Though many individuals will not suffer serious symptoms and will never require surgical treatment, fibroids affect more than 75 percent of women worldwide.
What are fibroids?
Fibroids are non-cancerous growths that develop in and around the uterus.
Known technically as leiomyomata, these tumors can vary in size and number causing pain, infertility, miscarriage, or early onset of labor.
How much is spent on fibroids annually?
The cost of fibroids is high. Females miss more work than their male counterparts due to fibroids, which may result ultimately in permanent treatment. In fact 200,000 hysterectomies are performed each year in the United States due to the presence of fibroids. Healthcare costs annually exceed $2.1 billion.
What are the symptoms of fibroids?
Fibroid symptoms vary and may include one or more of the following:
- Heavy bleeding during menstruation
- Intense pressure in the pelvic region
- More frequent urination
- Painful intercourse
- Menstrual period that lasts more than one week
- Spotting between periods
- Back pain/leg pain
- Trouble completely eliminating bladder
- Early labor
Where in the body do fibroids occur?
Many fibroids develop and grow within or on the uterus. These may be grouped one of four ways including:
- Submucosal—These fibroids grow directly in the uterine cavity.
- Intramural—This type of fibroid develops and grows within the uterine wall itself.
- Subserosal—These fibroids develop and grow on the outer tissue of the uterus.
- Pedunculated—This type of fibroid grows outward, either from the surface tissue of the uterus, or into the uterine cavity on a stalk, much like a mushroom.
More specifically, doctors classify fibroids based on location. A woman often has several fibroids growing either In the uterine wall, underneath the endometrium, under the uterine lining, Extending from the interior or exterior, On the uterine wall stemming from a stalk known as a pedicle.
Who gets fibroids?
Several factors impact a woman’s likelihood of developing fibroids. These include:
Age—Fibroids are more common in women of childbearing age and occur mainly in the 30’s and 40’s.
Family history—If a family member has fibroids, such as a mother; a woman is three times more likely to have fibroids herself.
Ethnic origin—African-American females are at greater risk for developing fibroids than Caucasian women of the same age.
Obesity—Women who are very heavy are two to three times more likely to develop fibroids.
Diet—A high consumption of red meat or ham may be associated with the prevalence of fibroids.
Who else at risk for developing fibroids?
Women who have been exposed to high levels of estrogen over time such as women nearing menopause, and those with high blood pressure may also be at higher risk for fibroids.
Is there a genetic link to fibroids?
Recent studies point to the fact that genetic factors may play a significant role in fibroid development. In fact, susceptibility to fibroids may be passed genetically to a woman from her father.
How do doctors diagnose fibroids?
Fibroids may be first detected in a routine pelvic exam.
Further tests to diagnose or confirm a suspicion of fibroids may include:
- Transvaginal ultrasound
- Hysterosalpingography (X-ray with contrasting dye)
- Hysteroscopy (viewing tool to look into uterus)
- Endometrial biopsy (tissue taken form uterus)
- Blood test (to detect anemia)
How are fibroids treated?
Fibroid treatment varies depending on the age of the patient, whether or not she plans to become pregnant, the specific symptoms associated with fibroids and the severity of the size and number of fibroids. Fibroid location in the body also affects the manner and type of treatment used.
Fibroids may be treated in a number of ways including:
Hormone treatment-Estrogen combined with progesterone in an oral contraceptive may reduce certain symptoms such as heavy bleeding during menstruation. Hormone therapies consisting of progestin only can help by keeping the uterine lining stable, which can further reduce the amount of bleeding. These medications can be delivered to patients in a number of different forms including pills, patch, injections, rings, IUD’s (intrauterine device), and implants. Hormone therapy does not cure fibroids completely, however. Once a woman ceases hormone therapy, fibroid symptoms generally reoccur.
Uterine artery embolization-This procedure works to effectively block the blood supply to fibroids, eventually shrinking them. Skilled radiologists insert small particles into the uterine artery to achieve this. Women who plan to become pregnant in the future should not consider this option.
Endometrial ablation-This type of treatment focuses on destroying the uterine lining which decreases the amount of bleeding each month. Though considered a minor, same-day procedure women who undergo an endometrial ablation are less likely to conceive in the future and may have complications during pregnancy. This option is usually reserved for women past childbearing age or those who do not wish to become pregnant.
Myomectomy-A myomectomy surgically removes fibroids while still leaving the uterus in tact. Depending on the location of the fibroids, the tumors are removed a variety of different ways. This can be achieved by way of an incision in the cervix into the uterine cavity using a hysteroscope, a small surgical camera. Other fibroids, including those that protrude outward from the uterus are removed abdominally through an abdominal incision or with the use of a larascope, a small camera inserted into a tiny incision. Women who plan to become pregnant in the future often opt for a myomectomy.
Hysterectomy-This involves the complete removal of the uterus and any fibroids attached. A hysterectomy allows for permanent removal of fibroids for women who do not wish to become pregnant in the future.
Pharmacologic treatment for uterine fibroids may also positively affect breast tissue. While a new antiprogesterone drug, mifepristone is undergoing testing for its ability to inhibit the growth of uterine fibroids it has also been implicated in breast cancer treatment as it may inhibit the spread of cancer cells in breast cancer patients as well.
How do fibroids impact fertility and pregnancy?
The presence of fibroids can hamper a woman’s ability to become pregnant or complicate pregnancy or delivery.
The most common problems include:
Infertility—Women may have difficulty becoming pregnant depending on where fibroids are located within the reproductive system.
Miscarriage—Women who become pregnant are at higher risk for miscarriage.
Cesarean section—Women with fibroids are six times more likely to require a cesarean section at the time of delivery.
Breech baby—Fibroids may impact the position of the baby causing problems with a vaginal delivery.
Labor fails to progress—Fibroids can sometimes “stall” the natural progression of labor.
Placental abruption—This very serious complication occurs when the placenta tears away from the uterus prematurely causing the baby to get less oxygen than necessary.
Preterm delivery—Uterine fibroids could possibly affect the pregnancy enough to cause preterm delivery.
How do fibroids develop?
For many years, doctors and research scientists struggled to find the reason for fibroid development and growth in women. Now, thanks to new technologies and discoveries, doctors better understand the factors affecting fibroid pathology. Scientists now know that fibroids grow at very different rates and some will eventually resolve on their own without medical intervention.
Growth Rates for Fibroids—Significant Differences
While most women will develop fibroids at least some time in their lives, one study of women up to age 50 revealed that while 70 percent of Caucasian women had fibroids, as much as 80 percent of African American women were found to have them. Research also revealed that though growth rates of fibroids were similar for all women under age 35, as Caucasian women aged rates were reduced. The same was not true for African American women. Further research also supports the idea that the tendency to get fibroids may be inherited and passed down through a woman’s father.
How Fibroids Behave
Scientists now better understand the behavior of fibroids and how they develop and grow. Research reveals that uterine fibroid tissue is abnormal and this abnormality facilitates fibroid growth. The very scarring and healing processes in the body somehow go wrong.
Growth Factors for Fibroids
Chemicals produced in fibroid cells tell other cells to grow larger and greater in number as they develop into special cells. These are known as growth factors. These growth factors bind to a specific location on the cell, which triggers chemical reactions within the cell. Fibroids stem from a number of different growth factors where estrogen is involved.
What are fibroids made of?
Fibroids are made of tangles of collagen. Treatments may include pharmaceuticals that break up collagen material.
What do uterine fibroids look and feel like?
Fibroids consisting of smooth muscle cells and connective tissue that is fibrous may be small, pea-sized growths, or become as large as a small grapefruit.
Is lifestyle and nutrition connected to fibroids?
Many studies have been linked to diet and the formation of fibroids. In one study it was found that women who consume dairy products once a day were less likely to develop fibroids than women who did not. Dairy products included milk, cheese, and ice cream. Recent research has also shown that green tea may help women with fibroids as well. Certain compounds found in the tea have inhibited fibroid growth in rodents. Further studies also conclude that fibroid cell growth may be inhibited as cells die due to green tea compounds.
Do hormones affect fibroid growth?
Government-backed research has found that fibroid cells are affected by a number of different growth factors. These include reproductive hormones such as estrogen that stimulate fibroid cell growth. Treatment that blocks or inhibits these growth factors may help prevent fibroids or at the very least slow cell progression.
What environmental factors may affect fibroid growth?
Possible environmental factors that may stimulate the growth of fibroids include pesticides or other chemicals found in the environment.
What lifestyle risk factors are present for developing fibroids?
Risk factors for fibroids include obesity or being overweight and having low levels of specific nutrients.
What diet can help decrease the risk of developing fibroids?
While there is no one food that can treat or prevent the growth of fibroids, diet and lifestyle likely play a role in the risk of developing fibroids. Specific foods may also work to reduce painful or uncomfortable symptoms associated with fibroids.
Foods rich in fiber help balance blood sugar, and facilitate weight loss. Raw vegetables, fruit, whole grains and beans may help with fibroids as well.
Potassium can help lower blood pressure by counterbalancing salt. Potassium-rich foods include avocado, bananas, citrus fruits and lentils.
Foods such as milk, yogurt, and full fat cheese contain minerals that may help slow fibroid growth.
Some studies indicate that green tea may slow fibroid growth by inhibiting inflammation and lowering estrogen levels.
What other lifestyle changes can be made to help lower the risk of fibroids, growth, or symptoms?
While diet alone may help lower the risk of developing fibroids or shrink existing fibroids, there are a number of lifestyle changes that may also help.
- Reduce alcohol consumption
- Balance estrogen in the body
- Avoid environmental chemicals that raise certain hormone levels
- Lose weight
- Lower blood pressure
- Get plenty of vitamin D
While fibroids affect three fourths of women worldwide, most will live normal, healthy lives with few if any serious symptoms or complications associated with fibroid growth. If you show signs of fibroid tumors however, consult a physician or other healthcare practitioner to determine if you need medical treatment or natural support through diet and nutrition supplementation.
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2“NIH Fact Sheets – Uterine Fibroids.” National Institutes of Health, U.S. Department of Health and Human Services, report.nih.gov/nihfactsheets/viewfactsheet.aspx?csid=50.
3Singh, Shalini, et al. “Current Practices for Treatment of Uterine Fibroids.” Journal of Mid-Life Health, Medknow Publications & Media Pvt Ltd, 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5753501/.
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