Until my doctor told me that there was a mass the size of a 22-week-old pregnancy in my pelvic area, I’d never heard of a fibroid. According to the National Uterine Fibroid Foundation (NUFF), possibly 80% of all women have uterine fibroids. <!--more-->Most of them don’t know it. Fibroids are muscle cells that grow within the uterus wall, or sometimes on the outside—regular cells that turn into fibroid mass. They can be as small as a 1cm and grow as large as a grapefruit; 40 lbs. is not unheard of, and there was one of 140lbs. They can be a single mass or a cluster of cells. Fibroids are usually diagnosed by a woman’s doctor doing a routine pelvic exam. Although fibroids can affect any woman

of childbearing years, black women get them 3 times more than white women. There is really no known cause for fibroids, although overweight women are more likely to develop fibroids than thinner women. Too much estrogen may also play a part in why women develop fibroids. Women who have had children have less chance. It may be hereditary. Whatever the cause of fibroids, they are always benign, never lead to cancer, and never increase a woman’s risk for cancer. Most women do not know that they have fibroids as, sometimes, they have no symptoms. In my case, the symptoms were present, and I chalked it up to something or other. I got used to feeling unwell that I didn’t know my pain was more than the monthly menstrual blahs. The first thing I noticed was a change in my waistline, a full feeling in the abdomen, and the actual presence of a mass in my pelvic area. I have most of the symptoms of fibroids: -full feeling in the abdomen -pain in the abdomen -frequent urination -heavy periods; periods lasting more than 5 days -low backache. -painful sexual intercourse These symptoms worsen during menstruation, but again most women complain of that, and so I felt a little guilty complaining that my pain felt so much worse. They are discomforts that I have learned to live with. On a daily basis, the most persistent symptom is the low back ache. After the initial diagnosis, my doctor sent me for a pelvic ultra sound. Most pelvic tumors are fibroid. The results came back with: “a massive fibroid, and possibly a second one behind it as there is a shadow.” I lovingly call them “my twins”. He thinks that it is best to just leave them alone if they don’t create any problems. But, I argued the quality of life in living with low back pain and the heavy periods—all of which I learned to tolerate before I knew of the fibroids. For the slight discomforts, over the counter pain killers can be taken. But, the consensus seems to be that fibroids may not have to be removed if you have non symptomatic fibroids or non-severe symptoms. From all the reading I have done, you should only consider removing them if the fibroids are so large that they may result in fertility problems, miscarriage, obstruction of nearby organs, or severe pain. The fibroid pushing against the bladder causes backache or against the kidney could cause problems. Each woman’s fibroid is different. Some can grow stem-like, and they can twist around each other and cause pain. Treatment depends on the size and location of the fibroid. My doctor is one of those physicians who prefer the “watchful waiting” attitude where with regular check ups the fibroid is monitored. Although there are other options for women with large fibroids, I find most of them to be limited. There are new treatments touted as non-surgical breakthroughs in fibroid treatment, but as with any new procedure, it is too soon to know the lasting effects: -Embolization—by inserting a catheter with particles into the fibroid, and blocking the blood to the fibroid so they shrink without destroying the uterus. -Myolysis— performed with a laparoscope, or laser to cut off the blood to the fibroid replacing it with scar tissue. Standard treatments for fibroids are: -Hormonal Drugs—may help to shrink the fibroids, but they almost always grow back once one stops taking the drugs; menopausal drugs that help shrink the fibroid, but can result in hot flashes and sexual side-effects -Myomectomy—which removes only the fibroid while leaving the healthy tissue of the uterus. There are several ways of performing this surgery, as with small incisions, abdominal, or through the cervix -Hysterectomy would be the last resort if the fibroid is large as this surgery removes the uterus. It used to be that the answer to fibroids was hysterectomy—removal of the uterus. Although I don’t want children, I wonder about the psychological or physical effects of having a hysterectomy as with any major surgery, there are side effects. According to (Nuff), only 1 in 4 of women with fibroids needs treatment for severe symptoms, and yet, 37% of all women have had a hysterectomy by age 60. The National Uterine Fibroid Foundation website states that every 10 minutes, 12 hysterectomies are performed in the United States and in ‘…a recent report published by Obstetrics and Gynecology, 9 of them probably didn't meet the guidelines set out by the American College of Obstetricians &amp; Gynecologists for hysterectomy.’ When I told the women at work about my fibroids, 2 out of 5 said that they’d had hysterectomies because of fibroids, and nearly all have known women who have had hysterectomies because of the disease. I find it startling that so many had hysterectomies when the new attitude is that it should be a last resort and only for large fibroids. While some women will require hysterectomies for severe symptoms, I am not sure that it is the procedure for me. Every woman must weigh her own options based upon her own situation. The option that seems more suitable for me would be to take the drugs to reduce the size of the fibroid, and then have it removed through an incision or abdominal cut (Myomectomy). But, this may not even work, new fibroids may grow, and I worry about the side effects of the hormonal or menopausal drugs. At this point, I haven’t made any decisions about treatment. I am sure whatever decision I make will lie somewhere between recommendations from my gynecologist, and the information I get from my own research. If it comes to it, I may well end up getting a hysterectomy, but for now, I am still weighing the options to see what is right for me. Sincerely Gale Prince