will naturally shrink (atrophy). That is, unless her estrogen levels remain elevated by way of synthetic hormone replacement therapy, obesity. or other factors. Fibroids are almost a direct result of estrogen dominance so in order to minimise the effects of your fibroids you have to get your estrogen dominance down.

Your aim, therefore, is to reduce your body’s estrogen levels so that the fibroids will not continue to grow.

Women associated with our network have successfully used progesterone to assist and bring about this effect. Further, they reduced their estrogen dominance in the body through diet, particular attention being given to increasing intake of fibre, exercise, reducing refined sugars, a combination of herbs and vitamins high in antioxidants, stress management and lifestyle.

This is where phytoestrogens can play a major part in protecting the body against the more potent estrogens that can be responsible for ‘driving’ fibroid growth, thereby blocking receptors with weaker plant estrogens, but still providing the body with estrogenic benefits.

Often women with fibroids have a history of taking some form of estrogen therapy. If women want to try this approach it does take persistence, time, tolerance, understanding and patience. It is not an instant fix and it may not be the answer. A number of women elect to have their fibroids removed and leave the uterus intact. That has been a very successful option for some.

Whilst progesterone therapy has proved successful for a majority of the women experiencing heavy bleeding associated with fibroids, there has been a couple of cases reported where fibroids have not responded to progesterone therapy. They, in fact, grew in size.

One lady required a hysterectomy because excessive bleeding was interfering with her lifestyle. The hysterectomy was necessary due to the location of her fibroids. And another lady had her fibroids successfully removed leaving her uterus intact, and continues in good health, maintaining her hormonal health with progesterone at 32mg, 2 weeks on, 2 weeks off.

‘Mary’ is a case in point. She managed to maintain her heavy bleeding subsequent to fibroids (and migraines) using progesterone at 64mg but was advised by her doctor to drop to 32mg. Her doctor believed her dose was perhaps too high. She was fine for 2 months, then suddenly episodes of migraines and renewed heavy bleeding re-emerged which led to a deficiency in her iron. She was referred to a gynecologist who recommended a hysterectomy. Fear stricken and in a state of panic, she contacted us. We suggested she get another ultrasound which was scheduled anyway.

Two days later she called back, ecstatic, stating that she’d retrieved the second test results from her doctor and, when compared with her results 12 months prior, realised that her fibroids had shrunk considerably. This affirmed to Mary that she was on the right track. Her body, particularly her fibroids, was responding favourably to progesterone. She just needed to return to the procedures that were working successfully for her. Mary went back to a 64mg dosage for a few months to stabilise herself, using her headaches as her barometer, and once she had her bleeding under control, gradually reduced her dosage to between 40mg, or 50mg when under stress which provides Mary with a good buffer.

Our website has always encouraged our women to do their own detective work. To make sure that whenever they have tests conducted, whatever they may be, to insist on a copy for their own records. This approach empowered Mary, but more importantly she was in a position to bring together two ultrasound comparative results which were in two different doctors’ records.

Our message: Always make sure you have regular checkups, appropriate tests, and remain under the supervision of your specialist. And if you’re not comfortable or satisfied with your treatment and outcome, get a second opinion. Having your own copy of your test results will assist your treating physician, and gives you the freedom to go elsewhere.