Uterine Fibroids after Menopause: Symptoms and Treatment

Uterine Fibroids after Menopause: Symptoms and Treatment | MenopauseCoach.com

According to statistics, 30–35% of women of reproductive age are diagnosed with uterine fibroids. The sizes and number of nodes are different. Often, they are so small that they do not manifest themselves. Many women do not realize that they have fibroids all their lives. Only 30–35% of women with diagnosed myoma have their symptoms. Myomas do not grow until puberty and after menopause.

At the time of menopause, the myoma, if it has not been cured, can manifest itself in different ways, either progressing or, on the contrary, involving. The most common reaction of the second type is regression. This is due to the fact that uterine fibroids after menopause are a hormone-dependent tumor, and during menopause hormone production decreases, which favorably affects the course of fibroids – sometimes even up to its complete resorption. However, this is not always the case. In addition, sometimes, uterine fibroids, before which did not manifest itself in any way, is detected precisely during menopause.

All these conditions require medical supervision, and with the activation of the tumor process and adequate treatment.

Causes of Uterine Fibroids Appearance

Currently, scientists are forced to admit defeat – the causes of myomatous nodes are unknown. There are two main theories, but none of them has strong evidence:

  • Embryonic theory suggests that abnormalities occur during fetal development. The smooth muscle cells of the uterus of the embryo do not finish their development for a long time, until the 38th week of pregnancy, and are in an unstable state (while the smooth muscle cells of the bladder and intestines “mature” already by the 16th week), due to which there is a higher risk occurrence of defects in them.
  • Based on the traumatic theory, a defect in the cells of the myometrium occurs due to repeatedly repeated menstrual cycles, inflammatory processes, abortions, curettage of the uterus, the inaccurate performance of obstetric manual methods during childbirth, and a small number of pregnancies.

The uterine fibroids after menopause nods always arise from a single cell. Due to damage, this cell begins to divide and forms a node.

Uterine fibroids are a disease that no woman is safe. Since the causes of the occurrence are unknown, effective methods of prevention do not exist, except for regular visits to the gynecologist twice a year. The doctor may pay attention to nonspecific signs and schedule an examination.

How to Detect Fibroids after Menopause? Symptoms and Methods of Diagnosis

The medical literature describes many symptoms of fibroids after menopause, but, most often they are talking about three of them:

  • Increased profuse menstrual bleeding
  • Large fibroids can put pressure on the bladder or rectum, leading to impaired urination, problems with stool. 
  • Stomach enlargement. Many women ignore this symptom because they believe that they just gained weight. 

Other possible manifestations: pain in the lower abdomen, lower back, legs, pain during intercourse. Although you need to remember that these signs are nonspecific and can often indicate other diseases

Can Fibroids Grow After Menopause?

Particularly noteworthy are patients with fibroids after menopause. First of all, it should be mentioned that menopause in such cases occurs 1-3 years later than in women without fibroids.

The content of female sex hormones that are produced by the ovaries becomes so low that all proliferative processes normally stop in the body. The menstrual cycle stops, and with it, cyclic hormonal changes. The size of the uterus and ovaries gradually decreases, the endometrium (mucous membrane) of the uterus becomes thinner and does not grow.

Along with the processes of “extinction” of the ovaries, uterine fibroids after menopause decrease and disappear. Risk factors for the absence of a decrease in fibroids after menopause are the presence of ovarian cysts and endometrial hyperplasia. If uterine fibroids do not regress to postmenopause and the first 1-2 years of postmenopause, then its further existence is accompanied by the risk of endometrial cancer, ovarian cancer, and uterine sarcoma!

Symptoms of Fibroids after Menopause

The main clinical manifestations of non-regressing (non-decreasing) uterine fibroids after menopause are as follows:

  • late onset of menopause (later 50-51 years);
  • spotting from the uterus;
  • lack of regression of uterine fibroids in the first 1-2 years of postmenopause;
  • endometrial pathology (endometrial hyperplasia, endometrial polyp, recurrent endometrial hyperplasia);
  • ovarian pathology (cysts and ovarian cystoma, cystic changes);
  • chronic anemia (decreased hemoglobin) in the absence of pathology of other organs and systems.

The following patients with uterine fibroids after menopause should cause oncological alertness:

  1. Women with increased ovarian size (in the first 5 years of menopause, their size decreases by 15-20%, after 10 years – by 30-35%. By 60-70 years, by 50% of the initial size);
  2. Patients with uterine myoma in postmenopause who are at risk are subject to mandatory surgical treatment (usually laparoscopic access for the removal of the uterus) to prevent the development of cancer of the female genital area.
  3. Women entering menopause:
  • with large sizes of myomatous nodes;
  • with submucous localization of uterine fibroids;
  • with recurrent and atypical endometrial hyperplasia;
  • with a combination of uterine fibroids and adenomyosis (internal endometriosis);
  • with the severe neuroendocrine syndrome (obesity, diabetes mellitus, arterial hypertension);
  • in the absence of regression of uterine fibroids after menopause against the background of age-related extinction of ovarian function.

In addition, the likelihood of activation of fibroids with menopause is increased in those women whose family history has had cases of this pathology. This is important to consider when treating uterine fibroids.

FAQ

What are uterine fibroids?

Uterine fibroids are a chronic multifactorial disease in which nodes consisting of smooth muscle cells are formed in the wall of the uterus with unpredictable growth dynamics. It is found in many women, is not life-threatening, but can lead to unpleasant symptoms.

What causes uterine fibroids to grow after menopause?

Possible causes of fibroids after menopause growth are ovarian cysts and endometrial hyperplasia. If uterine fibroids do not regress before postmenopause and the first 1-2 years of postmenopause, then it is associated with a risk of endometrial cancer appearance.

Can fibroids cause bleeding after menopause?

A benign tumor (myoma) leads to a significant decrease in the contractile function of the uterine muscles. Typically, myoma increases in the premenopausal period and stops growth in menopause. If this does not happen and is also accompanied by bleeding, a woman needs medical help.

What happens to fibroids after menopause?

In the postmenopausal period, fibroids significantly decrease in size or dissolve completely in connection with the cessation of estrogen production, typically.

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Uterine Fibroids after Menopause: Symptoms and Treatment
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Dr.Ruth Westheimer

An American sex therapist, media personality, author, radio, television talk show host, and Holocaust survivor.

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