Heavy bleeding due to uterine fibroids, in the first stage of menopause (perimenopause), may occur due to fluctuating levels of the hormone estrogen, but fibroids are rare in menopause and post-menopause. The more common reasons for heavy bleeding in menopause are dysfunctional uterine bleeding (unexplained bleeding), uterine hyperplasia (overgrowth of the uterine lining, which mainly happens to women taking replacement estrogen), and uterine atrophy (over-thinning of the uterine lining). All bleeding in menopause is abnormal, and should be investigated by your physician at once.
What Are Uterine Fibroids?
Endometrial fibroids, or uterine fibroids, are benign growths that form in the endometrial walls. According to Medline Plus, fibroids can be found in one of every five women in their reproductive years. They are more prevalent in African-American women and women over the age of 30. Uterine fibroids grow gradually and start to shrink around the time of menopause. These fibroids vary in number and size.
Symptoms
Symptoms of uterine fibroids are bloating, flatulence, urinary frequency, pelvic cramping, fullness or pressure in the lower abdomen and sudden severe pain. Symptoms also include blood clots and heavy bleeding. This bleeding can be experienced before and during menopause, and can vary in volume from light to heavy. Not all women experience symptoms with uterine fibroids, and some menopausal women don't know they have them until they have already begun shrinking from the decline in estrogen.
Causes of Uterine Fibroids During Menopause
The causes of uterine fibroids are unknown, but research has led to the discovery of a possible trigger, which are the hormones estrogen and progesterone. Hormones that are responsible for the functioning of the uterine lining (progesterone and estrogen) seem to have a direct contribution to uterine fibroid growth. This doesn't pose much of a problem to women in menopause, but it may be a problem for menopausal women using hormone replacement therapy (HRT). The estrogen in HRT may cause fibroids to form, or get bigger if they were there already.
Treatments
If you are in menopause and have uterine fibroids but no symptoms, careful watching and monitoring may be all that's required. This is usually a first course of treatment since fibroids are generally benign. Also in menopause, fibroids tend to shrink without treatment due to downward shifts in estrogen levels. According to Mayo Clinic, this is the best treatment option for a large amount of women. If this doesn't help or you start to have symptoms associated with the fibroids, you may have to take medications such as androgens (male hormones) and if you're taking estrogen replacements to treat menopausal symptoms, you may have to stop. Medications such as androgens are given to shrink the fibroid and stop the bleeding. If necessary, you may have to have the fibroid surgically removed or have the whole uterus removed (hysterectomy).
Risks
The known risk factors for uterine fibroids are race (more common in African-American women), genetics and obesity. Uterine fibroids are not dangerous, but may cause potential health complications. Most of the complications affect menstruating women, or women in perimenopause. Complications include a slightly increased risk of miscarriage and localized pain during pregnancy.
Tags: uterine fibroids, uterine lining, African-American women, bleeding menopause, bleeding uterine, menopausal women
