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What causes fibroids after menopause?

The muscles of the uterus at times develop growths or tumours known as Fibroids. They are also known by the names of myomas and leiomyomas. These growths are quite usual. In fact, during the entire life of women, approximately 50% are affected by it at some point. Although women in their 30s and 40s are increasingly susceptible to fibroids. 

Studies have also pointed at African-American women developing them quite frequently. While it sounds serious, these fibroids are mostly diagnosed as non-cancerous. There a possibility of one or more of these fibroids developing at a specific point in time. Their sizes can range anywhere from tiny to extremely large.

Fibroids developing after menopause


Fibroids typically are known to grow aided by oestrogen. Menopause is caused by a steep fall in the levels of oestrogen and progesterone in a woman’s body. It decreases the risk of fibroid developing in the uterus. There are a number of instances when the size of the fibroids actually reduces and decreases the symptoms of women who are going through menopause. 


Women who have subscribed to hormone replacement therapy (HRT), to get solace from a variety of perimenopause as well as menopause symptoms caused by decreasing oestrogen in the body, might not see their fibroids reduced. This is due to hormone replacement therapy, typically including oestrogen and progesterone, which are the culprits behind the developments of fibroids in the first place, especially in younger women. 

symptoms


A woman’s age does not factor into the symptoms of fibroids. They are consistently the same in women of all ages. These symptoms can include fatigue, enlarged abdomen, pelvic pressure or pain, the discomfort or pain during sex, anaemia, pain emitting from behind the legs, lower backache, and added pressure on the bowels or bladder. 


A number of women do not notice any of these symptoms. In fact, until they have a gynaecologist stumble across them during a routine check-up. On the other hand, there might be women who might have extremely severe symptoms. In fact, it is a possibility that the symptoms could render a woman incapable of going through her routine chores and hamper her daily life. 

Treatment

There are a variety of treatments prescribed for women based on their symptoms. If the symptoms are mild, the doctor might ask to wait and watch for them to dissipate on their own. If extreme symptoms are experienced by a woman, the treatment could include complete removal of the uterus. This surgery is known as hysterectomy. There are a number of other elements that factor into a doctor’s treatment plan. Some of these factors might include the age of a woman, the size of fibroids, the number and intensity of her symptoms as well as the locations of these fibroids. As long as the symptoms are dormant and not causing any symptoms, the doctors would generally suggest no treatment, unless they are unusually large in size.

“Wait and watch” approach

It is well known that fibroids shrink and disappear after menopause. This results in a number of women not opting for a treatment plan. However, it is vital to have the condition checked out by a doctor at regular intervals. Doing so can help catch it if the fibroids increase in size.

Medication

There are certain medications the doctor might prescribe if the fibroids are instigating any symptoms. These medications could include:

Medicine used to manage pain


Non-steroidal anti-inflammatory drugs as NSAIDs. These can help with the various symptoms and pain caused by fibroids. Medications such as ibuprofen could be prescribed.

Iron tablets/ supplements


Iron supplements can help with heavy menstrual bleeding experienced by women, especially during the monthly period. Excess of blood loss can make one susceptible to anaemia, which can be avoided by taking iron tablets. 

Birth Control Pills


Heavy bleeding can be controlled or avoided entirely by taking progesterone contraceptives and a low dosage of birth control pills.

Gonadotropin Releasing hormone agonists (GnRHa)


 lupron is the most common drug included in this class. These drugs are known to decrease the size of fibroids and enable a smooth removal if surgery is prescribed by your doctor in your treatment plan. Unfortunately, Lupron can have extreme side effects, including bone loss. Hence, a majority of doctors do not prescribe it for more than 6 months.

Surgery

Surgery is suggested for women who have fibroids extremely large in size or those who experience severe symptoms caused by these fibroids.

Hysterectomy :

A surgery which includes removing the uterus is known as a hysterectomy. In case the woman is on the doorstep of menopause or already has menopause, there is a possibility of the removal of her ovaries as well.


A hysterectomy guarantees a stop to all the symptoms caused by uterine fibroids. So it is the best choice to opt for if the symptoms are particularly severe. It should be definite that the woman does not want to have children or has already had them. A hysterectomy is performed by making an incision in the abdomen, or it could be done through the vagina. 

Endometrial ablation :

A procedure in which the lining of a woman’s uterus is destroyed or removed in order to control the symptoms is known as Endometrial ablation. It must be kept in mind that it is impossible to get pregnant once this procedure is conducted. So if a woman is considering having children in the future, this course of treatment must be avoided. For women going through postmenopause, this is not a problem.

Myolysis :

A needle is inserted into the fibroid by a doctor during the procedure known as Myolysis. The tissue of the fibroid is destroyed by a freezing mechanism or an electric current that is passed through a needle.

Uterine artery embolization (UAE) :

UAE can be an excellent alternative for women who do not want to opt for hysterectomy despite suffering from severe symptoms. The blood vessels that carry blood to the fibroid are completely blocked during this procedure. It causes the fibroids to decrease in size. However, there is no possibility of pregnancy once this procedure is conducted.

Myomectomy :

A procedure in which fibroids are successfully removed while still keeping your uterus is known as Myomectomy. This is the best option for women who are considering becoming pregnant in the future. However, it is not part of the treatment plan prescribed by doctors if you’re already in menopause.


There are a couple of ways in which this surgery is carried out. One of them includes a large incision made by a surgeon in the lower abdomen, which is followed by removal of the fibroids and closing the would. This procedure is known as abdominal myomectomy. During a laparoscopic myomectomy, four small incisions are made by a surgeon which allow insertion of medical instruments through the holes to remove these fibroids. 

Usually, after menopause, fibroids are seen to substantially decrease in size and not trigger any symptoms in most women. The size of the fibroids might not shrink if the women are subscribed to hormone replacement therapy or who still retain high levels of oestrogen in their body. There are a number of alternative treatment options that could be opted for. However, the treatment plan is created after a thorough analysis of the intensity of a woman’s symptoms and the size of her fibroids.


It is crucial to consult a doctor if there is vaginal bleeding or any other symptoms of fibroids even after menopause has set in. A doctor must be consulted, especially if there is vaginal bleeding to make sure there is not a serious issue underlying it. 

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