What are fibroids? This article explains what they are and why they are dangerous if left untreated.
Fibroids occur in the womb/uterus. They are normally non-cancerous (benign) smooth muscle tumors. They are also known as leiomyoma, leiomyomata, or myoma.
Fibroids vary from the size of a small seed (1 mm) to that of a large grapefruit (more than 200mm). They resemble glassy knots, and in cross-section often have whorls that look similar to plastered ceilings. Fibroids normally happen in groups and rarely just individual, one time tumors. Fibroids don’t just grow inside the uterus, they can also grow in the uterus walls, or on the outer surface of the uterus. The main cause of hysterectomies is down to Fibroid tumors.
What causes fibroids?
Sometimes fibroids are genetic. You are more likely to develop fibroids if another woman in your family has already suffered from them. Another cause of fibroid development is down to having too much estradiol and too little progesterone. Estradiol is part of the Estrogen hormone family, that needs good levels of progesterone to calm it’s stimulating influence of the body. This hormonal imbalance happens to many women during their “change of life” (menopause) and the years leading up to it. These years are referred to as the Peri-menopause years. Most women go through this change anywhere from 35-50 years old.
During the peri-menopausal years a woman’s reproductive systems starts winding down and with it goes significant changes in hormone levels. This is when fibroids tend to develop.
- Progesterone is produced post ovulation every month. After the age of 20, progesterone production starts to slowly decline
- Sex hormone-binding globulin (SBHG) controls how hormones work within the body and influence cell tissue. Between the ages of 25-49 these levels can drop by 50%, allowing estradiol to become more active on body tissues
- Inhibin levels in the ovaries drop. This allows Follicle Stimulating Hormone (FSH) levels to rise
- FSH encourages more follicles in the ovaries to grow each cycle, more than you have during the early reproductive years
- FSH builds slowly during perimenopause and peaks a year or two before the last menstrual cycle
- Estrogen dominance is when you have high levels of estradiol compared to the amount of progesterone. This can also cause fibroids to grow, as well as cause heavy, irregular or unpredictable bleeding among other things
- FSH over-stimulates the ovaries. During this process you experience a quick drop in the amount of follicles available for pregnancy as well as high levels of estradiol. It can last for a few months or a few years until menstruation finally stops completely and you go through menopause.
- Fluctuating hormones cause menstrual irregularities and illnesses. Commly experienced are irregular ovulation cycles/menstrual bleeding, and a higher risk of surprise pregnancies
- The ovaries finally stop producing progesterone so the uterine lining (endometrium) is thin
- High estradiol stimulates the tissue. Without progesterone to calm the effects of it, the endometrium is allowed to thicken, which can lead to precancerous cells developing
- Low SHBG and high androgens become noticeable about two years before the last period occurs and menopause is complete. Symptoms to watch out for include: increased facial hair, male-pattern belly fat, and acne
- Low Estradiol can cause hot flashes which are common around this time as well. Estradiol levels start lowering 1-2 years before menopause and lasts for a few years post-menopause.
- Postmenopausal women often have vaginal atrophy. This means that the vagina is dry and the walls are thin thanks to reduced estradiol levels. It can cause sex to be painful and increase your risk of infection in that area. While this is uncomfortable and annoying it is actually good for treating fibroids as it reduces the size of the fibroids that enlarged the uterus
Why are Fibroids dangerous?
All types of fibroid tumors are associated with decreased fertility because they can:
Compress the fallopian tubes, where egg and sperm meet
Interfere with the movement of sperm through the uterine cavity
Cause repeated miscarriages
Retard the growth of the fetus
Cause uterine inertia (failure to contract properly) during labour
Obstruct the birth canal
Cause hydronephrosis (dilation of the inside or collecting part of the kidney)
Cause premature labour
Increased estrogen production during pregnancy can result in fibroid enlargement. Degeneration of the fibroids during pregnancy may cause severe pain, so you may need to stop working earlier than you expected, and your recovery may take longer.
Fibroids increase the surface area of your uterus. More surface area means more endometrial lining to slough every month, and heavier blood loss. Having fibroids means you are not a good candidate for using a traditional copper IUD as birth control.
Understand more on Fibroids:
Progesterone treatment and side effects
 The information in this article has been taken with permission from the official Lawley booklet on Understanding Fibroids.