What are fibroids?

Fibroids are benign (non-cancerous) tumours. They occur in the uterus (womb). The womb is a hollow, pear shaped muscle.

For reasons that are currently being researched, a single muscle cell in the uterus may begin to grow & multiply rapidly. The resulting tumour is called a fibroid. (The word ‘tumour’ often evokes fear because it is commonly associated with cancer, but ‘tumour’ in medical terminology simply means “new growth” or overgrowth of cells).

Fibroids may put pressure on the bladder or intestines. When that happens, symptoms such as frequent urination, constipation, pelvic pain, or heavy menstrual bleeding may develop. On rare occasions, a large fibroid may block the opening of the uterus. In that case, a pregnant woman may need to have a caesarean delivery.

Development of Fibroids

The female hormone Oestrogen stimulates cell growth and therefore where there is an excess, then the oestrogen receptors i.e. breast cells and womb cells tend to become over stimulated. The main purpose of oestrogen in a woman’s body is to prepare the womb for the implantation of an egg. Oestrogen sends a chemical message to the smooth muscle cell lining of the uterus to reproduce in order to build a thicker muscular lining ready for the egg to attach. It also tells the ovaries to release an egg. During pregnancy the womb lining thickens in order to cushion the developing embryo. If an egg implants on the surface of the womb then a chemical message is sent out to produce progesterone and to lower the oestrogen production. The progesterone levels then send a chemical message to the muscle cells to slow their reproduction and started start absorbing nutrients to supply the placenta with food for the embryo. If no egg is reaches the uterus then the oestrogen & progesterone levels drop and then the lining breaks down and is released by the body as what we call a period. Unfortunately, women with fibroids are usually estrogen dominant and the oestrogen in the body reaches high levels throughout the menstrual cycle and as a result the uterine muscle cells can become over stimulated and keep reproducing and in some cases eventually form a firm muscular benign fibroid.

Medical Treatments.

There are a number of options offered by doctors to treat Fibroids, these include:

Myomectomy - removal of Fibroids leaving the womb intact.

Laparoscopic Myomectomy - Fibroids removed by keyhole surgery.

Hysteroscopic myomectomy - Fibroids are removed in cases where the fibroid or polyp is small and is projecting into the uterine cavity. Telescopic instruments are used to view the operation.

Hysterectomy Removal of the uterus and sometimes the ovaries. This is a last resort and should only be considered if all other options have failed and the sufferer is not willing to change her lifestyle or does not want children. Doctors would then recommend the synthetic oestrogen HRT (explaining the dangers of this is a whole other article) Among the substances used to produce some types of  HRT is Premarin, extracted from pregnant mare’s urine. Unfortunately, a large number of doctors recommend that a high proportion of women opt for hysterectomy despite the fact that there are other options available to treat fibroids, including the above. Always seek a second opinion from a different Doctor, if this is suggested. Such drastic surgery might cure the fibroids. Remember 99.97% of fibroids are non-cancerous and remain non-cancerous.

 Embolisation This is a new technique where pellets are inserted to block the arteries leading to the womb to reduce the blood supply and therefore reduce the Fibroids. This technique has apparently been successful; however, there have been concerns about the long-term effect on women who still wish to have children. Latest research shows that women who conceived prior to the embolisation, were able to conceive after the embolisation. For more details visit www.fibroids.co.uk . Embolisation is also available in the UK.

Before the above surgical treatments, women are usually offered drugs to reduce the oestrogen production in the body. The drugs work on the pituitary gland (which control hormone production) to reduce the oestrogen production; this in turn reduces the blood supply to the uterus. Because the oestrogen is reduced, the fibroids shrink during the treatment. The operation to remove the fibroids is then carried out with minimal blood loss. The side effects of this drug treatment include temporary and premature menopause. However, it can prevent a Myomectomy turning into a hysterectomy because of heavy blood loss. If the treatment is stopped, the Fibroids return to their normal size as the blood supply returns to the uterus. It is not a cure for Fibroids and is not advisable to take long term as a treatment for fibroids. Tamoxifen is also not recommended for fibroid sufferers as it causes the womb lining to grow and has been known to cause tumors of the womb.

 Very little progress has been made to find the cause and the cure for fibroids. As a result, 37% of all women in the United States undergo hysterectomy by age 60 for fibroids. Uterine fibroids are the most common reason for women to undergo hysterectomy in both the United Kingdom and the USA

Whilst hysterectomy is undoubtedly the correct management in a small minority of cases, there are modern, much less invasive and disfiguring alternatives available from surgeons and radiologists with the appropriate training.

According to Dr Stanley Birnbaum a gynaecologist at the Cornell medical centre/ New York hospital, the problem is “doctors are spending more time performing unnecessary hysterectomies and not enough time familiarising themselves with more effective and less invasive alternatives ……. if the doctor doesn't know how to perform the new surgery then they will neither attempt nor advocate it.”

Dr William Ledger an authority on gynaecology at the New York hospital stated that doctors do respond to what patients want. When patients ask for a new treatment they generally received it. However when patients are unaware of the new treatments, less effective treatments were offered to them. However, with the current trend of women obtaining up to date information from reliable internet sources such as MedlineTM & MedscapeTM, doctors are finding that patients sometimes know more about their treatments then they do, this forces them to keep up to date or lose the patients. In the UK Doctors are not required to attend courses yearly as in other professions to update themselves on new medical treatments. This often leads to gaps in their knowledge.

Why are hysterectomies controversial?
Critics contend that in the past some doctors, with the goal of preventing uterine cancer, have performed hysterectomies on women who didn't need them. In very rare cases, doctors have been charged with using hysterectomies as a form of birth control or involuntary sterilization, especially for women of color. There have also been cases where hysterectomies were performed without the knowledge or consent of the patient.

For many women, the biggest drawback to a hysterectomy is loss of fertility. Once you have a hysterectomy, you cannot conceive, and for many women of childbearing age, this is a significant loss. Some women experience a loss of sexual desire, although this problem appears treatable with hormone therapy. Women who feel pushed into a hysterectomy may also have a negative reaction to it. Having uterine fibroids does not increase your risk of cancer.

Fibroids are a multicultural issue. Fibroids affect 50% of women of all races, however 50-80% of Afro-Caribbean, Indo-Asian & Jewish women are affected by this problem. The reasons for this

Women worldwide have been faced with the unexpected news that they have fibroids. Most women have never heard of them prior to their diagnosis. For a woman the idea of a tumour occupying their womb is frightening especially in the absence of information about this benign problem. Some women feel a mixture of emotions, they are sometimes scared, sometimes embarrassed to discuss it with friends & family. Unfortunately the lack of information leads women to accept a hysterectomy (removal of the womb) for this treatable condition. Many Doctor's fail to explain that fibroids are not a life-threatening condition and in fact 99.97% are benign and they will never become cancerous even if they grow in size.

Holistic Help

For a good general overview of holistic health I highly recommend the books Healing fibroids Naturally, Fibroid Tumors & Endometriosis Self Help Book by Dr Susan Lark & Women's Bodies Women's Wisdom by Dr Christine Northrup. These books have great information on Holistic ways of dealing with fibroids. In addition Queen Afua’s positive uplifting books , written for  African-Caribbean women, called Heal Thyself  & her book Sacred Woman explain how to have a healthy lifestyle can help fibroid symptoms. They are available from the Sisternetwork Bookshop.

Many Holistic practitioners recommend a number of self -help activities for those who have been advised by their Doctors that surgery is unnecessary perhaps because of the age of the patient or the small size of fibroids. Meditation and deep breathing can help with Fibroids. When we are stressed we also tend to tense parts of our body as a response to physical and emotional stress. Some people subconsciously tense the pelvic muscles, which blocks the blood flow and cuts off the supply of nutrients to our organs. When the oxygen levels drop in the muscles, lactic acid is produced which causes cramping & discomfort. The muscles should have a good blood flow to and from them in order to help toxins to be removed from them. 

Synthetic foods, and toxins reduce the effectiveness of your immune system. Eating a healthy balanced, whole food diet will help to keep you stay healthy.

This information is not intended to replace the advice of your Doctor. If you have menstrual irregularities always seek the help of a qualified medical practitioner. Always have the diagnosis of fibroids made my a Medical Doctor. Have regular medical check-ups for your fibroid. Bleeding between cycles may indicate other problems so always go to your Doctor. Always seek an alternative health practitioner, who is qualified, with previous success with treating fibroid sufferers.

For more information click the links below or visit Fibroid Network Charity at www.fibroidnetworkonline.com