“Women’s health needs to be front and center – It often isn’t but it needs to be” ~Cynthia Nixon

Talking about Women health: Uterine Fibroids

Let’s talk about Women health today, as very rarely do we all speak about it. Our health is our Capital and we need to be aware of our precious health. This post will be very specific about Uterine Fibroids in women. Recently, I attended a Cloudnine Hospitals FB live session, taken by renowned Obstetrician and Gynecologist Dr. Sriprada Vinekar. Having the privilege to attend such an informative session, called me to share the insights from Doctor to all dear readers.

Here is all what you need to know about Uterine Fibroids, their identification and what impact can they have on your normal health. The answers are all basis the knowledge received from this live session, along with some references.

What are Uterine Fibroids?

Uterine Fibroids are benign growths of uterine muscular tissues. They can be tiny, less than a cm and can be as large as 10-15cms or more. At a time, a woman can have one or many fibroids in her Uterus. More than 50% of the women have Uterine Fibroids as they reach 50years of age. Since they are benign, most of the time they are non-cancerous. The chances of these fibroids becoming cancerous are, as less as 0.1% (Sigh of relief).

Usually, these Fibroids grow, may be at a pace of 1 cm/year,  hence getting a manual scan done to keep a tap on their growth becomes a necessity. If they grow very rapidly, they can attain cancerous form (very very rare and more so in menopausal women). They are then tumors and less of fibroids. It is expected that as women reach their menopause, the fibroids shrink on their own (due to the hormonal regulations).

What are the symptoms of Fibroids in the uterus? How do I know that I have fibroids?

As per Dr. Sriprada, different women may have different symptoms, basis the size and presence of fibroid. Many women are even asymptomatic for fibroids. Fibroids are classified basis the locations from which they bulge out.

• Mostly Fibroids grow within the wall of Uterus
• Submucosal ones bulge inside the Uterine Cavity and if there are too many, they may crowd the cavity completely, resulting in pain and more bleeding during Menstrual cycle and Pregnancy-related complications too.
• Few Fibroids grow on the outside of the Uterus and if they grow really big, they can exert pressure on nearby organs.

At times, they may even arise at the entrance of the fallopian tube and this may result in Fertility related complications.

Here are some Symptoms of Fibroids:

• Heavy flow during periods
• Severely Painful periods with lots of clots
• You may bleed between your period cycles
• Lower Back pain and Abdominal Pain
• Pelvic Pain (which doesn’t seem to go away)
• If the Fibroid is big and putting pressure on Urinary Bladder, one may face Frequent Urination

Related Read: Tips to avoid Breast cancer

What causes fibroids?

The real reason for fibroids is yet not known, but it is believed to be majorly due to:

• Genetic predisposition with excess estrogen
• Obesity, usually obese women have more Estrogen, which can result in worsening of the Fibroids
• Family History, yes it prevails in Fibroids. If your mum/sister has Fibroids, you have high chances of developing the same.
• Women who get periods at a much younger age are at a higher risk
• Some races are more prone to having Fibroids, usually, Black women / Africans have more chances of getting Fibroids
• Diet-related: Ones consuming more Red meat, more alcohol, lots of caffeine (coffee), less of Fresh Fruits and Vegetables are at a much higher risk. The reason is all of these foods, directly or indirectly raises the Estrogen levels/to create an imbalance between Progesterone (suppressing it) and Estrogen(dominating it) Hormones in the female body.
• If you have PCOD, you are at a slightly higher chance of getting Fibroids, as it is all due to Hormonal Imbalance, which you’re already subjected to.

Do Fibroids make you gain weight?

No, it is the opposite, you may get Fibroids if you are Obese (control your obesity now!)

Do Fibroids impact Pregnancy/process of Conceiving?

This was the most asked Question during the FB live. As per the doctor, not every Fibroid results in Pregnancy Complications. Rather most of the time Fibroids do not interfere in Pregnancy. It all depends upon the size and the location of the Fibroid.

• If it is 1-4cms fibroid in the uterus, it will not cause any issue in conceiving or during your pregnancy, but larger ones, like 7cms and more can cause certain complications.
• As mentioned above, large Fibroids bulging inside the uterine cavity or those that arise at the entrance of Fallopian Tube may cause Infertility.
• If the placenta is attached to the place where fibroids are there, then there is a possibility of having growth issues in the developing fetus.
• Certain big fibroids may cause the baby to be in an abnormal position, which can result in preterm delivery.
• If the Fibroid is at a lower part of the uterus, then one may face issues in Normal Vaginal delivery.

Can Uterine Fibroids be Life Threatening?

Uterine Fibroids are not Life Threatening (usually). Also, Stress is not related directly to Fibroids. In certain cases, where women face severe bleeding due to Fibroids may become anemic. This anemia can be treated very easily with iron pills, but in case it remains Untreated, this anemia may result in sudden Heart stroke and can be Life threatening.

What is the Best Treatment for Uterine Fibroids?

Fibroids can be identified via Ultrasound. This is the best identification, as Fibroids can be asymptomatic also. If they are big enough, your gynecologist may be able to feel them during routine pelvic examination too. Advanced Treatments of fibroids are available, but there is no single way to treat Fibroid. The best way can be judged by your gynecologist after a thorough examination.

1. Medication Management: As per Doctor Sriprada, various new drugs have entered the market with promising results. Usually with a treatment of 6months, one can expect it to shrink around 50% and the symptoms are relieved. Medicines only shrink the Fibroids, they cannot eliminate fibroids. But again, all Fibroids DO NOT shrink with medications. Also, once the medication is stopped, there is a high possibility that Fibroids may grow again.
2. Embolization: This process works on cutting off blood flow to the fibroids, causing them to shrink and ultimately die. This is an effective means, but should not be preferred, if a woman wants to conceive at any time after this process.
3. Surgery: Different modes of Surgery are available:
   • Laparoscopic myomectomy: It’s a less invasive process, and can be used on women with fewer fibroids. The fibroids are removed via abdominal incision here.
   • Traditional Myomectomy: Multiple, large or deep Fibroids need to be treated by this surgery. Here only Fibroids are removed completely and Uterus remains intact. This is the treatment of choice majorly.
   • Hysterectomy: This surgical process results in the removal of the whole Uterus. Though this is the permanent solution for Uterine Fibroids, it is not always preferred mode, as then you cannot bear children and it calls for a start of menopause.

Can one have children easily after getting the treatment for Fibroids done?

As per Doctor, your Uterus needs 3 months to heal, after that you can start to plan for your baby. Also, discuss your baby planning options with your gynecologist before getting the treatment done for them so that they don’t impact your fertility.

Are there any chances that Uterine Fibroids can Come Back After the Treatment at a later stage?

Yes, Fibroids which remain untreated during surgery or which are very small may grow slowly. If you undergo medications only, then there are high chances that Fibroids might grow again after shrinking.

Is in anyways consuming Red Meat related to enhanced chances of Fibroids or is it a myth?

It is not a myth, but a well-studied fact that more consumption of Red Meat and beef leads to Fibroids.

Are there any means or Natural foods to prevent/reduce Fibroids?

Since it is a genetic predisposition along with Hormonal and Family history, a lot cannot be curtailed when it comes to fibroids. But here are some ways with which you can lessen up your risk:

• Maintain a healthy Lifestyle, exercise regularly, try Yoga at least 7  hours a week or more (Related Read: Family Yoga)
• Say No to Obesity and No Abdominal fat
• Opt for more of Fresh Fruits and vegetables, as they have proved to protect you from Fibroids
• Say No to Alcohol, Red mead and lessen the consumption of Beef and Dairy products (as they are a lot hormone-regulated)

Most of the questions that were asked during the Live session with Dr. Sriprada have been shared in this post. Still, you may wish to hear out the recording, then head to the Live session.

Self Love is the greatest medicine, Be aware and take care of your Health!

Other References:

https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/diagnosis-treatment/drc-20354294

https://www.webmd.com/women/uterine-fibroids/ss/slideshow-fibroid-overview

Much Love,