UTERINE FIBROIDS – DO YOU HAVE ANY QUESTIONS? PART 1
by Ngozi Osuagwu, MD | July 9th, 2017
I was in my mid 30s when I was diagnosed with uterine fibroids. I was on oral contraceptives and I was bleeding heavily. Oral contraceptives were supposed to lighten your period but it was not working for me. I went to my gynecologist and she ordered a pelvic ultrasound. The pelvic ultrasound showed that I had uterine fibroids. She informed me of the results. I was not surprised. Uterine fibroids were common in women of all ethnic groups. Eighty percent of black women and 70% of white women will be diagnosed with uterine fibroids before they turned 50 years old. I also knew that for black women, they tended to be diagnosed at an earlier age and they had more symptoms related to fibroids than any other ethnic group. My gynecologist asked if I had any questions. She smiled because we both knew what happens when you inform a woman for the first time that she has fibroids – many questions are generated. The only difference was that I was a gynecologist, so I knew the answers.
What are uterine fibroids? They are benign (not cancerous) growth of the muscle of the uterus. You might hear it called leiomyomas or myomas. They vary in size, number, shape and location in the uterus. Some women may have one fibroid and some may have multiple fibroids. Fibroids can occasionally have ‘growth spurts’ which means they can be one size now and become very large in a few months.
How did I get it? We do not quite understand why some women get it and others do not, but we know that there are factors that put you at increased risk for getting it. It occurs in women after puberty and before menopause because it is dependent on the hormone estrogen that is produced in the ovary. Most women will be diagnosed by the age of 50. It is more common in black women. We know that if you start birth control pills before age 16 , that would put you at increased risk of getting fibroids. Other risk factors include getting your period early, having low vitamin D levels and eating high fatty foods.
What are the symptoms of uterine fibroids? The symptoms can be generalized into two categories – heavy menstrual flow and pelvic pressure. With the heavy bleeding, you can become anemic and feel tired all the time. You can bleed so heavily that you have accidents (bleeding through your underwear and clothing). The pelvic pressure occurs because the uterus can be so large making you look like you are pregnant when you are not. You might have urinary frequency which means that you are urinating a lot. You might have painful menstrual cramps and back pain and feel very uncomfortable.
There are some women that do not have symptoms. In their case, fibroids are found when the doctor is performing a pelvic exam and notices that the uterus is larger than normal.
How do you make the diagnosis? The diagnosis is usually made based on your history (the story you tell the doctor) and your physical exam. The doctor will suspect that you have fibroids and then order a pelvic ultrasound to confirm the diagnosis. Sometimes the uterus is so large that the ultrasound cannot show everything and an MRI will need to be ordered.
What other test do you need to order? A complete blood count (CBC) is ordered to see if you are anemic. Some women have had heavy bleeding all their life and have thought that was normal and never knew they had fibroids. It can take up to 5 years of real heavy bleeding before the diagnosis of uterine fibroids is made because we have ignored our symptoms. A thyroid screening test and maybe vitamin D levels may be ordered.
Will I be able to have children? Yes, you may be able to have children but it is dependent on the location and size of the fibroids in the uterus. You have to start trying to have a child for us to know if the fibroids will cause a problem. It is hard to know who will have a problem. After 6 months of trying without getting pregnant with known uterine fibroids, the doctor will start an infertility work up. Once you are pregnant, you may be at risk for miscarriage or preterm labor, but the majority of women with uterine fibroids that become pregnant will have healthy babies that go to full term without problems.
Check out next week’s blog on more questions and answers when it comes to uterine fibroids.
Thanks for the information-much needed considering the high frequency of occurrence in women:-)
It is so important that all woman know about fibroids because even if they do not have fibroids, they surely know someone who has them. Thanks for your comment.