Debunking Myths About Fibroids
There are several prevailing myths about fibroids, the most common benign tumors
of the uterus. 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
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.
Created: 12/11/2003  - Donnica Moore, M.D.