Do fibroids go away at menopause?

Written by christine lebednik
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Uterine fibroids, benign tumours that occur within the female uterus, affect between 20 and 80 per cent of women by the age of 50. Clinicians have observed that in some menopausal women uterine fibroids tend to shrink and often ultimately disappear. Post-menopausal fibroids do occur, however. In terms of the status of post-menopausal fibroid occurrence, several factors enter into predicting the likelihood of post-menopausal shrinkage and/or disappearance of uterine fibroids. Those factors include: possible causes of fibroids, the typical life cycle of fibroids, effects of hormone-replacement therapy (HRT), the possible role of progesterone in menopausal and post-menopausal women with fibroids and the general prospects with reference to post-menopausal fibroid occurrence.

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Causes of Fibroids

Medical experts do not know what actually causes uterine fibroids. However, they do know that fibroids are affected by levels of female hormones. Recently, some practitioners have proposed the idea that an excess of the female hormone oestrogen (also known as oestrogen dominance) is a key factor in causing fibroids. Some researchers contend that oestrogen dominance may be the root cause of fibroids. Some clinicians, based on this idea, are trying new treatment protocols for patients with uterine fibroids.

Life Cycle of Fibroids

Fibroids appear most often in women between the ages of 30 and the onset of menopause; they do less commonly occur in women in their 20s and in older women. The typical life cycle of uterine fibroids is to gradually enlarge in size from first occurrence on through menopause and then to shrink in many, but not all instances, in post-menopausal women.

Menopause and HRT: Effects on Fibroids

For women who enter menopausal years with existing uterine fibroids, generally the fibroids will shrink and often ultimately disappear over time. However, another key factor comes into play in menopausal and post-menopausal women. That factor is whether the woman is using conventional HRT. The overall effect of HRT is to continue oestrogen dominance, which in turn maintains conditions under which uterine fibroids thrive. Generally, therefore, for menopausal and post-menopausal women who are not using HRT, they can expect a probability (but not a certainty) that their uterine fibroids will shrink and likely eventually disappear, but this is much less likely for menopausal and post-menopausal women using HRT.

Use of Progesterone in Treating Menopausal or Post-Menopausal Fibroids

As the new idea that oestrogen dominance is a factor in the existence and possibly a root cause of uterine fibroids gains acceptance alternative treatments may help counteract the fibroid-related effects of conventional HRT. A proposed means of alleviating the fibroid-related effects of traditional treatments is the use of natural progesterone to help create conditions likely to promote shrinkage of uterine fibroids. Although the protocol of counteracting oestrogen-dominance effects with reference to uterine fibroids with intake of natural progesterone is too recent a practice to demonstrate sufficient evidence for a conclusive determination, initial results show considerable promise in promoting conditions even in women using HRT that support the shrinkage of uterine fibroids.

Post-Menopausal Fibroid Occurrence

While it is relatively rare, development of uterine fibroids in post-menopausal women with no pre-existing fibroids does occur. Because the development of new fibroids in post-menopausal women is rare, little information is available on this aspect of the fibroid phenomenon. Some experts do suggest that hormonal ratios, rather than simply the volume of oestrogen itself, plays a role and that environmental influences such as pesticide and auto-exhaust fumes can disrupt the normal hormonal balances thus leading to the development of fibroids in women of any post-puberty age.

Conclusion

Fibroids do not 'go away' at menopause and do not always disappear in post-menopausal women. However, in the absence of HRT treatment or with a progesterone addition to the treatment protocol, there is a high likelihood that fibroids will at least shrink and possibly disappear in most women with pre-existing fibroids at the time of menopause.

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