TALKING ABOUT FIBROIDS
My Weekly’s favourite GP from TV and radio writes for you
Today we’re talking ladies’ bits – and you may believe you needn’t read on if you’re past menopause. But while fibroids and endometriosis usually get less troublesome after the change, there are exceptions.
Fibroids are non-cancerous growths of the muscle that lines your womb. They can be the size of a pea or a football. You can have one or several, of multiple sizes.
They’re very common – as many as 1 in 3 women get them at some point. They depend on hormones to grow, so they’re most common from the age of 30 to 50. After the menopause they usually shrink. They often run in families and are more common among women of Afro-Caribbean descent.
Lots of us have fibroids without knowing it – sometimes they’re found when you’re having a scan of your womb for another reason. However they can cause heavy, painful periods – I’ve seen women with anaemia so severe they can hardly function. They don’t tend to affect how regular your periods are, but they can lead to bloating, needing to pass water more often or pain when you make love. Problems with getting pregnant due to fibroids are rare. Sometimes no treatment is needed. Painkillers or tablets to lighten your periods are an option for smaller fibroids. For large ones causing severe symptoms there are medicines that act to block the female hormones in your body. These can either be used to shrink fibroids before surgery, or instead of surgery. In days gone by, hysterectomy was the only surgical
AVOIDING TRIGGERS LIKE SPICY FOOD, ALCOHOL, CAFFEINE AND SMOKING MAY HELP WITH HOT FLUSHES AROUND THE MENOPAUSE
procedure; now there are less invasive alternatives.
After the menopause, heavy periods due to fibroids aren’t usually an issue. However, if you’re taking HRT, the oestrogen and progesterone can “feed” the fibroid. This can mean you still have bloating and troublesome periods. Ask your GP for options.
Endometriosis is a condition where endometrium (tissue lining your womb, usually shed when you have a period), ends up in other parts of your body – usually in your pelvis, around the outside of your womb or ovaries. However, it can grow on the outside of your bladder or lower bowel and can end up sticking bits of these organs to each other.
Because endometriosis can affect so many parts of your tummy, it causes a wide array of symptoms – painful periods (pain usually starting a few days before); pain in the pelvis, lower tummy or lower back; bleeding between periods; problems getting pregnant; or pain on going to the toilet. These can range from mild to seriously disabling.
We don’t know exactly why endometriosis happens or how many women get it. It’s often mistaken for other problems – partly as some women suffer in silence and partly because traditional scans aren’t too accurate at picking it up. Doctors used to think endometriosis went away on its own after the menopause, when your hormone levels drop. We now know that’s not always the case. It’s not common but may be more likely if you take HRT.
Some women breeze through the menopause, but about 4 in 5 get hot flushes and night sweats. If you have endometriosis or fibroids, you may want to avoid HRT. There are lots of alternative treatments but look for the “Traditional Herbal Remedies” logo that means they’re safe. Consider black cohosh (like Menoherb) or red clover isoflavone (like Promensil). Next week: Living with Dementia
OESTROGEN CREAMS OR PESSARIES CAN HELP WITH VAGINAL DRYNESS – THE DOSE IS SO SMALL THEY’RE UNLIKELY TO AFFECT FIBROIDS OR ENDOMETRIOSIS