Although fibroids often develop in childbearing age, they can persist during and after menopause. Although it is rare, some begin to experience this condition when they reach this stage.
Menopause is a period in a woman’s life characterized by a series of changes. The ovaries lose their function due to the exhaustion of their follicles, and, consequently, the production of female hormones decreases.
This hormonal disturbance not only causes typical symptoms such as hot flashes but also leads to other health risks. This time we will see what fibroids are and why they persist in menopause.
What is menopause?
Menopause is the time when a woman stops having her menstrual cycles. Its diagnosis is made retrospectively, after having experienced 12 months without menstruation, and as long as there are no other causes that justify the lack of cycles.
On average, the starting age of this stage is around 51 years and 4 months. However, it can also occur from 45 to 55 years old. In particular, menstrual periods become less frequent for a few months and then stop completely.
What are fibroids?
Fibroids, also called fibroids or leiomyomas, are the most common non-cancerous pelvic tumors in women. Its prevalence (the number of existing cases) increases with age. According to information in the Menopause magazine, between 70% and 80% of women will develop this condition at some point in their lives.
They arise from the uterus walls, more specifically, from the smooth muscle cells and fibroblasts of the myometrium (intermediate layer of the uterus). Its size is variable; however, it generally does not cause symptoms and does not require treatment either.
Many women are unaware that they have this condition and only detect it when they consult for another reason. When there are symptoms, these can include abnormal uterine bleeding, pelvic pain, and inflammation, among others. In the fertile stage, the presence of fibroids has reproductive effects, such as infertility or miscarriages.
Why are fibroids formed?
To date, scientists and doctors have been unable to determine the exact cause of this condition.
However, female hormones are known to influence their formation. As we have commented, its development is more frequent in women’s reproductive years, when hormonal activity is at its highest point.
In turn, there are other risk factors, such as the following:
- Nulliparity (when a woman has not had children).
- Early menarche (first menstruation).
- Increased frequency of menses.
- History of dysmenorrhea (difficult and painful menstruation).
- A family story of uterine fibroids.
- African descent.
- Clinical conditions like hypertension and diabetes.
What happens to fibroids in menopause?
At menopause, menstrual cyclicity stops, levels of female hormones decrease, and there is a cessation of the abnormal symptoms of uterine bleeding associated with fibroids.
Most, but not all, women have fibroid shrinkage at menopause. In other words, they tend to shrink in size when hormone levels are lower.
In turn, hormone replacement therapy (HRT), which is used to treat some of the menopause symptoms, appears to influence fibroids. For this reason, its use in patients with this disease is still debated.
This type of therapy is believed to influence many women with fibroids to continue to have symptoms after menopause. The risk of symptoms may depend, in part, on the location of the fibroid and the type of hormone replacement therapy administered.
However, a relationship was found between this therapy and growth of fibroids, but without clinical symptoms. The latest published studies indicate that fibroids’ presence does not represent an absolute contraindication for the use of postmenopausal hormone therapy.
Despite this, experts agree on the need for patients to be examined periodically to determine if their fibroids are increasing in size. If so, the advice is to stop treatment.
What to do with fibroids in menopause?
Many factors will be considered when deciding on a treatment plan for this condition during this stage. Some of these factors include, for example:
- Age of the woman.
- Symptoms you are experiencing.
On many occasions, watchful waiting will be chosen due to fibroids’ tendency to shrink or disappear after menopause. However, it is always important to consult your doctor or gynecologist regularly to see your progress.