Myths About Fibroids
Debunking the Myths, Misconceptions, and Misinformation
There are several myths about fibroids. The first
is a great relief to debunk- the myth that fibroids lead to cancer. In fact,
999 out of 1000 fibroids are not cancerous. In the 1 out
of 1000 cases that become malignant, women are generally over age 50 or their
fibroids grow unusually rapidly. In borderline cases, your doctor may recommend
a hysterectomy even if you don't have bothersome symptoms. Benign fibroids
may also grow to be huge, however, sometimes as large as a pregnancy!
Myth: Fibroids increase your chances of endometrial cancer.
Fibroids are associated with a fourfold increase in the risk of endometrial
cancer (cancer of the lining of the womb), but fibroids don't cause this. The
current thinking is that the same factors increase your risk for fibroids that
also increase your risk for endometrial cancer.
Myth: If you have fibroids, you must have a
hysterectomy. This thinking was common in the 1970's when there were
4 times as many hysterectomies performed per year in the US as there are now.
Now we know that even those fibroids that cause bothersome symptoms can often
be treated with medicine or a lesser surgical procedure than removing the uterus
entirely. We also know that fibroids generally shrink in size after menopause.
With the advent of uterine-sparing surgical techniques and the use of lasers,
we have greater ability to remove just a fibroid without removing the entire
uterus. This is of great importance to women with fibroids who want to be able
to become pregnant.
Myth: If you have fibroids, you can't become
pregnant. Fibroids can prevent pregnancy in certain patients, but the
majority of women with fibroids will never even know that they have them. Most
often, fibroids are incidental findings when a woman has an ultrasound test
for another reason. In some patients, however, fibroids may cause miscarriages
or other obstetric complications, depending upon the fibroid's size and location,
and whether the pregnancy is a singleton or a multiple. Occasionally, doctors
will recommend removing a fibroid during pregnancy (myomectomy). More
commonly, doctors will recommend a myomectomy to patients who have had previous
complications of pregnancy as a result of their fibroids.
Myth: Birth control pills can "treat" fibroids
or reduce fibroid size. There is no evidence that this occurs. Some
patients with heavy bleeding, however, may notice a decreased amount of menstrual
blood loss when on birth control pills. The theory behind the use of low dose
birth control pills in the treatment of fibroids, especially among perimenopausal
women, is that they decrease hormonal fluctuations during the menstrual cycle,
and this may decrease their stimulatory effect on fibroid growth. Birth control
pills are quite useful in the treatment of endometriosis, another very
common condition causing pain and bleeding and stemming from the lining of the
uterus, but quite different from fibroids.
Myth: Birth control pills are bad for women
with fibroids. There is no association between birth control pills
and fibroid growth or recurrence, despite the fact that they contain estrogen.
There is reason to believe that women entering menopause who have large or symptomatic
fibroids should defer estrogen replacement therapy or use only the smallest
doses. This must be discussed with your physician on a case by case basis,
considering all risks and benefits.
Myth: There is a "miracle diet" that can cause
fibroids to "vanish". This is a wholly unsubstantiated claim. There
are no dietary supplements or practices that can reduce fibroid size, nor are
there any magical therapies.
Myth: You are more likely to have fibroids if you have fibrocystic
breasts. While the words "fibrocystic" and "fibroids" are similar,
there is no relationship between the two conditions other than that they are
both very common in premenopausal women and they both regress in menopause.
Myth: You don't need your uterus after you've
had your children, so just remove it if it gives you any problems. This
was the prevailing medical approach until recently. We considered that once
it bore our children, the womb's job was done and it became as unnecessary-and
dispensable--as the appendix. Recent research, however, suggests that the uterus
is a biologically active organ that may interact with other organs such as the
ovaries in ways that have yet to be understood. For example, even when a woman
has only her uterus removed, her ovaries stop functioning prematurely in about
half of premenopausal women without any surgical complicating factors. This
may explain some of the recent surprises in studies of menopausal women on hormone
replacement and their risk for various diseases. This may also explain the
observation that many women who have had a hysterectomy report decreased libido
and decreased sexual satisfaction, although many researchers attribute this
to lost uterine contractions and cervical stimulation, which heighten the sexual
response in many women.
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Created: 10/17/2000  - Donnica Moore, M.D.