I decided to write this blog post because I have family members and friends who have been living with this medical condition and the additional medical conditions that accompany it for years. And yet, it has never really been a topic of conversation for most, at least until recently with the presentation of a more advanced treatment for uterine fibroids. This new treatment is called uterine artery embolization/uterine fibroid embolization. But before we get into this specific treatment let's grasp a basic understanding of what a uterine fibroid really is.
So, what are uterine fibroids exactly?
They are benign tumors composed of smooth muscle in the uterus of women.
The uterus with uterine fibroids of different classifications
What's their prevalence?
75% of women battle with uterine fibroids, and 50% of African American women have uterine fibroids.
Can they become cancerous?
Less than 0.1% of the fibroid tumors become malignant (or cancerous).
How do the fibroids develop?
A genetic predisposition exists, and the tumor develops from an overgrowth of smooth muscle and connective tissue in the uterus. Both estrogen and progestin receptors are present in fibroids and elevated estrogen levels may cause fibroid enlargement.
What causes uterine fibroids?
- Genetics
- Hormones - estrogen and progesterone are two hormones that stimulate the growth of the uterine lining during each menstrual cycle in preparation for pregnancy, and promote the growth of fibroids. Thus, fibroids tend to shrink after menopause when our hormones decrease.
What are the risk factors?
- Heredity - if your mother or sister has fibroids, you chances are increased
- Race - African American women are more likely to have fibroids. AA women have fibroids at a younger age, and they are more likely to develop more and larger fibroids
- Size - obese women are at a higher risk of developing fibroids
- Other factors - onset of menstruation, having a diet high in red meat and low in greens and fruit. Drinking alcohol, including beer tends to increase the risk of developing fibroids.
What should we be looking for to know if we have uterine fibroids?
- Most produce no symptoms
- Abnormal/heavy menstrual period
- Prolonged menstrual periods (7 days or more)
- Pelvic pressure or pain
- Frequent urination
- Difficulty emptying your bladder
- Constipation
- Back ache or leg pains
What size are uterine fibroids?
The size can range from the size of your thumb nail to a size so large that the woman begins to look pregnant.
The varying sizes of actual uterine fibroids
An actual very large uterine fibroid
Cynthia Bailey Before (picture on right) and After (picture on left) Uterine Artery Embolization
When should you contact your doctor?
- Pelvic pain that doesn't go away
- Overly heavy or painful periods
- Spotting or bleeding between periods
- Pain consistently during intercourse
- Enlarged uterus and abdomen
- Difficulty emptying your bladder
What can be done to relieve uterine fibroids?
- Hysterectomy - the surgical removal of the uterus. This method can be the only effective method in some cases.
- Myomectomy - the surgical removal of the uterine fibroids from the uterus. This method is preferred for women who would like to become pregnant.
- Laparoscopy - a surgical procedure that utilizes a laparoscope (a thin lighted tube with a camera at the end) that is inserted into the abdomen through a small incision. The laparoscope allows the doctor to view the pelvic cavity, and other tools are inserted through the laparoscope or inserted through other small incisions in the abdomen in order to remove the fibroid
- Uterine Artery Embolization - this procedure can be performed by a radiologist, and this procedure cuts off the blood supply to the uterine fibroids, starving the fibroid thus causing shrinking. This procedure is minimally invasive and less aggressive than the removal of the uterus. This procedure is effective, but not recommended for women who wish to become pregnant.
- Medications - anti-estrogen medications such as progesterone, but too much progesterone can cause menopausal symptoms and osteoporosis. Meaning, hormone therapy should not be a long-term treatment option.
Uterine Artery Embolization
- Minimally invasive
- Less aggressive
- Cuts off blood supply for fibroids, leading to fibroid shrinkage or death
- Very effective, but not for everyone. Your doctor has to decide given your health picture, if you are a great candidate fro this procedure. Reasons for not choosing this procedure include having:
- A history of pelvic radiation
- A history of kidney failure
- Possible pelvic cancer
- An active, recent, or chronic pelvic infection
- Poorly controlled diabetes
- Inflammation of the blood vessels
- An untreated bleeding disorder
- A severe allergy to contrast material containing iodine
- Symptom relief usually within the first three months after your procedure
- Menstruation can return within a few months after the procedure, but some women actually go into menopause after this procedure. Studies have shown that going into menopause after this procedure is highest among women 45 years of age and older.
- The impact on fertility are due to:
- subtle ovarian damage = making getting pregnant difficult
- increased risk of pregnancy complications
- however, there is a percentage of women who have successful pregnancies after this procedure.
In a few months, one of my close relatives will be having this procedure done, and this works out well for blog participants, as I will post her progress, her biggest concerns or problems, and complications. Also, an actor of Atlanta Housewives, Cynthia Bailey has had her own struggle with fibroids, please take some time to check out her story as well through this link Cynthia Bailey's 14 Year Struggle with Uterine Fibroids, and Cynthia Bailey's Uterine Fibroid Treatment. Please keep in mind that your doctor should go over ones candidacy for this procedure, and once the candidate in properly informed it is then the candidates decision to proceed with the procedure. I hope this post helps shed some light on a health condition that women cope with, but don't actually get to talk about often. Please feel free to comment or ask questions. Until next time...
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