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Hope For Fibroids Bulletin Board Poster (PDF) Uterine Artery Embolization Patient
Brochure (PDF)
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“WHAT IS THE ANSWER TO MY UTERINE FIBROID QUESTION?” A PATIENT ASKS HER INTERVENTIONAL RADIOLOGIST AND GYNECOLOGIST
FAQs section #
1 is Uterine Fibroid discovery research
questions. Please feel free to e-mail your uterine fibroid questions to Hope For Fibroids hope@hopeforfibroids.org. Thank you for sending your questions and comments to Hope For Fibroids.
What is the difference between a Nabothian Cyst and a uterine fibroid?
A Nabothian cyst is a cyst in the cervix.
Nabothian cysts do not need to be
treated. Uterine fibroids are benign tumors of the uterus. They are not
cancers, but can cause symptoms such as excessive bleeding during or
between periods, pressure on the bladder or rectum, discomfort during
sexual relations or interference with fertility. Symptoms from fibroids,
the most common of which is excessive bleeding, can be anywhere from mild
to disabling.
Will polyps interfere with a UAE procedure? Polyps are overgrowths of endometrial tissue - like a skin tag growing inside the uterus. They are usually benign, but can be a cause of abnormal bleeding. Hysteroscopy or D&C should remove the polyps that are present - but more may grow. In women who have
abnormal bleeding and both fibroids and polyps, a D&C is probably a good
first step to clear out the polyps and see if the fibroids are causing the
bleeding. If bleeding continues to be a problem, then
evaluation for
UAE is reasonable.
Polyps do not interfere with or increase the complication risk of UAE.
UAE generally does not treat endometrial
polyps.
It is very rare for endometrial polyps to be cancerous. Are you sure this is a polyp it is unusual for a polyp to cause bleeding heavy enough to cause anemia. Short-term hormonal therapy with various forms of progesterone could be used along with iron therapy to improve anemia. - Francis L. Hutchins, Jr., MD There is no clear relationship between endometrial polyps such as described here and infertility. Having said that, if no other cause for infertility can be found one cannot argue with the concern that this may be a factor. The standard method for removal of these polyps is hysteroscopy, a minimally invasive procedure which may be able to be performed in the office. - Francis L. Hutchins, Jr., M.D. They may fall off. They only need to be removed if they are causing spotting. - Francis L. Hutchins, Jr., M.D. Polyps are rarely cancerous and are frequently on a stalk. Causing them to retract back into the cervix. An office hysteroscopy would be more informative. Observation is also a possibility especially since the original observation could be incorrect - there may be no polyp. - Francis L. Hutchins, Jr., M.D. Endometrial polyps are relatively common and rarely cancerous. They are often associated with abnormal bleeding and in your situation, because you are menopausal, would require at least a biopsy of the endometrium. This can be done best by hysteroscopy since removal of the polyp would be desired. Hysteroscopy is commonly done in the office under local anesthesia or in an outpatient operating room. Sedation can be used if desired. Post-operative recovery in the case where no sedation is used is immediate. With sedation it is several hours depending on the dose used. Whether polyps can be treated by diet is not something that has been studied to the best of my knowledge and therefore cannot be recommended. If however there has been postmenopausal bleeding a biopsy of the endometrium and removal are required. - Francis Hutchins, Jr. M.D. It is rare for polyps to cause pain, unless they are huge. – Paul Indman, M.D. (Refer to "Molly's Persistent Bleeding" - a 66-year-old woman had bleeding due to polyps. - William Parker, M.D.)
What is the size of a
normal uterus and how much does it weigh?
A normal
uterus is about 8 x
6 x 4 cm and has a volume of 75-200cc. This is about the size of a
woman’s fist. It weighs 100-200gms (there are 28 gms in an ounce). To estimate the overall size of a fibroid uterus one would need the complete set of measurements of the uterus with fibroids, i.e., ht, width and depth so that the volume can be computed and compared to known gestational age equivalents. Having said that, an 11cm fibroid certainly could make the overall uterus seem the size of a 13wk. pregnancy or greater. The bigger question is why would this require a hysterectomy? (Refer to Treatment Guide.) - Francis L. Hutchins, Jr., M.D. What are the risk factors that can influence fibroid growth?
The tendency to form fibroids
appears to be largely inherited. However, the degree to which fibroids
cause symptoms appears to be determined by both genetic and hormonal
factors. Anything that increases the level of estrogen in a woman’s system
may cause fibroids to be more bothersome or to grow faster or larger. Some
of the things that increase estrogen levels are the onset of menstruation
before the age of 12 (which prolongs the time a woman is subject to
estrogen), being overweight, never being pregnant, smoking, and a
sedentary lifestyle.
By age 35, about 80% of African-American women and about 35% of
Caucasian women in the United States of America have been diagnosed with
fibroids. Uterine fibroids
cause symptoms in about half the women who have them. Cervical fibroids grow from the cervix, are relatively rare, generally are not involved with infertility, like all fibroids they are benign and UAE would likely affect them like all other fibroids. They are not a particularly significant entity. - Francis L. Hutchins, Jr., M.D. Yes,
cervical fibroids respond to UAE. The risk of slough may be higher
than background. The risk of complications of myomectomy is
also higher than normal, since they are usually near the largest blood
vessels supplying the uterus. -
There is no age restriction. I have treated women as young as
in their mid 20s, and I have performed UAE on a few women in their
late 50s and early 60s. These women were post-menopausal, but continued to
have symptoms from their fibroids that were aggravated by Hormone
Replacement Therapy. In general, menopause is a final cure for fibroid
symptoms in most women.
What size does the uterus and uterine
fibroids have to be for a woman to start having symptoms of severe pain?
Even very small fibroids can cause
severe symptoms if they are in the wrong location.
How should a doctor handle a patient who
decides not to have a uterine fibroid treatment performed even though the
uterine fibroids are growing? The decision
to treat fibroids rests with the patient. Fibroids should be treated when
the patient feels that her symptoms warrant treatment. There are
some women who will tolerate a lot of symptoms before they feel that the
symptoms are bad enough for them to want to have a therapy.
Did you ever hear of a procedure to get rid of uterine fibroids that requires the woman to fast and change her diet? - Harrisburg, PA There are lots of claims about dietary changes and
fibroids. To my knowledge none of them have any scientific validity,
and many of them are such extreme diet changes that it can be very
disruptive to one’s life. Note:
I haven’t heard of this, but it’s obviously nonsense. To my knowledge, there is NO relationship between dairy intake and fibroids, nor is there any theoretical reason to think that there might be. See how burdensome this diet would be – no milk,
no cheese, no yogurt, no butter…?
There isn’t any evidence that any of the alternative treatments have the slightest effect. If patients are following fibroids that don't need immediate treatment, most of the alternatives are unlikely to hurt anything. - Paul Indman, M.D.
Some herbal remedies can contain harmful
ingredients. A woman should check the ingredients carefully before
using them. - Robert
Worthington-Kirsch, M.D.
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