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Women’s Health with Minoos Hosseinzadeh, M.D. Fibroids Part I: How Unchecked Uterine Growths Can Lead to Infertility
Uterine fibroids are tissue growths in the uterus that are benign; meaning, non-cancerous. The incidence of uterine fibroids is reported to be as high as 40-50 percent, and as a result, they are the most common type of tumors found within the pelvic cavity. Although these fibroids can be found at any age, they are typically seen in women between the ages of 30 and 40 years of age. They are also more common in women of African-American descent, in whom larger fibroids are often found to be present at a younger age.
In the United States, fibroids are the number-one indication of hysterectomy.
Determining the Causes of Fibroids
Although the cause of fibroids is still unknown, what is known is that they grow in response to the female hormone estrogen. In general, elevated estrogen levels can lead to fibroid growth, whereas low estrogen levels can prevent further growth. In certain circumstances, lowered estrogen levels can also cause existing fibroids to shrink. A good illustration of this occurs in both pregnancy and menopause. During pregnancy, estrogen levels are higher and these augmented levels can elicit uterine fibroid growth. However, as women enter menopause, estrogen levels decrease and fibroids can shrink.
Identifying the Types of Fibroids
Fibroids are classified and named based on their location within the body. The three main types of fibroids include:
Intramural fibroids – These fibroids are strictly confined to the wall of the uterus.
Subserosal fibroids – Located on the surface of the uterus, these fibroids project outward.
Submucosal fibroids – These fibroids grow specifically within the cavity of the uterus.
Fibroids can vary in size from very small to very large, and can appear as single growths or as a grouping of multiple growths. The symptoms of fibroids are dependent on their number, size and location.
Recognizing the Symptoms Associated with Fibroids
Many women who have fibroids are unaware of their condition, primarily because they are asymptomatic. But, as fibroids grow, they can cause a number of emotionally and physically painful symptoms – including infertility and increased incidence of miscarriage. Some of the more common symptoms include:
Heavy bleeding at the time of menstruation, usually coinciding with abdominal and pelvic cramping. Women may also have more days of bleeding during their menstrual cycle. If left to continue without treatment, the condition can lead to anemia and also present with fatigue and lethargy.
Bleeding in between menstrual cycles.
Pelvic pain and pressure as the fibroids enlarge.
Changes in urinary and bowel habits as the fibroids enlarge, such as urinary frequency and constipation.
Infertility, if the fibroids are blocking the tubes.
Miscarriage.
It is very important that fibroids be diagnosed as early as possible. In rare cases, there is the risk of the fibroids becoming malignant, or cancerous. What every woman needs to know about fibroids is that there are many treatment options available that can be tailored to meet their individual needs, including medical, surgical and radiological interventions, which will be discussed in detail in the November issue of OC Life. For women experiencing fibroids or concerned that they may have fibroids, there is good news: Today, there is no need to live with fibroids and endure their emotional and physical effects. Fibroids are generally treatable, and needn’t encumber women’s lives or impact their chances of starting a family and enjoying good health.
OC Life Readers: Email questions to Women’s Health with Dr. Minoos at DrMinoos@OCPCmagazine.com. ____________________________________________________________________________
Dr. Minoos Hosseinzadeh is a nationally recognized specialist in reproductive endocrinology at the largest and most-established locally-based fertility center in Orange County, Calif., Coastal Fertility Medical Center (http://www.coastalfertility.com). Double-board certified in Obstetrics and Gynecology and Reproductive Endocrinology & Infertility, she is also a member of the American Society of Reproductive Medicine, Society for Reproductive Endocrinology and Infertility, American College of Obstetrics and Gynecology and the Royal College of Physicians and Surgeons. She has presented at several national and international fertility meetings and authored numerous papers on hormone replacement therapy and age-related female infertility.
