Fibroids and Menopause – Do they SHRINK with age?
I am 62 years old. I have fibroids, but my doctor said they would go away. However, I have been suffering for a long time. What can I do?Askawayhealth Community Member
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What are Fibroids
Uterine (womb) fibroids are the most common benign gynaecologic tumours in premenopausal women worldwide.
They are benign as they mostly do not grow aggressively like cancer leading to complications like death. But fibroids affect1 out of 3 women and can result in very serious health problems.
We estimate that nearly 70–80% of women will develop fibroids at some point during their lifetime.
Previously, doctors felt that fibroids shrink as women enter Menopause.
However, today, we know that this is not a consistent finding, so let’s explore why this is the case.
In addition, what are the options for women who struggle with fibroids over the age when they should have disappeared?
What Is Menopause
Menopause is when a woman has not had periods for 12 months. Perimenopause is the time before that when the hormone levels start to fluctuate – ovulation (egg release and chance of pregnancy) may still happen. Still, it starts becoming less frequent as menopause arrives.
What Happens To Fibroids at Menopause
Usually, we expect that by the time a woman reaches menopause, her Fibroids will begin to shrink.
This is because research shows that fibroids depend on Oestrogen and Progesterone reproductive hormones.
In fact, fibroid tissues appear to be more sensitive to these hormones than other parts of the womb that do not have fibroids.
Around the time of perimenopause and menopause, the hormones’ levels start to reduce; therefore, the fibroids that depend on them cannot grow.
However, in some instances, some women in perimenopause and menopause have fibroids.
Women can develop fibroids in their early 20s or 30s and continue into Menopause.
Or women may develop fibroids in their 40s or 50s.
Although menopause helps to relieve the symptoms of fibroids, it does not prevent them from developing at that stage for the first time.
In a California study, the second highest incidence of fibroids was in the age group of 50–54 years old.
According to that same study, women between the ages of 45 – 49 develop fibroids most often. More than 30% of newly diagnosed fibroid condition was in women at that age.
Racial or ethnic differences are something else of interest in how fibroids grow.
Some scientists observed that African American and white women have similar growth rates of fibroids until age 35 years. However, after age 35, growth rates slow in white women but not African American women.
Perhaps this is why women of African origin have a higher burden of the condition – we don’t know why this is the case.
Why Fibroids May Continue after 60
- Excess Weight. Obesity (BMI >30) – as women age and enter menopause, they may add weight. Excess fat supports a high Oestrogen environment, preventing the fibroids from shrinking away.
- Aromatase enzyme – even when women do not have Oestrogen naturally produced by the ovary, they have male /androgenic steroid hormones. The aromatase enzyme produced by the fibroids converts these steroids to Oestrogen, which could explain why Oestrogen is still present in some women even though they are menopausal.
These are a couple of reasons why fibroids may persist despite the general belief that they should shrink after/around Menopause.
Menopause and Fibroids – Troublesome Symptoms
The most common problem they cause around that time is abnormal bleeding, including heavy, prolonged and unscheduled or unexpected bleeding.
Consequently, the general approach when women are asymptomatic or have mild symptoms is to wait for Menopause.
Treatment Options for Fibroids in Late Menopause
In the recent past, if symptoms affect the quality of life in this stage, a hysterectomy was the treatment of choice.
Today, however, we have medical options that ease these symptoms and reduce the size of the UFs.
These are hormone and non-hormone medicines.
Some are used to treat other health conditions such as endometriosis, infertility, breast cancer and endometrial cancer.
They suppress Oestrogen and help shrink fibroids. However, they can have various side effects, so it’s good to be aware of this and discuss them clearly with your doctor when considering the methods.
Others are Uterine Fibroid Embolisation (UFE) and endometrial ablation.
In UFE, inactive material is introduced into the fibroid’s blood supply to starve it of nutrients, so it dies.
Endometrial Ablation may suit some types of fibroids as it removes the inner lining of the womb and any fibroids located there.
You can have an endometrial ablation as an outpatient, but in both of these cases, there is still a small chance of regrowth of fibroids.
Hysterectomy, for many ladies, is still the most effective treatment option (there is no chance for the fibroids to grow back).
Read more about these options.
Steps Going Forward
So let’s take these key points away:
Women can still suffer from fibroid problems during Menopause when they should be shrinking.
It is still unclear why some fibroids shrink, and others do not during this stage of life. However, hormonal regulations are thought to be involved.
Although the statement that most fibroids shrink with the onset of Menopause is realistic, it does not happen in every case.
There are options that women can consider and choose depending on their personal circumstances.
Editing By AskAwayHealth Team
All AskAwayHealth articles are written by practising Medical Practitioners on various health care conditions to provide evidence-based guidance and to help promote quality health care. The advice in our material is not meant to replace the management of your specific condition by a qualified health care practitioner.
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