Are You One Of The Many Women Facing Fibroids in Perimenopause?
One of the many things we women often encounter in midlife are fibroids. These benign tumours, affecting up to 80% of women by age 50, are usually harmless. However, as they grow, they can cause discomfort and may even give you a bit of a pregnant look. They’re especially common during perimenopause because of hormonal changes.
Since they’re linked to hormones, there is a natural regression of them after menopause when oestrogen and progesterone levels decrease. From my experience, conventional doctors don’t really worry about them because, in their eyes, the hormonal clock of a woman in her 50s has run its course, so why bother about treatment options? Everybody just seems to wait until we’re officially done with hormone production. 😕
What are the symptoms?
Fibroids can present a variety of symptoms, depending on their size, number, and location in the uterus. Some women may experience heavy or prolonged menstrual bleeding, which can lead to anaemia and fatigue. Others might feel pelvic pain or pressure (that’s what I experienced), frequent urination, or constipation due to the fibroids pressing on nearby organs. You can even have a sensation of fullness or bloating, which can be mistaken for weight gain. However, it’s important to note that many women with fibroids experience no symptoms at all, which is why regular check-ups are crucial during perimenopause.
Types of Fibroids
Fibroids aren’t one-size-fits-all; they come in different types, each affecting your body in unique ways.
- Submucosal fibroids grow into the uterine cavity and can cause heavy bleeding and fertility issues.
- Intramural fibroids, the most common type, develop within the muscular wall of the uterus and can lead to heavy periods and pelvic pain.
- Subserosal fibroids grow on the outside of the uterus and may press on the bladder or bowel, causing discomfort.
- Pedunculated fibroids are attached to the uterus by a stalk, which can twist and cause sharp pain.
Understanding the type of fibroid you have can help tailor your treatment options.
Fibroids and Hormone Replacement Therapy
What happens if you don’t want to go down the route of shrivelling into old age and decide to stay juicy by keeping your hormones at pleasant levels with replacement therapy? What’s happening to your fibroids then?
Well, if you reintroduce oestrogen, there is the potential that they could continue to grow or return! It’s therefore crucial to discuss the right oestrogen dosage with your doctor and keep a close eye on them. But don’t worry—it doesn’t mean that HRT is off the table if you have fibroids.
Research shows that using transdermal bioidentical oestrogen, particularly in combination with progesterone, can be a safer option for women with fibroids. Transdermal applications, such as patches or gels, deliver oestrogen directly into the bloodstream without passing through the liver first. This method not only provides a more stable dose of oestrogen but also has a lesser impact on the liver’s production of binding proteins that can increase fibroid growth.
When bioidentical progesterone is added to the regimen, it can further mitigate the potential for fibroid growth. Progesterone works by counterbalancing the effects of oestrogen on the uterine lining and fibroid tissue, which can slow or even prevent further fibroid enlargement. Studies have suggested that this combination—transdermal oestrogen with bioidentical progesterone—can be effective in managing menopausal symptoms without significantly impacting fibroids.
It’s important to note that every woman’s response to HRT is unique, so ongoing monitoring with your healthcare provider is essential. Together, you can adjust the treatment to ensure it meets your needs while minimising the risks associated with fibroids.
Natural Treatment Options
According to Dr. Aviva Romm’s book “The Menopause Intelligence,” it is possible to significantly reduce and even eliminate smaller fibroids naturally through food and supplements.
If you’re following any of my meal and lifestyle plans, you’re already halfway there, but there are some specific items that she recommends adding. I followed below diet for 6 months and was able to shrink my largest fibroid from 10 to 6 cm. I almost immediately (after about 3-4 weeks) noticed a difference and am blown away by the power of food. I shouldn’t be, but I still am.
Fibroid-friendly Nutrition
- 🥩 Eliminating red meat and ham
- 🐟 Increasing intake of healthy fish
- 🥬 Embracing leafy green vegetables
- 🍋 Eating citrus fruits daily
- 🌱 Adding 2 tbsp of ground flax seeds
- 🥕 Including foods high in vitamin A
- 🍺 Avoiding alcohol, particularly beer
- 💊 Supplementing with green tea extract, curcumin, and vitamin D3.
Lifestyle Tweaks
Beyond diet, several lifestyle factors can significantly influence the growth and management of fibroids.
- Stress management is crucial, as chronic stress can disrupt hormone levels, potentially contributing to fibroid growth. Mindfulness, yoga, and deep breathing can help reduce stress and support hormonal balance.
- Regular exercise is also beneficial, not only for overall health but also for maintaining a healthy weight, which is important because excess body fat can lead to higher oestrogen levels, potentially fuelling fibroid growth. Aim for a mix of HIIT, strength training, and flexibility exercises to keep your body strong and resilient.
- Maintaining a healthy weight through a balanced diet and regular activity can reduce the risk of fibroid development and ease symptoms if they are present. For a more structured approach to nutrition, consider my 8 Weeks to Successful Weight Loss Program, designed to help you shed excess weight safely and sustainably while supporting your overall health.
Together, these nutrition and lifestyle adjustments create a supportive environment for your body, helping you manage and potentially reduce fibroid-related challenges. Keep in mind, while these lifestyle tweaks can be a game changer, they’re no substitute for expert medical guidance from your healthcare provider.
Medical Treatment Options
I’m a big advocate of natural treatment, but I thoroughly looked at the medical options as well. Mainly because I didn’t expect the nutrition route to work as well as it did! So, what are the conventional treatments available?
- Medications such as GnRH agonists can temporarily shrink fibroids by lowering oestrogen levels, although they may cause menopause-like symptoms.
- Non-invasive procedures like uterine artery embolisation work by cutting off the blood supply to fibroids, causing them to shrink. Be aware that this option can be pricey and won’t always “kill” the fibroids completely. The cautious prediction is a shrinkage of 40-60%. Also, the costs might not be covered by your health insurance.
- For larger or more problematic fibroids, surgical options, including hysterectomy (removal of the uterus, which comes with the risk of earlier onset of menopause) might be recommended.
Each treatment option has its own risks and benefits, so it’s essential to discuss them thoroughly with your healthcare provider.
Fibroids can be disruptive, but with the right knowledge and approach, you can manage them effectively. Whether you choose natural methods, medical treatments, or a combination of both, the key is to do your research so that you can make an educated decision and avoid unnecessary and invasive treatments.
Supporting Studies
- Wise, L. A., et al. “A prospective study of physical activity and risk of uterine leiomyomata.” American Journal of Epidemiology, vol. 165, no. 2, 2007, pp. 157-163.
- Shan, H., Geng, J., Zhang, C., et al. (2021). “Association between obesity and the risk of uterine fibroids: a systematic review and meta-analysis.” Journal of Epidemiology & Community Health, vol. 75, no. 2, pp. 197-203.
- Pavone, D., et al. “Epidemiology and risk factors of uterine fibroids.” Best Practice & Research Clinical Obstetrics & Gynaecology, vol. 42, 2017, pp. 3-14.
- Parker, W. H., et al. “Bilateral oophorectomy versus ovarian conservation: effects on long-term women’s health.” Fertility and Sterility, vol. 88, no. 5, 2007, pp. 1273-1279.
- Shuster, L. T., et al. “Premature menopause or early menopause: long-term health consequences.” Maturitas, vol. 65, no. 2, 2010, pp. 161-166.
- Adegoke, O. A., et al. “Psychological stress and risk of uterine fibroids: A prospective cohort study.” Stress and Health, vol. 35, no. 3, 2019, pp. 324-330.
- Palomba, S., Di Carlo, C., Falbo, A., & La Sala, G. B. (2013). “Effect of hormone replacement therapy on uterine fibroids in postmenopausal women: A randomized controlled trial.” Menopause, vol. 20, no. 5, pp. 573-579
