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Fibroids. How Did I Get Here?
Most American women will develop fibroid tumors at some point in their life. One study shows that 80% of African American women develop fibroid tumors by age 50.
Fibroid Tumors
Uterine fibroid tumors are benign (noncancerous) muscle and connective tissue growths that may occur anywhere within or on the uterus wall.
Depending on the location, fibroid tumors are classified as:
Intramural fibroids, the most common, grow in the uterus wall without significant pain.
Subserosal fibroids grow outside the uterus, which can cause the most pain as they push against other organs.
Submucosal fibroids develop underneath the uterine lining and can extend into the uterine cavity, leading to heavy bleeding and more serious complications.
Pedunculated fibroids grow on small stems inside or outside the uterus.
Fibroid tumors can also vary in size from as small as a pea to as large as a grapefruit. More severe forms can take the size of a basketball.
Symptoms
Many women do not experience symptoms, especially in the early stages when the fibroids are small. If a woman does experience symptoms, depending on the size and frequency of fibroids, it may present as:
Heavy and prolonged menstrual bleeding
Severe pain during menstruation
A sensation of pressure or fullness in the lower abdomen
Lower back or abdominal pain
Lower abdominal swelling
Pain during intercourse
Constipation
A frequent urge to urinate
Fibroid Risk Factors
The exact cause of these tumors is unknown. However, several factors may be related to the abnormal growth of uterine tissue, most of which involve estrogen abnormality.
Hormonal Imbalance
It is known that fibroid tumors are estrogen-dependent and usually present due to a hormonal imbalance (higher than normal estrogen levels). This is why fibroids are more prevalent during a woman’s fertile years and pregnancy and begin to disappear as the woman’s hormone, estrogen, declines with menopause.
Inadequate Liver Function
The health of other organs, besides the reproductive system, may also affect fibroids. It is important to consider liver function as the possible cause of hormonal imbalance and elevated estrogen. The liver is the organ responsible for breaking down estrogen, among other hormones. For any reason, if the liver does not metabolize estrogen and its metabolites, they are recycled throughout the body leading to inflammation and abnormal tissue growth.
Poor Gut Health and Nutrition
The intestines serve a very important role in the metabolism of estrogen. The friendly bacteria, or flora, prevent the reactivation and recycling of excess estrogen. In contrast, "unhealthy" gut bacteria secrete more of an enzyme known as beta-glucuronidase, which causes estrogen to be recycled back into the body via the intestines. In addition, a low-fiber and high-fat diet also increases the activity of this enzyme, leading to an increase in estrogen levels throughout the body.
Additional Risks
Overexposure or an imbalance in estrogen seems to be the contributing factor in the development of uterine wall abnormalities, as it is a reproductive hormone that stimulates cells to release growth chemicals, causing excessive growth of the tissue of the uterine lining. A woman may be over-exposed to estrogen and have a greater chance of developing fibroid tumors earlier if she:
Started menstruating at an early age (before 11)
Has few or no babies
Is overweight (fat stores excess estrogen)
has an underlying pathological condition that prevents estrogen from metabolizing properly
Is exposed to xenoestrogens from hormone replacement therapy, meat, dairy, plastics, pesticides, herbicides, oral contraceptives, and more.
It is believed that high estrogen levels and low progesterone levels may also lead to fibroid tumor development and growth. Factors that increase this imbalance are:
Environmental estrogen or xenoestrogens (found in unfiltered water, pesticides, herbicides, and insecticides, including glyphosate as found in conventional food, some sanitary items, cleaning products, plastics, and canned foods).
obesity
underactive thyroid (hypothyroidism)
ovulatory dysfunction (irregular period)
perimenopause
low fiber, high-fat diet
High-Risk Population
Although estrogen is an important factor in this condition, doctors do not completely understand why the growth appears in some women over others. Even though the exact cause or reasoning behind the development of fibroid is unclear, a few noteworthy patterns are observed.
Women between the ages of 30 and 40 are most affected.
The occurrence is more common in black women.
Black women under 30 may experience faster growth of fibroids size if diagnosed.
Having a family member with fibroids increases a woman's risk.
Being overweight, obese, and having high blood pressure may also increase your risk.
Complications of Fibroids
Depending on the severity of the fibroids, you may experience further ailments, such as:
Infertility (if the fibroid tumors grow and block the Fallopian tubes)
Persistent blood loss (which may lead to anemia)
Impaired kidney function (if the growth blocks the ureters)
Check out our latest fibroid healing resources here.
Diagnosing Fibroids
Fibroids are usually discovered without intention during a routine gynecological or pelvis exam. The doctor may palpate the uterus and notice irregularities in shape, and refer you for further testing, depending on a full assessment and complete history. Testing and imaging may be requested to diagnose and confirm fibroids, including :
X-ray. Electromagnetic energy produces images of bones and internal organs onto film.
Transvaginal ultrasound (also called ultrasonography). An ultrasound test uses a small instrument called a transducer placed in the vagina.
Magnetic resonance imaging (MRI). A non-invasive procedure that produces a two-dimensional view of an internal organ or structure.
Hysterosalpingography. X-ray examination of the uterus and fallopian tubes uses dye and is often performed to rule out tubal obstruction.
Hysteroscopy. Visual examination of the cervix canal and the uterus interior using a viewing instrument (hysteroscope) inserted through the vagina.
Endometrial biopsy. A procedure in which a tissue sample is obtained through a tube inserted into the uterus.
Complete Blood Count, Fe factors, & hormone testing. Specific blood test to check for iron-deficiency anemia as a result of heavy bleeding, if reported.
Possible additional testing. Urine analysis & stool analysis.
Medical Treatment of Fibroids
Many years ago, a hysterectomy was considered the only treatment option for fibroid tumors. Still, it often led to bladder complications, sexual dysfunction, or early menopause. Now there are more options, but hysterectomies are still the number one procedure being performed, and 76% are deemed unnecessary.
In the modern-day, when necessary, a gynecologist can perform:
A supra-cervical hysterectomy removes the uterine cavity but leaves the cervix, vagina, ovaries, and tubes intact.
A myomectomy removes the tumors and leaves the uterus and other organs intact.
A uterine artery embolization blocks blood flow to the fibroids, causing them to die off.
An MRI-guided ultrasound destroys the fibroids using heat.
Injection of chemicals directly into the tumor to potentiate shrinkage
Or medical monitoring is a 'wait and see' technique where the gynecologist frequently checks the tumor size while waiting for menopause, which will cause the hormone levels to drop naturally and possibly cause the tumor to disappear.
NOTE: All invasive procedures may come with complications
Despite having fibroid tumors, there is hope in managing your condition holistically and restoring full health. Check out our blog on the Lifestyle Approach to Healing Fibroids.