Here’s all you need to know about uterine fibroids during menopause

Many women suffer from fibroids during menopause. Here's why they develop and the treatment options that are available to get rid of them.
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Most fibroids shrink on their own when estrogen levels decline. Image courtesy: Shutterstock
Dr Pratima Thamke Updated: 18 Jul 2022, 21:48 pm IST
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Uterine fibroids (leiomyomas) are small tumors seen on the wall of a woman’s uterus. These tumors are usually benign (non-cancerous). Furthermore, they are uncomfortable and lead to pain. They are seen in women who are of childbearing age, but fibroids during menopause are very common among women. Yes, you can even have them for the first time during this stage of life.

The link between fibroids and hormones

Did you know? Two hormones, progesterone, and estrogen, are responsible for the formation and growth of fibroids. If the estrogen level is too high it can lead to the growth of fibroids and once they get larger, progesterone too can contribute to the growth of fibroids.

Cause of fibroids

Although there isn’t a clear explanation for why fibroids form, they typically appear when your body is producing a lot of estrogens. But when you go through menopause, your body changes, which affects how likely it is that you may get uterine fibroids.

Menopause and fibroids

During a perimenopause stage, when a woman goes 12 months without a monthly cycle, the body experiences a very low level of estrogen and progesterone, unlike during the childbearing years when these hormones are most prevalent. And as your body shifts from perimenopause to the menopause stage, your ovaries stop producing estrogen. As a result, your chance of developing new fibroids will therefore decrease. The dip in hormone levels may also help the existing fibroids decrease in size.

Fibroids after menopause

It is highly uncommon for women to experience uterine fibroids after menopause, and it is still unknown why this happens. After menopause, however, fibroids’ growth will result in fewer or no symptoms.

fibroids during menopause
Even your hormones affect the size of fibroids. Image courtesy: Shutterstock

Risk factors for fibroids:

Certain issues such as hypertension, obesity, not being pregnant, stress, and low vitamin D can lead to fibroids.

Here are the symptoms of fibroids:

Heavy bleeding, frequent spotting, anaemia, menstrual-like cramping, fullness in the lower belly, abdominal swelling, lower back pain, frequent urination, incontinence or urine leakage, painful intercourse, fever, nausea, and headaches.

One will have to seek immediate help after noticing these worrisome symptoms. Do not take your symptoms lightly at all by ignoring them. In menopause, we need to follow the fibroids. If these are small and show no symptoms, there may be no need to treat it.

Fibroid treatment during menopause

Sometimes, fibroids will not cause any symptoms and may not require treatment. But, a large number of women tend to experience unpleasant symptoms.

Here are some options for treatment:

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1. Birth control pills

It can be challenging to tackle fibroids during menopause. But one might be advised to take birth control pills. The combination of progestin-only birth control pills works for fibroids. Progestins tend to relieve symptoms of menopause more effectively.

2. Surgery

Myomectomy: Even surgery can be another option. One can be asked to undergo a myomectomy. Myomectomy will help with fibroid removal and doesn’t require the removal of the uterus.

fibroids during menopause
Ensure all your doubts are clear before going for surgery. Image courtesy: Shutterstock

Hysterectomy: A hysterectomy (surgical removal of the uterus) may also be suggested for women. You will have to follow the guidelines given by the doctor.

3. Forced ultrasound surgery (FUS)

Forced ultrasound surgery (FUS) uses high-energy, high-frequency sound waves to destroy fibroids.

4. Uterine artery embolization (UAE)

Uterine artery embolization (UAE) is done to cut off blood supply to the fibroids.

5. Myolysis

The myolysis procedure can be done by inserting a needle into the fibroid and sending an electrical current via the needle into the fibroid to destroy the tissue.

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About the Author

Dr Pratima Thamke is a Consultant Obstetrician and Gynaecologist at the Motherhood Hospital, Kharghar ...Read More

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