Do fibroids change during or after menopause?

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Some call it The Change, The Big M or even Grand Climacteric. Menopause is a part of life for all of womankind. Typically beginning between the ages of 45-55, cessation of monthly periods has its advantages and disadvantages. Over the course of 7-15 years, levels of the hormones estrogen and progesterone vary greatly.  

Menopause is preceded by a perimenopause, with perimenopause divided into two stages. 

Early stage – Variability in length of menstrual cycle 

Late stage – Over 60 days elapse between periods 

Women detect perimenopausal symptoms at any point between 30-50 years of age, though most will be toward the latter end of that range. Symptoms include: 

  • Irregular periods that may be longer, shorter, or heavier than in the past  
  • Hot flashes 
  • Insomnia 
  • Fatigue (may be caused by anemia due to heavier than normal blood loss during menstruation)  
  • Night sweats 
  • Vaginal dryness 

So while these symptoms are unpleasant in themselves, let’s see how this period in life and the changes that come with it affect the formation and growth of fibroids. 

Concerning the early stage, we see a study with over 30% of newly diagnosed fibroids being between the ages of 45-49. This is a peak in diagnoses which then declines following the late stage of menopause.  

Fibroids consume more estrogen and progesterone as opposed to other tissues in that general area. Recent findings have shown that estrogen increases the expression of progesterone receptors, and for whatever reason, are drawn to certain tissues, including uterine fibroids. One would think that hormone production changes would affect the presence and growth of uterine fibroids. Unfortunately, the situation isn’t always that simple.  

While some fibroids do respond to lower hormone levels by shrinking, other women aren’t as lucky. Risk factors that increase the possibility of having fibroids during and after menopause include: 

  • High blood pressure 
  • Vitamin D deficiency 
  • Obesity 
  • Elevated stress 
  • Family history of fibroids 
  • No history of pregnancy 
  • African heritage 

Additionally, women who take Hormone Replacement Therapy (HRT) following menopause may well have at least as many fibroid issues as they had before menopause, owing to the hormones being taken synthetically.  

Treatment options 

Treatment options for women in perimenopause and for women who have reached menopause are very similar to those for younger women [link to older post listing treatment options here]. The only difference being that the watch-and-wait period option may be taken more seriously because after all, there is a higher chance that the fibroids will shrink at this stage in life than there was earlier.  

The best plan — no matter which option you feel suits your own priorities and lifestyle – is to consult your doctor, test what needs testing when instructed, and act as your own educated health advocate. Fibroid treatment is almost always ongoing to some extent, necessitating that the patient feel comfortable and confident with her doctor. Choose carefully [link to post about choosing a doctor here] and let that confidence help you feel more confident that you’re doing the best you can to feel better.