Perimenopause and Fibroids Together: Challenging but Manageable

Perimenopause is the transitional phase before menopause.

It typically occurs in individuals in their 40s but can start earlier for some.

Non-cancerous growths in the uterus called Fibroids are most prevalent in the perimenopausal years.

According to NHS, about two in three women will develop at least one fibroid at some point in their life, most commonly between the ages of 30 and 50.

During Perimenopause, the prevalence of Fibroids is high, with 51% of perimenopausal women having ultrasound evidence of Fibroids.

The risk of developing Uterine Fibroids is at its highest during Perimenopause.

This article provides insight into the symptoms, causes, risks, management, etc., of Perimenopause and Fibroids affecting simultaneously.

Fibroids Perimenopause symptoms

Fibroid growth rates increase during the reproductive years, and the symptoms peak during Perimenopause.|

Symptoms of Fibroids during Perimenopause can include:

• Heavy or painful periods
• Abdominal pain or lower back pain
• Frequent urination
• Constipation
• Pain during sex

It is important for women experiencing these fibroid symptoms to consult a doctor, as Fibroids can resemble other conditions, such as Uterine Cancer.

Causes of Uterine Fibroids in premenopause

The specific cause of Fibroids is uncertain, but they have been connected to the ovaries’ production of the hormone Estrogen. 

During Perimenopause, Fibroids may worsen due to fluctuating hormone levels, particularly high Estrogen, which can encourage fibroid growth.

Fibroids typically form in women throughout their reproductive years when Estrogen levels are elevated.

When Estrogen levels are low, like after menopause, when a woman stops having her period every month, they tend to get smaller. 

Women who have children are less likely to get Fibroids.

Fibroids might start to shrink in Perimenopause as Estrogen begins to wane, but this process can take a while.

The number, size, and position of Fibroids within the uterus can affect the severity of symptoms.

Risk factors for developing Fibroids during Perimenopause

The risk factors for developing Uterine Fibroids during Perimenopause include:

• Age: Women are more likely to develop Fibroids as they approach menopause, with the risk peaking in the perimenopausal years
• Estrogen levels: Fibroids are dependent on Estrogen and Progesterone, and their growth is linked to the hormonal fluctuations that occur during Perimenopause
• Family history: A familial predisposition to Fibroids increases the likelihood that a woman will develop them
• Obesity: Obesity is linked to a higher likelihood of developing Fibroids
• No history of pregnancy: Fibroids are more likely to happen to women who have never given birth
• Long-term, extreme stress: Chronic stress may contribute to the development of Fibroids
• African American women: African American women are at a higher risk for Fibroids
• Hypertension: High blood pressure may increase the risk of Fibroids
• Low vitamin D levels: According to certain research, insufficient vitamin D may enhance the risk of Fibroids

Diagnosis of Fibroids during Perimenopause

Fibroids during Perimenopause can be diagnosed through a combination of methods, including:

• Physical examination: A pelvic exam may be conducted by a physician in order to detect irregular uterine shape changes that may suggest the existence of Fibroids
• Imaging studies: Ultrasound, Magnetic Resonance Imaging (MRI), or hysterosalpingography may be used to visualize Fibroids and assess their size and location
• Blood tests: To rule out other conditions and to assess hormonal levels, blood tests may be conducted

Treatment for Fibroids during Perimenopause

Fibroids during Perimenopause cannot be prevented, but managing hormonal balance and maintaining a healthy weight may help reduce symptoms.

Fibroids Treatment during Perimenopause depends on the size and location of the Fibroids, symptom severity, and overall health status. 

They may include:

• Medications: Medications can help control symptoms, including excessive bleeding and pain. Gonadotropin-Releasing Hormone (GnRH) agonists help reduce Fibroids by preventing the generation of Progesterone and Estrogen
• Minimally invasive procedures: Uterine Artery Embolization (UAE) and Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) are procedures that can reduce or eliminate Fibroids
• Surgery: In the worst cases, Fibroids or the uterus may need to be removed through surgery

To find the best course of treatment for Fibroids during Perimenopause, speak with a doctor. 

Hormone Replacement Therapy (HRT) may also be a consideration for women with Fibroids who are experiencing menopausal symptoms and want Fibroids treatment without surgery.

However, this should be discussed with a doctor, as HRT can stimulate fibroid growth.

Complications of untreated Fibroids

The complications of untreated Fibroids during Perimenopause can be significant.

If left untreated, Fibroids can lead to various complications, including:

• Severe menstrual bleeding, which, if left untreated, can result in anemia and potentially endanger an individual’s life
• Abnormal uterine bleeding, which can account for more than 70% of all gynecological consultations in Perimenopause and postmenopausal women
• Pelvic pain and pressure
• Frequent urination and constipation
• Unexplained abdominal pain

These complications can significantly impact a woman’s quality of life and should be addressed promptly.

Waiting for menopause to alleviate the symptoms can lead to worsening of Fibroids and their associated complications.

Lifestyle modifications/alternative therapies for Perimenopause Fibroids

Lifestyle changes that can help manage Fibroids during Perimenopause include:

• Diet: Having a diet with fruits, vegetables, and whole grains but limited in red meat, high-fat, and processed foods may help manage fibroid symptoms. Eat foods for shrinking Fibroids
• Weight management: Maintaining a healthy fat amount and weight can help reduce Estrogen production, which in turn may help in managing fibroid symptoms
• Stress management: While the impact of stress on Fibroids is still being studied, managing stress through relaxation techniques like yoga, massage, and tai chi may be beneficial
• Blood pressure management: There is a strong link between Fibroids and high blood pressure, so managing blood pressure through diet, lifestyle, or medication as advised by a doctor may be helpful

These lifestyle changes, along with regular exercise and some alternative therapies, can contribute to managing fibroid symptoms during Perimenopause.

Alternative therapies for Perimenopause Fibroids may include:

• Acupuncture: It may help reduce fibroid symptoms such as pain and heavy bleeding
• Herbal remedies: Certain herbs such as chasteberry, milk thistle, and turmeric may help manage fibroid symptoms
• Mind-body therapies: Yoga, meditation, and deep breathing exercises may help reduce stress and manage fibroid symptoms
• Massage therapy: It may help reduce pain and discomfort associated with Fibroids

Before you start any new treatment or natural remedies for Fibroids, you should talk to your doctor, especially if you already have a medical problem or are taking medicine for it.

Conclusion

During Perimenopause, the prevalence of Fibroids is high, with 51% of perimenopausal women having ultrasound evidence of Fibroids. 

Symptoms of Fibroids during Perimenopause can include heavy or painful periods, abdominal pain or lower back pain, frequent urination, constipation, and pain during sex. 

Although the precise etiology of Fibroids is unknown, the hormone Estrogen released by the ovaries has been connected to the condition. 

Treatment options for Fibroids during Perimenopause depend on the size and location of the Fibroids, symptom severity, and overall health status.

It may include medications, minimally invasive procedures, or surgery. 

To find the best course of treatment for Fibroids during Perimenopause, speak with a doctor. 

Frequently Asked Questions

• ncbi.nlm.nih.gov
• nhs.uk
• ncbi.nlm.nih.gov