Health Mastery Q&A with Dr. Dave

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Q: Dr. Dave, I have been trying to get pregnant for 2 years now. I saw a doctor who said that I have fibroids and that the fibroids may be the reason I haven%uFFFDt conceived. What are fibroids? Is there hope for me?

Health Mastery Q&A with Dr. Dave

Q: Dr. Dave, I have been trying to get pregnant for 2 years now. I saw a doctor who said that I have fibroids and that the fibroids may be the reason I haven%uFFFDt conceived. What are fibroids? Is there hope for me? Prayin2BMom

A: Prayin2BMom, I understand your anguish about this, and believe me, you are not alone. But there may be hope.

Let%uFFFDs talk about fibroids. Fibroid, or fibroid uterus, is the name given to a non-cancerous growth in the muscle layer of the uterus (The uterus (womb) is lined with extremely powerful muscle).

Fibroids are very common, especially in Black women. It is estimated that about 25% of all reproductive age women have them. This number is much higher for Black women. For most women, fibroids are benign and generally not problematic. It is important to understand that there is no increased risk of uterine cancer in women who develop fibroids. Most fibroids are found incidentally during routine annual pelvic examination%uFFFDwhich every woman should have. Overtime, in response to estrogen and other female hormones, these growths tend to get larger. But most fibroids eventually regress%uFFFDalmost certainly by the time of menopause, since the source of estrogen wanes at this time. Problems start when a woman develops symptoms.

COMMON SYMPTOMS ASSOCIATED WITH FIBROIDS:

1. Lower abdominal/pelvic and back pain: ranging from mild to severe debilitating pain

2. Blood loss/anemia: due to prolonged menstrual (or even non-menstrual) bleeding

3. Constipation- due to the fibroid growth pushing against the intestines, preventing normal bowel movements.

4. Frequent urination, unstable bladder and/or kidney damage- caused by the fibroid growth pushing against the urinary bladder causing retention of urine.

5. *Infertility- caused by the fibroid growth preventing implantation of a fertilized egg (see picture)

* As you can tell from the picture, if a fibroid happens to grow inside layer of the uterine wall, it can prevent implantation of a fertilized egg. These fibroids often have to be treated in order to aid full term pregnancy. Keep in mind that just because you have pain from the fibroid tumors doesn’t mean you will necessarily have trouble becoming pregnant. Only your doctor can tell with special imaging tests, like an ultrasound, if a fibroid threatens a successful full-term pregnancy.

TREATMENT STRATEGIES: The treatments for fibroids vary from medications, ranging from hormonal therapy to surgical procedures. The best treatment strategy often depends on the presence or absence of symptoms, severity of symptoms and the desire to become pregnant. For those who have no symptoms, treatment may not be necessary. In women who wish to become pregnant, one option is a myectomy (pronounced m%u012B-%u02C8ek-t%u0259-m%u0113), which entails removal of the fibroids without removing the uterus or ovaries. A newer procedure is called uterine artery embolization (UAE) in which the blood supply to the fibroid is cut off, causing it to shrink. In many cases, a myectomy or UAE can resolve fertility issues.

In women who do not wish to become pregnant and/or have severe symptoms, another option is hysterectomy where the entire uterus is surgically removed. Prayin2BMom , since you have attempted unsuccessfully to become pregnant, you should have an in depth conversation with your gynecologist and a high-risk obstetric specialist about the treatment options and which is right for you. There IS hope. I am praying with you.

Master your health, Dr. Dave

Dave Montgomery, MD, PhD is Senior Fellow in Cardiology at Northwestern University and a sought after Speaker and Health Coach. http://davemontgomerymd.com

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