Fibroids and menopause: what you need to know

Science is not yet clear on why and how uterine fibroids develop. We know that they occur most often in women between 30 and 50 years old. They are also extremely common: up to four out of five women have fibroids, although most have no symptoms. 

We also known that oestrogen and progesterone promote the growth of fibroids. Especially if oestrogen levels are too high, it can lead to fibroid development and growth.  

During the menopausal transition your hormones fluctuate, which can lead to fibroid growth. You are especially at risk in the years leading up to menopause (perimenopause), when progesterone levels drop faster than oestrogen levels, leading to oestrogen dominance: increased oestrogen levels relative to progesterone levels in the body. 

Hormonal changes can also trigger a variety of menopausal symptoms, such as hot flashes, sleep problems and mood swings. 

There are also other factors besides hormones that can contribute to the development of fibroids. Heredity can play a role: women with relatives with fibroids have an increased risk of developing them. Lifestyle factors, such as diet and stress, also influence your hormone levels and can lead to oestrogen dominance which, in turn, can influence the formation of fibroids. Untreated high blood pressure and obesity are risk factors, too. Some forms of HRT, particularly those containing oestrogen, can cause fibroids to grow in size.  

Many women are unaware they have fibroids because they do not have any symptoms. Uterine fibroids are often found by chance during a routine pelvic exam. This means the presence of fibroids may go unnoticed for years.  

However, if you have a large fibroid or many fibroids, you are likely to have uncomfortable symptoms. You may experience: 

• Heavy or long periods 
• Painful periods 
• Bleeding in between menstrual periods  
• Pain during sex 
• Increased need to urinate (bladder pressure) 
• Lower back or pelvic pain 
• Gastrointestinal symptoms, stabbing abdominal pain 
• Infertility or recurrent miscarriages 

Good to know: unusually heavy or prolonged menstrual bleeding is the most common symptom of fibroids, but this connection is not always observed. Therefore, it’s very important to have yourself examined as soon as possible in order to find what is causing your symptoms so that you can get the right treatment. 

Fibroids most often appear when you're of childbearing age – generally from the age of 30. It is estimated that 70 to 80 percent of women develop one or more fibroids at some point in their fertile years.  

Research shows that fibroids thrive on excess oestrogen, which is why they frequently develop in women in perimenopause, especially when oestrogen levels are elevated relative to progesterone. 

While all women are at risk for developing uterine fibroids, studies confirm that Black women of African descent are disproportionately affected. Fibroids also develop at earlier ages and are larger in Black women of African ancestry. 

After menopause, fibroids tend to shrink in size due to lower oestrogen levels. However, they can still be an issue, leading to pain and unusual bleeding. If you have gone through menopause and are experiencing symptoms, you should see your GP. 

The exact cause of uterine fibroids isn't clear, which makes prevention more difficult. However, you can reduce the risk of fibroid development, growth and complications by taking good care of yourself and supporting your hormonal balance. A healthy diet and sufficient exercise and rest are more important than ever during this stage of your life. Find out what you can do to support your health (and thereby your hormonal balance). 

In addition to a healthy diet and lifestyle, supplements can play a crucial role in supporting menopausal health. Make sure your diet includes extra Vitamin D, magnesium and omega-3 fatty acids. Many women also benefit from a high-quality multivitamin and mineral complex. Have you just started taking supplements? Remember that supplements usually take about three months before any change is noticeable. 

If fibroid symptoms don't improve with medication or are severe, then surgery to remove your fibroid may be considered. It can be comforting to know that surgery can reduce or relieve your symptoms. While fibroids do not regrow after surgery, new fibroids (and thus fibroid symptoms) may develop. Therefore, it is important to keep taking care of yourself to reduce the risk of recurrence.