If You Have Fibroids, Is Waiting Until Menopause Worth It?
We at the Fibroid Treatment Collective, observed an interesting phenomenon in the late 1990s five years after we introduced uterine artery embolization (UAE) to the U.S. in 1994. Women who had been our fibroid patients in previous years, returned in their early 50s to have UAE. We were curious why they waited to have UAE, so we asked about it. They all had the same story. They first came to us in their late 40s, and thought that UAE was an excellent procedure, but they were convinced that menopause would shrink the fibroids. However, almost every patient returned during menopause with bigger fibroids.
Why is this?
For years doctors would tell their patients that the fibroids would shrink after the change of life. But few patients with fibroids made it to menopause because they ended up undergoing a hysterectomy (removal of the uterus) instead. We believe it’s because there’s an unknown substance secreted by fat cells that mimics the effect of estrogen on fibroids. It makes them grow. So does estrogen replacement therapy.
What’s the take home message, then?
The best time to treat fibroids that are causing symptoms is now. If you’re in your late 40s you are also in what amounts to an “estrogen bath.” Right before menopause when estrogen is removed from the body as the ovaries stop functioning, women will experience several months to years of estrogen dominated menstrual cycles. We know that fibroids are estrogen sensitive. This period in a woman’s life is almost always a growth spurt for fibroids. Waiting for “a few years” for fibroids to shrink during menopause is likely to result in a few more years of growth and worsening symptoms of pain and bleeding instead. Food for thought!
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