What You Need to Know About Fibroids After Menopause

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The word “fibroid” is a scary word to hear for many women. Even though most uterine fibroids are noncancerous, they are still classified as tumors. Fibroids are something almost every woman experiences. In fact, researchers estimate that 70% to 80% of all women will have a fibroid at some point in their lifetime.

Some women will never be aware of uterine fibroids because they have no symptoms. They may only find out about a fibroid by accident while undergoing another procedure. Other women with fibroids will struggle with abnormal menstrual cycles, fertility issues, and pain.

The development of fibroids is related to hormone fluctuations during a woman's childbearing years. That's why many women see a decrease in fibroids after menopause. However, others do not. Regardless of how fibroids develop, there are several treatment options available. 

This article will discuss symptoms of fibroids after menopause, risk factors, and treatment options.

Woman clutching lower abdomen in pain

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What Are Fibroids?

Fibroids can appear in various places of the uterus, or womb. These growths can occur within the lining of the uterus, the muscle layer surrounding the uterus, the outer layer of the uterus, or free-floating on the outside of the uterus, attached by a stalk-like stem.

Fibroids are made of muscle and fibrous tissues. They vary in size. The hormone estrogen affects the size of the fibroid and the rate at which it grows. Since estrogen triggers fibroid growth, most fibroids will shrink during menopause, when estrogen levels decline. However, this is not the case for all women.

How Are Fibroids Connected to Hormones?

To understand how fibroids and hormones interact after menopause, you need to understand the various phases in the menopause process. 

Premenopause is the time between a person's first period and the onset of perimenopause.

Perimenopause is the transitional period leading up to menopause. This phase commonly starts in your early 40s and lasts up to 10 years. During this phase, the ovaries produce fewer hormones, and periods become unreliable. Since the ovaries are still producing estrogen and other hormones, however, it’s still possible to become pregnant or have estrogen trigger fibroid growth.

It's worth noting that women who have had their ovaries surgically removed for any reason will not experience perimenopause and instead will experience sudden menopause.

Menopause and postmenopause can be challenging to differentiate at times. When a woman has gone without a period for 12 months (excluding pregnancy and disease conditions), she has reached menopause. The postmenopause period is the period after a woman has gone through menopause. At this stage, the hormonal fluctuations tend to be less drastic and stay at a consistently low level.

Menopause

Menopause occurs after a woman has no periods for 12 consecutive months. On average, a woman will be around 51 years old when menopause begins. During menopause, the body slows down production of two lesser-known sex hormones—the luteinizing hormone and follicle-stimulation hormone. 

Hormones tend to work together as a team. When one hormone is undetectable or missing, it’s like losing the team captain. The body struggles to figure out if it can produce more or less of the other hormones to compensate for the missing hormone.

As production of these lesser-known hormones slows down and becomes more challenging for the body to find, the more common hormones—estrogen, progesterone, and testosterone—struggle to regulate themselves. When these hormones struggle to regulate themselves, they can cause you to feel hot flashes, night sweats, and other common menopausal symptoms.

Risk Factors

On an elementary level, fibroid growth is straightforward. In order to grow, the fibroid needs to be fed by hormones like estrogen and progesterone.

During menopause, when hormone levels decrease, the fibroid isn't being provided enough hormones to grow, and in some cases, there aren't enough hormones for the fibroid to remain the same size. So, the fibroid begins to shrink and even disappear. However, this is not always the case.

The following are a few risk factors that increase the possibility of fibroids during and after menopause:

  • High blood pressure
  • Vitamin D deficiency
  • Obesity
  • High levels of stress
  • Family history of fibroids
  • No history of pregnancy
  • Being African American (Black women are two to three times more likely than Whites to experience fibroids)

Symptoms

Regardless of your age or whether you’re in menopause or not, fibroid symptoms remain the same. Some of the more common symptoms are: 

  • Fatigue
  • Abdominal cramping
  • Low back pain
  • Feeling of pain or pressure in the pelvis
  • Pressure on the bladder or bowels causing more frequent trips to the bathroom

Treatment

Not too long ago, the only treatment available for fibroids was surgery. However, doctors, researchers, and specialists of all kinds have put in a lot of hard work to find alternative ways to treat fibroids. Surgery is now one of the last treatment options for most people. Treatment options may include the following items.

Hormones

Depending on your age and the severity of your fibroid symptoms, your doctor may try bridging the gap between premenopause and menopause with hormone replacement therapy.

In this approach, your healthcare team is hoping the body will naturally take care of the fibroid as your estrogen levels decrease. In the meantime, they may prescribe low doses of synthetic hormones to help stabilize the body's own hormone production. During this treatment, your fibroid will be closely monitored for changes, and if additional growth occurs, hormone replacement therapy will be stopped.

If additional treatment is needed, your doctor may prescribe alternative medications, such as Lupron Depot (leuprolide acetate), that can help shrink the fibroid.

Hysterectomy

Depending on the size and severity of the fibroid, your age, and your symptoms, your doctor may recommend that you have a hysterectomy. During this surgical procedure, your doctor will remove your uterus and possibly your ovaries as well. 

Myolysis

During this procedure, your doctor will insert a needle into the fibroid. Then they will send an electrical current through the needle into the fibroid to destroy the tissue. 

Uterine Fibroid Embolization 

Uterine fibroid embolization (UFE) is a minimally invasive procedure in which a surgeon inserts sand-like particles into the artery that supply the fibroid. This creates a clot that blocks off blood supply from the fibroid, preventing estrogen and other nutrients from reaching the tumor. In turn, the fibroid will shrink.

A Word From Verywell

Although fibroids aren’t cancerous, they can still cause discomfort and other problems. If you have symptoms of fibroids or are concerned about the possibility of fibroids, it is best to talk to your healthcare provider. A doctor can officially diagnose a fibroid and offer appropriate treatment options based on your situation. 

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5 Sources
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