Military Officer - March 2008 - (Page 48) askthedoctor Uterine Fibroids Though these benign tumors often have no symptoms and go unnoticed, they sometimes cause troublesome complications and can affect fertility. By Rear Adm. Joyce Johnson, D.O. U Time Heals Some Fibroids ■ The hormonal changes that occur during menopause generally shrink uterine fibroids, easing unpleasant symptoms. terine fibroids, also known as leiomyomas, or “muscle tumors,” are actually tumor growths of muscle tissue. The uterus is made of mucle so that, during childbirth, it can contract and push a baby out. Uterine fibroid tumors almost always are benign and very rarely become cancerous. About a third of women over age 30 have uterine fibroids; no one knows what causes them. They are most common in women of childbearing age, and they generally shrink after menopause, in response to hormonal changes. They are more common in African-American women than in most other ethnic groups. Women who are overweight are slightly more apt to develop uterine fibroids, and fibroids also are more common in women who have never had children. Uterine fibroids can range in size from microscopic to weighing several pounds. They tend to grow slowly under the uterine lining, between the uterine muscles, or on the outside of the uterus. Their size and location can interfere with fertility and also can cause complications during pregnancy. Uterine fibroids also cause other complications that can be troublesome: heavy vaginal bleeding, pain, and a feeling of fullness. Severe bleeding can result in anemia. Pain caused by uterine fibroids generally responds to over-the-counter medication. Feeling full — because of the size and weight of a tumor — might only be resolved by medically shrinking or surgically removing uterine fibroids. Large uterine fibroids also can press on the bladder, causing frequent urination. Uterine fibroids generally are discovered during investigation of these symptoms or during a routine gynecologic exam. If a health care provider suspects a patient has uterine fibroids, evaluation might include ultrasound or other imaging techniques. Laparoscopy or hysteroscopy — surgical procedures involving a scope for visualization — might be needed to confirm a diagnosis. Treatment varies with the symptoms, the size of fibroids, and the patient’s age and plans for future pregnancies. If there are no symptoms, treatment rarely is needed. If a woman does not intend to become pregnant in the future, a hysterectomy (removal of the entire uterus containing the fibroids) is a common treatment. Another, newer treatment option is UAE (uterine artery embolization), which attempts to shrink fibroids by blocking their blood supply. For women who hope to become pregnant in future, a myomectomy can be performed. This procedure surgically removes just the fibroids, leaving the uterus intact. Various types of hormonal therapy also can be used, especially to reduce severe bleeding. However, once hormonal treatment is stopped, problems will recur. MO — Rear Adm. Joyce Johnson, USPHS-Ret., D.O., M.A., is vice president, Health Sciences, Battelle Memorial Institute, Arlington, Va. Find more health and wellness resources at www .moaa.org/wellness. For submission information, see page 18. PHOTO: STEVE BARRETT 48 MILITARY OFFICER MARCH 2008 http://www.moaa.org/wellness http://www.moaa.org/wellness
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