As women age, they undergo various physiological changes, and one significant milestone is menopause. Menopause marks the end of a woman's reproductive years, typically occurring in her late 40s or early 50s.
During this transition, hormonal fluctuations can have diverse effects on the body, influencing various health conditions. One such condition that intersects with menopause is the presence and behaviour of uterine fibroids.
Fibroids are benign growths that form in the uterus. They can vary in size and most women assigned female at birth, will not experience any symptoms and not know they have any. For those who do have problems these may include heavy, painful periods; abdominal and/or lower back pain; need to pass urine often; constipation; and pain during sex.
Like many gynaecological problems the exact cause of Fibroids is unknown, but it is thought to be related to Oestrogen so tend to develop in the pre-menopausal phase of life, (16-50 years) when Oestrogen levels are at the highest and tend to shrink post-menopause when Oestrogen levels drop.
What happens to Fibroids during Perimenopause?
As the Oestrogen levels drop during perimenopause and menopause some gynaecological issues like, fibroids and endometriosis, can dissipate. However, menopause symptoms can become problematic and may require Hormone Replacement Therapy (HRT) to relieve these and provide long-term protection against other problems caused by lowering Oestrogen levels like Osteoporosis or cardiovascular disease.
The concern for the woman with fibroids is, if fibroids are fed by Oestrogen, does Oestrogen-based HRT exacerbate fibroids?
Is there research on the impact of menopause on fibroids?
Like many aspects of menopause treatment, the research is minimal, conflicting and somewhat confusing.
A small study in 2002 found there was a significant increase in the growth of fibroids predominantly in the first two years of usage. From year three the growth appeared to slow. A larger study in 2019 showed a similar result but concluded that this should not be an absolute contraindication for usage of HRT but advised closer monitoring of those women with large fibroids and/or symptomatic condition.
It is agreed by many menopause specialists the benefits of using HRT for the relief of menopause symptoms and the long-term benefit on overall health greatly outweighs the risk of fibroid growth, but closer monitoring should be provided.
Fibroids can be asymptomatic and pose no problem for the individual, however, for those women who do suffer difficult symptoms from them the thought of them decreasing in menopause may be a comfort.
Therefore, taking medication that can enlarge the fibroids or worsen the symptoms is not a pleasant prospect for them. However, the symptoms of the menopause and the prospect of long-term health issues may override these concerns and with close monitoring fibroid symptoms should lessen with time and good management of HRT will help control menopause symptoms as well.
How else can I manage fibroids during menopause?
Another way of managing the impact of fibroids when going through menopause is making lifestyle changes. As with all menopause symptoms, making positive changes to your lifestyle helps manage a lot of the negative symptoms that occur. Regular exercise, and a balanced diet are always a good place to start.
If you have access to myTamarin menopause support through your employer and would like to discuss any issues, book a 1-1 with a menopause expert at myTamarin via the website or app.
NHS, (2022) Fibroids. www.nhs.uk
Medical News Today, (2022) Fibroids after Menopause: Symptoms, Treatment and Outlook. www.medicalnewstoday.com
Wagner, K. (2023) What You Need to Know about Fibroids after Menopause. www.verywellhealth.com
Anon, (2021) Fibroids and HRT – Menopause Treatment. www.menopausetreatment.co.uk
Yang, C.H. et al, (2002) Effect of Hormone Replacement Therapy on Uterine Fibroids in Post Menopausal Women. www.pubmed.ncbi.nlm.nih.gov
Moro, E. et al, (2019) The Impact of Hormone Replacement Therapy on Post Menopausal Women with Uterine Fibroids. www.ncbi.nlm.nih.gov
Newson, L. (2020) Balance – Fibroids and the Menopause. www.balance-menopause.com
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