Fibroids can have significant effects that interfere with daily life. Many women worry that invasive surgery is their only option, but new understanding about the causes of fibroids has led to treatment strategies that involve hormones and minimally invasive surgery as options. Progesterone may be a treatment alternative to surgery.
Fibroids
Fibroids are mostly benign tumors of the muscle in your uterus and get their common name from their fibrous consistency. The medical term for a fibroid is leiomyoma. Fibroids affect 20 to 25 percent of women, although studies that consider women with and without symptoms have shown that as many as 80 percent of women may have fibroids. Although most patients with fibroids do not have symptoms, you may experience vaginal bleeding, general abdominal pain, constipation, abdominal or pelvic pressure and infertility depending on the size of your tumor. Bigger fibroids generally cause more frequent and severe symptoms. A small fragment of these tumors can be cancerous and require immediate intervention owing to their quick growth, early spread and poor long-term outcome.
The Role of Hormones
Research into what causes fibroids has yielded mixed results. The human body contains 23 chromosomes, and genetic defects occur in 40 percent of fibroids. Defects in chromosomes 6,7,12 and 14 dictate the frequency and the direction with which these tumors grow. The hormones estrogen and progesterone also have effects on fibroids, which have specific receptor locations at which these hormones are activated. Further evidence of the role of hormones in these tumors relates to conditions that cause high or low level of estrogen and progesterone. For example, early menstruation and obesity produce high levels of hormones and are associated with higher rates of fibroid tumors. By contrast, menopause which is a low hormone state, tends to decrease the size of fibroids. Pregnancy is a condition that requires high levels of progesterone, and women with early and or multiple pregnancies have lower rates of fibroid tumors.
Progesterone and Fibroids
Progesterone has the potential to treat fibroids. Progesterone can both increase and decrease the size of fibroids depending on the dosage. Higher doses of progesterone cause growth in these tumors, so treatment recommendations are for the lowest possible effective dose. Treatment outcomes with progesterone have been mixed, with some women improving and others experiencing worsening symptoms. The American Society for Reproductive Medicine states that progesterone can effectively control the bleeding caused by fibroids, but such treatment will not affect the size of the tumors. Dr. John Lee has written extensively about progesterone and recommends its use in the treatment of fibroids.
Other Fibroid Treatments
Several medical, hormonal and surgical treatments can alleviate symptoms or remove fibroids from your uterus. Treatment options depend on your symptoms. For example, treatment with oral contraceptives may relieve painful menstrual cycles and heavy bleeding but will not resolve pelvic pressure, painful intercourse or fertility issues. Surgical interventions vary and can include minimally invasive techniques that leave small scars and decrease recovery time. Your surgical options depend on the size, number and location of the tumors. A careful discussion with your physician can be helpful in determining the best treatment.
References
- "Williams Gynecology"; J. O. Schorge et al.; 2010
- "Fertility and Sterility": Etiology, Symptomatology, and Diagnosis of Uterine Myomas; William H. Parker, M.D.; April 2007
- American Society for Reproductive Medicine: Uterine Fibroids: A Guide for Patients
- "What your Doctor May Not Tell You About Menopause"; John R. Lee, M.D.; 2004
