DEAR DR. DONOHUE: A 50-year-old friend of mine was diagnosed with leiomyoma of the uterus. Does this have anything to do with fibroids? She has fibroids, but her doctor says they are best left alone, since they shrink at menopause. What causes leiomyoma? Can it become cancer? What treatments are available? — L.B.
ANSWER: “Leiomyoma” (LIE-oh-my-OH-muh) is the medical word for “fibroid.” Fibroids are noncancerous growths of the uterine muscle. The uterus basically is a muscular sack with a lining designed to nourish a fetus.
The cause of fibroids hasn’t been determined.
They’re extremely common. By age 35, 40 percent to 50 percent of women have one or more. By age 50, 70 percent to 90 percent have at least one fibroid. For most of these women, fibroids cause no trouble and can be ignored.
Large fibroids might cause pelvic pain, and they can press on adjacent structures such as the bladder. When that happens, a woman has a need to empty her bladder frequently. Heavy menstrual bleeding is a sign of fibroids. They also can bring painful menstrual periods, and sometimes they make sexual relations uncomfortable. Infertility is cited as a possible effect, but infertility due to fibroids is rare.
Transformation into cancer is possible, but not probable. If a fibroid grows rapidly, that’s a sign of cancer change and must be investigated. Most fibroids shrink with menopause.
Doctors can treat fibroids in a number of ways. One is removal of the uterus — hysterectomy. If a woman wants more children, sometimes removal of only the fibroid is possible, and this can be managed in some cases with a scope and special instruments. Uterine artery embolization is a newer treatment in which a slender, soft tube (a catheter) is passed from a surface artery to the uterine artery. When it’s at the precise spot, the doctor releases sand-size synthetic particles that clog the artery and cut off the fibroid’s blood supply. It withers and is shed.
The booklet on fibroids describes them in detail. To order a copy, write: 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.
DEAR DR. DONOHUE: I don’t think you will consider this a health problem. It isn’t, but it is still a problem for me. It is freckles. They cover my face in the summer, and they really bother me. How do I stop them? I am 16, and freckles are ruining my life. — L.M.
ANSWER: Sunlight causes freckles. In the winter, when the sun is less intense, they fade. In summer, the stronger sunlight activates skin cells to produce melanin, the dark pigment responsible for tanning — and for freckles.
Sunscreens with an SPF — sun protection factor — of 15 or higher afford a good defense against the sun’s ultraviolet rays. You shouldn’t go outside without applying it, and you should reapply it as often as the label directions say. If you can find it, get a sunscreen with protection against both ultraviolet A and B.
A hat provides shade for the face and is another protection against freckles.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.
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