DEAR DR. DONOHUE: I am 42 and have an anemia. My doctor thinks it results from my menstrual bleeding, which is quite heavy. I have been taking iron pills, but I am still anemic. The doctor says I should have my fibroids removed, and that will stop the excessive bleeding. I have no other symptoms — no pain. Will you explain what fibroids are? They aren’t cancer, are they? — E.B.
ANSWER: Fibroids are not cancer. They’re growths of the uterine muscle. The uterus is mostly muscle, with an inner lining designed to nourish a fertilized egg. Quite often, fibroids don’t cause any problems. Large ones can lead to heavy menstrual bleeding, which, in turn, gives rise to an anemia. They also can put pressure on the adjacent urinary bladder and bring on the need to urinate frequently. Sometimes they produce pelvic discomfort, and they might be involved with infertility.
About two-thirds of women in their 40s have one or more fibroids. What causes them is still a matter of speculation. Female hormones make them grow. That’s why menopause, with its drop in hormone production, usually shrinks fibroids. They also run in families, so there is a gene influence.
The best treatment for fibroids depends on their location in the uterus and their size. Sometimes removal is achieved with instruments introduced into the uterus through the vagina — no skin incision. Recovery from this procedure is fast. Laparoscopic surgery — surgery done with a scope and instruments inserted through small incisions — is another technique that permits quick recuperation. At times, the entire uterus has to be removed.
A newer and popular treatment is uterine artery embolization. Here a slender, pliable tube is threaded from a surface artery to the artery that supplies the fibroid with blood. When the tube arrives at that artery, the doctor releases tiny pellets that promote the formation of a clot (embolus). Without nourishment, the fibroid shrinks and is eventually shed.
The booklet on fibroids gives greater details on this common condition. Readers can obtain a copy by writing: Dr. Donohue — No. 1106W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.