How Uterine Fibroids Affect Fertility and What To Do With Them

Fibroids are benign tumours that originate from the smooth muscle layer of the uterus and its accompanying connective tissue. They are the most common benign tumours found in females and are typically found during the middle and later reproductive years.

Most of these fibroids are asymptomatic, although continuous growth may cause heavy and painful menstruation, painful sexual intercourse, and urinary frequency and urgency. Although rare, these fibroids may also interfere with pregnancy because of the blockages which may result from the growth.

What causes the growth of fibroids?

The growth of fibroids during pregnancy still remains a mystery but a genetic predisposition may have a role. Fibroid growth seems to run in families; and women of African descent are two to three times more likely to develop uterine fibroids than any other races.

Estrogen, which is produced naturally in the body, seems to stimulate the growth of fibroids. These growths can show up as early as 20 years old and may later shrink towards menopause or when the body stops producing estrogen. Several other factors may contribute to the growth of fibroids and these include being overweight, never having any children or nulliparity, onset of menstrual period before the age of 10, and women of African descent.

Fibroids and Fertility

Fibroids that change the shape of the uterine cavity or are within the cavity decrease fertility by about 70%. Other than this, fibroids may also cause some inflammation in the surrounding tissues and decrease blood supply. It is best to seek advice from your doctor in order to discuss options and possible alternatives in order to manage this problem.

What are the signs and symptoms of uterine fibroids?

When women do experience signs and symptoms, the most common is irregular vaginal bleeding or an increase in vaginal bleeding with the presence of blood clots. The fibroid may also grow big enough to cause pressure on the urinary bladder and rectum which may cause a sense of urgency in urinating or even constipation. This may also result to abdominal pain, having a feeling of bloatedness, increase in the size of the waist, and a change in abdominal contour.

What examinations determine the presence of fibroids?

An abdominal, transvaginal or pelvic ultrasound can help identify the number, size, shape of most fibroids. This is a procedure in which high-frequency sound waves create images of the pelvic organs. Ultrasound has the ability to detect the size and shape of the pelvic organs, such as the bladder, the uterus, ovaries, cervix and vagina. It can also detect inflammation, free-fluid, cysts and tumors inside the pelvic cavity.

An endometrial biopsy is performed by taking a tissue sample from the uterus. It is used to assess changes in the tissue and look for signs of malignancy.

A hysteroscopy looks at the uterine uterus by passing a small fiberoptic camera into the cervix.

Hysterosalpingography involves the use of a dye which is injected into the uterus and fallopian tubes in order to view the uterine structures through the use of an xray.

How are fibroids treated?

Treatment of fibroids depend on the size, shape, location, age of the woman, as well as the couple’s desire to have any children. In most cases, treatment in not necessary especially if the woman has no symptoms. If no malignancy is found, bleeding can be managed by hormonal therapy. However, a procedure known as dilation and curettage may be performed if the abnormal vaginal bleeding caused by fibroids needs surgical scraping.

The woman’s doctor may need to constantly check upon the tumor in order to monitor if it continues to grow over time and to make sure that no malignancy occurs. Pelvic examinations may be done every 6 month, although this may not be necessary.

Myomectomy is the surgical removal of fibroids only. Hysterectomy involves the surgical removal of the uterus as well as the fibroids. Hysterectomy with the removal of fallopian tubes and ovaries may be indicated if a suspicion of cancer or if ovarian masses are present.

An innovative approach to uterine fibroids and pregnancy comes in the form of uterine artery embolization, or clotting of the arterial blood supply to the fibroid. This procedure is done using a catheter which is inserted into the femoral artery then clotting the artery tiny plastic or gelatine sponge particles the size of grains of sand. This material blocks blood flow to the fibroid and shrinks it. However, this method is only good for women who have used other methods which did not work for them or for those who do not wish to undergo surgery

How do I prevent the growth of uterine fibroids?

Women should watch their weight and avoid gaining it by the age of 18. Body weight tends to increase estrogen production, thus increasing the chances of a fibroid growth. Exercise, along with proper diet are important in order to maintain a normal weigh which is proportional to her height.

Tobacco use should be stopped in order to improve the general health and well-being of the woman’s body.

Avoidance of meats, other than salmon, mackerel, tuna and cold-water fish which actually help reduce inflamed tissues and fibroid irritation is advised. Eat a diet of fruits and vegetables which are naturally high in fiber and digestive enzymes which help eliminate fibrin in the body.

Reducing estrogen in the body can also help in limiting fibroids. This is done by stopping intake of hormone replacement pills, birth control pills and spermicides.

Stress can deplete progesterone in the body and lead to surges in estrogen. Practice relaxation techniques such as meditation, yoga or exercise in order to do this.

In order to help eliminate toxins and excess fat in the body, drink at least two teaspoons of apple cider vinegar mixed with 8-oz water once daily.

Fibroids and Traditional Chinese Medicine

TCM treat fibroids during pregnancy more gently and at times, more effectively. According to TCM, fibroids are caused by static blood flow. Therefore, steps in order to help soothe and eliminate fibroids include wearing of loose, comfortable clothing and taking warm baths. Lemon and lime are believed to correct static blood and therefore should be taken.

Uterine fibroids may or may not affect fertility. It usually depends on the growth and location, but for couples who are experiencing infertility due to this problem, it is best to seek the professional advice of your doctor.