Fibroids are the most common cause of hysterectomy.  But what are they?
Channel: BioBalance Healthcast
Date: 2023-04-17

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog.

The most common cause of hysterectomy in women are benign masses that grow within the uterine wall. They occur in 4 out of 5 women, and they can be small and asymptomatic, or they can grow large and cause pain, uterine bleeding, pelvic pressure, urinary incontinence and pregnancy complications.

Uterine Fibroids are “the most common tumor in women world-wide”.
Although benign, uterine fibroids are associated with significant morbidity; they are the primary indication for hysterectomy, and a major source of gynecologic and reproductive dysfunction, ranging from menorrhagia and pelvic pain to infertility, recurrent miscarriage, and preterm labor. 

Fibroids are also referred to as “leiomyomas”, “myomas”, “fibroid tumors”, and sometimes slangily referred to as “fireballs”.  They are in fact “ball-like” in shape and when we inspect them at hysterectomy, they are made up of swirling muscle cells that are laid down in concentric circles.  
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Gynecologists find fibroids when we examine a patient at their yearly visit by feeling an enlarged irregular uterus.  The fibroids are within the wall of the uterus and often cause heavy uterine bleeding.  Where the fibroids are, within the wall of the uterus, determines whether they are more likely to cause bleeding or not.  Placement up against the uterine cavity (“submucosal”) increases risk of bleeding, and placement in the middle and surface of the uterine wall (“subserosal”) decreases risk of severe bleeding.

At BioBalance Health LLC we require every patient who comes to us who still has a uterus to have a formal abdominal and vaginal ultrasound to diagnose fibroids and other uterine abnormalities,  before we will give them estradiol pellets.  Testosterone doesn’t have a negative effect on fibroids so we can still put a woman on testosterone with fibroids. Otherwise, we have the risk of fibroid growth in our consents, and we discuss this issue when a patient’s ultrasound shows significant fibroids.
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What causes a woman to be more likely to have fibroids during her reproductive years? 
Triggers for Fibroid Development
• Race 
• Genetics/ family history
• Diet
• Early Age at First Period
• Toxins in the environment especially in early life
• Obesity
• Advancing age
• Vitamin D deficiency
• Hypertension
• Pregnancy suppresses the growth of fibroids

 Race: Both Black and Hispanic women are the most likely to develop fibroids and experience enough symptoms to cause the need for a hysterectomy. Black women are 3X as likely as white women to have fibroids, and they are more likely to have very large fibroids. In some circumstances fibroids can prevent pregnancy and cause recurrent miscarriages and preterm labor. 60% of African American women aged 35-49 years reported uterine fibroids, whereas 80% of those aged ≥ 50 have uterine fi-broids.

Genetics/Family History: If a woman has a mother or sister with fibroids, then that woman has twice the risk compared to a woman without a family history of fibroids. “Uterine fibroid-linked mutations in MED12” are the most common mutation we have found, however a mutation in the COMP pathway is also found to be associated with fibroids.
Diet: A diet with high intake of meat, fat and alcohol increases a woman’s risk of developing fibroids.  A diet deficient in fresh fruit and vegetables also increases the risk of fibroid appearance and growth. Smoking is highly associated with fibroid growth.
Early age of Menarche is a risk for developing fibroids, which increases the years a woman is exposed to estrogens.
Toxins from the environment, and from alcohol increases the development of fibroids.  Cleanses might help rid your body of toxins that might methylate your genes and stimulate fibroid growth.
Obesity and Being overweight: Body fat increases the estrone estrogens in the circulation, which stimulates fibroids to grow.  

HRT is only one of the factors that causes growth of fibroids in menopausal women.  If estrogen is balanced with progesterone (not progestins) growth is less likely.  Testosterone has no effect on fibroids so replacing testosterone is not a factor for Fibroid growth. At BioBalance we have medicated pellets that combine Testosterone with Anastrazole which suppress the growth of fibroids.  We use these on our patient who have known fibroids, if they are willing to undergo treatment with this 

Vitamin D deficiency
The role of Vitamin D in development of fibroids is being researched at this time, however an adequate Vitamin D blood level is needed to help prevent Fibroid growth.
“Approximately 80% of African American women have vitamin D deficiency, compared with only 20% of Caucasian women”. This is one of the factors in Race being a factor in the development of fibroids.