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Fibroids. How Did I Get Here ?

Most American women will develop fibroid tumors at some point in their life. In fact, one study shows that 80% of African american women develop fibroid tumors by the age 50.

Fibroid Tumors

Uterine fibroid tumors are benign (non cancerous) growths of the muscle and connective tissue that may occur anywhere within or on the wall of the uterus. 


Depending on the location, fibroid tumors are classified as:

  • Intramural fibroids, the most common, grow in the wall of the uterus without significant pain.

  • Subserosal fibroids grow on the outside of 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 and lead 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 are unknown. However, there are several factors that may be related to the abnormal growth of uterine tissue and most of them involve estrogen abnormality.

Hormonal Imbalance

It is known that fibroid tumors are estrogen-dependent and they usually present due to a hormonal imbalance (higher than normal estrogen levels). This is the reason why fibroids are more prevalent during a woman’s fertile years and pregnancy and began to disappear as the woman’s hormone, estrogen, declines with menopause.


Inadequate Liver Function

The health of other organs, besides the reproductive system, may have an affect on fibroids as well. It is important to consider liver function in the possible cause of hormonal imbalance and elevated estrogen. The liver is the organ that is responsible for breaking down estrogen, among other hormones. For any reason, if the liver does not metabolize estrogen and its metabolites, then 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, are responsible for preventing 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 of estrogen levels throughout the body. 


Additional Risks

Over exposure or an imbalance in estrogen seems to be the contributing factor in the development of uterine wall abnormalities, being that 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 levels of estrogen and low levels of progesterone 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 with this condition, doctors do not completely understand why the growth appear in some women over others. Even though the exact cause or reasoning behind the development of fibroid is unclear, there are a few note worth patterns observed.


  • Women between the ages of 30 and 40 are most affected.

  • The occurrence is more common in black women.

  • Black women under 30 years old 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 increase your risk as well.


Complications of Fibroids

Depending on the severity of the fibroids, you may experience further ailments, such as:

  • Infertility (if the fibroid tumors grows and blocks the Fallopian tubes)

  • Persistent blood loss (which may lead to anemia)

  • Impaired kidney function (if the growth blocks the ureters)


Diagnosing Fibroids

Fibroids are usually discovered without intention during an routine gynecological or pelvis exam. The doctor may palpate the uterus and notice irregularities in shape and refer you for further testing, also depending on a full assessment and complete history. Testing and imaging may be requested to diagnose and confirm fibroids, including :


  • X-ray. Elctromagnetic energy used to produce images of bones and internal organs onto film.

  • Transvaginal ultrasound (also called ultrasonography). An ultrasound test using a small instrument, called a transducer, that is 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 that uses dye and is often performed to rule out tubal obstruction.

  • Hysteroscopy. Visual examination of the canal of the cervix and the interior of the uterus using a viewing instrument (hysteroscope) inserted through the vagina.

  • Endometrial biopsy. A procedure in which a sample of tissue is obtained through a tube which is 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, it was the hysterectomy that was considered the only treatment option for fibroid tumors, but it often led to issues like bladder complications, sexual dysfunction, or early menopause . Now there are more options, but hysterectomies are still the number one procedure being performed and 76% of them are deemed unnecessary. 


In modern day, when necessary, a gynecologist can perform:


  • A supra cervical hysterectomy which removes the uterine cavity but leaves the cervix, vagina, ovaries and tubes intact.

  • A myomectomy which removes the tumors and leaves the uterus and other organs intact.

  • A uterine artery embolization which blocks blood flow to the fibroids, causing them to die off.

  • An MRI-guided ultrasound which destroy the fibroids using heat.

  • Injection of chemicals directly into the tumor to potentiate shrinkage

  • Or medical monitoring, which 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 cause the tumor to possibly disappear.

NOTE: All of the invasive procedure 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.


About Me

Hi I am Dr. MIG, the family nurse practitioner, certified lifestyle medicine professional, fitness enthusiast, herbal counselor and wellness motivator and I am happy you landed here !

 

Check out the rest of Rooted Vigor's content as I encourage a whole mind, body, and soul approach to disease prevention and lifestyle modification.

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