By Paul M. Dake M.D.
Q: I am 48 years old and have had lower abdominal pain with my periods for the last 5-6 years. My doctor examined me recently, told me my uterus was enlarged to the size of an 8-week pregnancy (though I had a tubal ligation 15 years ago), and that I probably have uterine fibroids. My sister has had the same problem. Should I be worried?
A: Uterine fibroids are the most common benign neoplasms (growths) in American women, and are more commonly found in black women. The most important word in that sentence is ‘benign’, which means they cannot become cancerous.
The fibroids become more common as a woman ages; about 80% of women 50 years of age can be shown to have them (usually by ultrasound), though only 20-50% of women with them having any symptoms at all.
The usual symptoms are excessive menstrual bleeding, pelvic pressure, changes in bowel function (either diarrhea or constipation, for no other apparent reason), urinary symptoms (usually a sense of urgency, frequent urination, and even difficulty passing urine), low back pain, and painful intercourse.
Fibroids respond to fluctuations in the female hormones (estrogen and progesterone) and when those levels decrease, such as at menopause, they nearly always shrink rather quickly in size and the symptoms related to them steadily improve, and usually disappear.
Given your age, your symptoms should begin to subside in the next year or so. When they occur in younger women, the usual recommended treatment for severe symptoms that do not respond to hormonal suppression treatment (such as birth control pills) is hysterectomy which, in fact, accounts for 39% of all hysterectomies performed in this country in the last decade or so.
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