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If you're experiencing heavy or uncomfortable periods, uterine fibroids could be the cause. Although this sounds alarming—the thought of an internal tumor is less than pleasant—with the proper medical care, uterine fibroids are totally manageable. Benign growths that pop up within the uterus, uterine fibroids can have a variety of symptoms ranging from minor to severe. Although some fibroids are undetectable and you won't even know they're there, others can contribute to cumbrous or painful menstrual periods. There are some studies that suggest uterine fibroids might also negatively impact fertility. Ahead, doctors discuss how to detect and treat uterine fibroids, as well as measures you can take to prevent them.
What Are Uterine Fibroids?
Uterine fibroids are benign tumors that form from the smooth muscle cells of the uterine wall. They effect reproductive-age women and may or may not cause symptoms. Typical symptoms include heavy bleeding, uterine pressure, and painful periods.
Ann Peters, MD gynecologist and surgeon in The Gynecology Center at Mercy Medical Center in Baltimore, Maryland says, "Uterine fibroids are like real estate. Their severity depends on location, location, location."
Fibroids can complicate pregnancy depending on where they've implanted and their size. "It's not that much of a concern if it's hanging off the uterus," says Peters. "If a fibroid is sitting in the cervix, however, the cervix might not dilate correctly which could encumber a vaginal delivery. If it's on the muscle wall of the uterus, it might not allow the uterus to contract properly and I'll recommend removing it. The worse case scenario," explains Peters, "is when a fibroid develops inside the cavity of uterus, where a pregnancy implants and the placenta forms. If the placenta shares the fetus with the fibroid it can cause preterm labor."
Norbert Gleicher, MD, Medical Director and Chief Scientist at Center for Human Reproduction agrees with Peters' assessment. "Most specialists will say that effects depend on the location of the fibroids within the uterus," he says. "Everybody agrees that fibroids that protrude into the endometrial cavity harm pregnancy chances and increase miscarriage risk. The larger the worse; the more the worse. Some studies also suggest that fibroids, especially those found inside the uterus can negatively impact fertility."
Gleicher adds that for the most part, "while many women do not experience any negative health outcomes as a result of their fibroids, some may develop iron deficiency anemia secondary to heavy bleeding."
Adding an easily-absorbed iron supplement to your diet, like Floradix, can give you extra support if you experience heavy periods.
Detecting Uterine Fibroids
Until fibroids become symptomatic, you might not even know they're there, explains Gleicher. "Often a woman has no idea, until a fibroid (or many fibroids, in combination) grows to a size that becomes symptomatic."
If your periods become cumbersome—last longer than seven days, or contain clots —you should alert your doctor who will perform a sonogram to check for fibroids. "When we do the [annual pelvic] exam," says Peters, "we examine the uterus and can feel fibroids unless they're hidden inside the uterus wall. In that case, we would need to use an ultrasound to detect their presence." Again, this is not cause for alarm, as Peters notes fibroids have to grow to a certain size in order to cause any symptoms. In other words, they will let themselves be known.
What Does Uterine Fibroid Pain Feel Like?
Although menstrual cramps can vary from period to period, if cramps suddenly become more uncomfortable than usual, this might be due to fibroids. Uterine fibroid pain often presents as pressure. Sometimes, contingent on size and location, the fibroid can push up against the bladder, bowel, or intestines. Constipation and frequent urination can indicate the presence of a fibroid if you're experiencing pressure in the abdominal area. Gleicher says the sensations caused by uterine fibroids "can take all kinds of forms, from pressure—especially on the bladder with urinary symptoms—to sharp pains, especially when a fibroid outgrows its blood supply, which usually happens only in pregnancy."
How to Treat Uterine Fibroids
There are several options for treating uterine fibroids from medical treatments (which can include hormone therapy and anti-inflammatory drugs) to surgical treatments (more specifically, a procedure known as a myomectomy). "This depends on the ultimate goal and who the patient is," explains Gleicher. "If she does not want any more children, she has many choices, including even a hysterectomy (removal of uterus). If she still is planning on pregnancies, required treatments become more selective to the case and may include embolization via catheter, or surgery." Another option, he adds, is in some cases to just leave the fibroids alone and let the body correct itself. Of course, the safest bet is always to see your doctor, who will decide on a course of treatment (which might include letting the body correct itself).
Yelena Deshko, a naturopathic doctor and founder of The Timeless Clinic in Ontario incorporates acupuncture into her treatment of uterine fibroids. "In my practice," she explains, "I commonly use acupuncture as an adjunctive treatment for fibroids. Of course the size of the fibroids plays an important role. In my clinical experience, a holistic approach incorporating dietary and lifestyle changes, herbal medicine, as well as acupuncture produces the best outcomes."
How to Prevent Uterine Fibroids
It's unclear what causes fibroids to present, making their prevention a bit tricky. "Although it is not well understood why some women develop fibroids, high levels of estrogen do contribute to their growth," says Deshko. To this end, your diet and lifestyle can possibly play a mitigating factor if you're already predisposed to fibroids. "Avoiding exogenous estrogen exposure as well as optimizing estrogen detoxification can be beneficial in controlling fibroids," Deshko explains.
"While avoiding estrogen exposure all together may not be feasible, there are a couple of measures you can take." Plus, she adds that optimizing liver detoxification can help "efficiently break down and excrete excess estrogens. Eating a diet rich in cruciferous vegetables such as broccoli, cabbage, kale and Brussel sprouts can help the liver break down harmful estrogens further. In my practice I also commonly recommend supplements and herbs such as DIM, Curcumin, Milk Thistle, and Inositol depending on the patient case."
Genetics, according to Peters play a huge role in whether or not you'll develop uterine fibroids. "We can't turn off the ovaries until menopause," she says. Although she agrees with Deshko adding that diet, weight, and lifestyle may be something a woman can try. "Estrogen drives the growth of fibroids, so women who are heavier or eat a lot of soy and red meat might be more at risk."
Gleicher adds that race may also determine your risk for uterine fibroids. "Black women are at significantly higher risk to develop fibroids than Caucasian and Asian women," although he says the reasons for this are unknown.
With medical intervention at the slightest sign of discomfort—you know your body best, and can gauge what's uncomfortable or abnormal for you—you can keep uterine fibroids in check and their symptoms at bay.