Wednesday, July 26, 2017

Sex and the Aging Woman II~Uterine Fibroids

About 75 percent of women get Uterine Fibroids (UF). UF are the cause of about 200,000 hysterectomies per year. Black women are two to three times more likely to get UF than women of other ethnicities (Axe, 2017).

UF are non-cancerous tumors that grow inside a women's uterine wall. They can range from a few millimeters to the size of a watermelon (2017).

There are different types of fibroids that women get. Here's a list and a description of each:
  • Intramural - These grow within the muscular uterine wall, and are the most common. These can actually distort and stretch the uterus, if they're large enough. These can also cause prolonged, heavy periods; and pressure and pain in the pelvic region.
  • Subserosal - These grow outside the walls of the uterus, and sometimes press on the bladder causing difficulty in emptying your bladder, and sometimes even backaches. 
  • Pedunculated - These grow on small stalks inside or outside of the uterus.
  • Submucosal or Intracavitary - These grow underneath the uterine lining. These will likely cause heavy, prolonged periods. These are not as common as other types of fibroids (Axe, 2017).




Many risk factors contribute to getting uterine fibroids, and these risk factors are:
  • Heredity - If your mother or sister has fibroids, your chances of getting them are greater.
  • Age - Fibroids usually show up around your 30's or 40's.
  • Nationality - Black women are two to three times more likely to develop fibroids than other nationalities, and tend to get them at younger ages, have more of them, and larger ones.
  • Diet - Poor quality beef, and any pork has been linked to  higher fibroid risk.
  • Obesity - Being overweight creates a higher risk. 
  • High Blood Pressure - High blood pressure seems to create a higher risk.
  • Hypothyroidism - Hypothyroidism has been associated with uterine fibroids.
  • Early Menstruation - Women who started their periods before 10 years old are at higher risk.
  • Birth Control - Because of the increased estrogen levels caused by them, birth control pills can cause fibroids to grow more rapidly (Axe, 2017).

Certain foods may make fibroids worse, so try your best to avoid them. These foods are:
  1. High fat, processed meats - These meats can increase inflammation and many times contain chemical additives.
  2. Conventional dairy - Because it is high in steroids and other chemicals, non-organic dairy can alter hormones and encourage the growth and development of fibroids.
  3. Refined sugar - Two factors that encourage the development of fibroids are weight gain and hormonal imbalance, which can be caused by the effects of refined sugar. "Studies have shown that a high dietary glycemic index is associated with a higher risk of uterine fibroids in some women (Axe, 2017)."
  4. Refined carbohydrates - These carbs can cause insulin levels to spike, while causing and hormones to become unstable. 
  5. Alcohol - Alcohol can increase inflammation throughout the body. It reduces immune function and encourages hormonal imbalances.
  6. Caffeine - Drinking more than two cups a day can increase estrogen levels and worsen fibroids (Axe, 2017).

There are ways to possibly ward off and treat these growths naturally, yet this isn't information that we get from most doctors. Here are some foods that you should include in your diet that may help keep fibroids at bay:
  • Organic foods - "Eating organic foods can help to shrink and prevent fibroids. Pesticides impact estrogen and other hormone levels." Hormonal balance is the key to treating fibroids naturally, so you'll want to avoid pesticide ingestion as much as you can.
  • Green leafy vegetables - These vegetables discourage fibroid growth in a woman's body, because they are rich in vitamin K, which aids in clotting and helps control menstrual bleeding.
  • Cruciferous vegetables - These vegetables help to detox your liver and balance estrogen levels. Consuming large amounts of broccoli, tomatoes, apples, cabbage and Chinese cabbage seems to be a protective factor for uterine fibroids, according to research. Large consumptions of these vegetables and fruits, are believed to be able to reduce the incidence of uterine fibroids in women.
  • Beta - Carotene rich foods - The body turns beta - carotene into vitamin A, which promotes the growth of healthy tissue, and also repairs tissue, and these things can be helpful in healing fibroids. Carrots, sweet potatoes, spinach and kale are high in beta - carotene. 
  • High iron foods - Fibroids can cause heavy periods can lead to excessive blood loss, which in turn can cause anemia. Foods high in iron like grass-fed beef and legumes, can help to replace loss iron and prevent anemia. 
  • Flaxseeds - These can help to balance estrogen levels in the body, and this can help to shrink fibroids. At least two tablespoons per day should be helpful. Sprinkle them on your oatmeal or in smoothies, or just eat them as they are.  
  • Whole grains - Use whole grains like millet, spelt, rye, oats, buckwheat, and brown rice, instead of refined grains (Axe, 2017). 

There are many different treatments for fibroids. The one that's best for each woman will be based on many factors. Here's a list of those treatments:
  • Watchful waiting - If your fibroids don't bother you, then this may be the best thing to do. And if you're close to menopause, they naturally start to shrink during menopause.
  • Medications:
    • Gn - RH agonists (Lupron, Synarel, etc.) - These block the production of estrogen and progesterone, which puts you in a post-menopausal state temporarily. This stops your menstrual cycle, shrinks the fibroids, and may improve anemia caused by excessive menstrual bleeding. This is only a temporary fix, and is only administered for 3 to 6 months, because of the side effects.
    • Progestin releasing IUD - This device can relieve heavy bleeding caused by fibroids. It also prevents pregnancy, but does not shrink fibroids.
    • Tranexamic acid (Lysteda) - This is a non-hormonal medication that's taken to lessen heavy periods, and is only taken during heavy period days. 
    • Other medications can be used, but they don't shrink fibroids (Mayo Clinic, 2017).
    • Noninvasive procedure:
      • MRI guided FUS - This is done on an outpatient basis, requires no incision and preserves your uterus.  This is performed while inside an MRI scanner equipped with a high energy ultrasound transducer, which focuses soundwaves into the fibroids which heats and destroys small areas of fibroid tissue (2017). 
    Focused Ultrasound
    Surgery (FUS)



    • Minimally invasive procedures:
      • Uterine artery embolization - Small particles are injected into the arteries to the uterus. This cuts off the bloodflow to the fibroids, which cause them to shrink and die.
    Uterine Artery Embolization

      • Myolysis - This laparoscopic procedure uses either radiofrequency energy, an electric current, or laser to destroy the fibroids and shrink the blood vessels that feed them. Cryomyolysis is a similar procedure that freezes the fibroids.
      • Laparoscopic or robotic myomectomy - A surgeon removes the fibroids leaving the uterus intact, during a myomectomy. If there are only a few fibroids your doctor may suggest a laparoscopic or robotic procedure.
      • Hysteroscopic myomectomy - "This procedure may be an option if the fibroids are contained inside the uterus (submucosal). Your surgeon accesses and removes fibroids using instruments inserted through your vagina and cervix into your uterus (Mayo Clinic, 2017)."
      • Endometrial ablation - Performed with a special instrument inserted into the uterus, this treatment uses heat, microwave energy, hot water, or electric current to destroy the uterine lining. This will end menstruation or reduce the menstrual flow. This does not affect fibroids outside of the uterine interior lining.
    • Traditional surgical procedures:
      • Abdominal myomectomy - This open abdominal surgical procedure is used if you have multiple fibroids, very large fibroids, or very deep fibroids. Many of the women who are told that they need a hysterectomy, may be able to have this procedure instead.
      • Hysterectomy - This is major surgery for a woman, because it removes the uterus. This should be thoroughly researched and discussed before making this decision, because it's permanent and comes with many possible side effects (May Clinic, 2017).

    All of these procedures come with some types of side effects, so it's important for you to ask lots of questions and do your research. Talking to other women who have had these procedures can be very helpful. You have to figure out which is best for you.

    I suffer from Uterine Fibroids. They have caused me severe bleeding during my menstrual cycle, which has affected my quality of life. I would have to change within every hour for the first two days of my cycle, because my flow was that heavy. This is with using a super-plus tampon and overnight pads (both heavy duty protection), together. I would also bleed for weeks, and at odd times.

    My heavy loss of blood also caused me to become anemic, but I was able to eventually fix that by taking iron pills. That was an ordeal because for a while they made me too sick to take, but I figured out that it was because I drank so much soda. Not while taking the pills, but at that time I drank so much of it, it still affected my digestion of iron pills. When I stopped drinking soda, I had no problems taking the pills, and I took them following a meal; this cured my anemia. 

    I was given many options, and the ones with hormones I stayed away from because I have had negative reactions from hormones in the past; they would cause depression. Other options were suggested, but I felt that they weren't for me. So the first option that I looked into was the Uterine Artery Embolization, but I was not a good candidate because my fibroids are intramural, subserosal, penduculated, and submucosal. AND some were very large which made it possibly dangerous to have this procedure. I was not denied it, but I didn't want to take the chance of the possible side effects.

    The next option was to take the medication Lysteda. This caused heavy clotting, but it reduced the bleeding and helped improve the severity of my menstrual cycle. This medication became unavailable for a while, so I needed another option. 

    I had a new doctor on my case, and she went over all of my options again, and she assured me that the IUD didn't have the hormones of the past and she felt that it might be a good option for me. I was elated by the thoroughness of the information that she gave me, because I was beginning to think about a hysterectomy. Something that I told myself that I would never do, unless it was to save my life. 

    I agreed to having an IUD inserted in hopes that it would help to reduce my periods, and it did. My quality of life improved, so I was able to go swimming again, and I didn't have to cancel plans when my period came on. The plan is that by the time it's time to remove the IUD (which is about 5 years), I will be well enough into menopause that they will start to shrink naturally.

    So, my advice would be to find out about all of your options and do your research if you suffer from UF. Make sure that you learn about all of the side effects of your options, because that is important. I hope this article is helpful, and I wish any woman that suffers from this condition the best of luck in choosing a treatment. 

    Talk to you all soon!!! 😊

    ~LAF~

    References

    Axe, J. (2017). 8 ways to heal or prevent fibroids. Draxe.com.
         Retrieved from https://draxe.com/fibroids/

    Mayo Clinic Staff (2017). Uterine fibroids. Mayoclinic.org.
         Retrieved from http://www.mayoclinic.org/diseases-conditions/
         uterine-fibroids/diagnosis-treatment/treatment/txc-20212592

    FUS and UAE pics from Mayoclini.org/uterine fibroids.

    Uterine fibroid pic from MedicineNet.com
         http://www.medicinenet.com/image-collection/uterine
         _fibroids_picture/picture.htm

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