When you’re dealing with uterine fibroids, your menstrual flow can become very heavy. Your periods may also last longer than the typical seven days. Obviously, this can be uncomfortable and, at times, inconvenient. But if you’re thinking that it’s just annoying, think again. As it turns out, heavy periods can actually affect other areas of your health.
How Do I Know if My Periods Are Abnormal?
It’s easy to say that a heavy period could be cause for concern. But it can be difficult to quantify what “heavy” really means. Flow varies from woman to woman, so any major change could be problematic. As a general rule of thumb, however, your bleeding is excessively heavy if:
There are less than 21 days between your periods (longer than 35 days between cycles is also unusual, but this would not be considered a problem of excess bleeding)
Periods last longer than 7 days
You pass large clots during your period (anything bigger than the size of a quarter warrants a discussion with your doctor)
You’re losing more than 80 cc of blood. (Of course, no one expects you to actually measure your blood loss. But if you’re soaking through super tampons or pads in an hour or less, chances are you’re losing too much blood.)
My Period is Too Heavy – What Do I Do Now?
If you think that your periods are too heavy, talk to your doctor right away. Make an appointment with your gyno, even if it’s not time for your annual exam. Here’s why: heavy periods can lead to anemia, a condition that sets in when you don’t have enough iron in your blood. Anemia needs to be addressed immediately, because it can affect your body’s ability to carry oxygen to your extremities. Over time, it can also lead to iron deficiency which, in turn, can affect the body’s bone marrow response. Additionally, anemia can cause symptoms like fatigue, weakness, dizziness, pain, headaches, cold hands and feet, chest pain and even heart attacks.
Once you mention heavy bleeding to your doctor, he or she will likely suggest an anemia screening, to make sure you’re staying ahead of the issue. But it’s also important to try and determine the cause of your heavy bleeding, or else your continued blood loss will likely keep you in an anemic state.
Fibroids and Heavy Periods
Uterine fibroids can develop within the uterine lining (submucosal), the uterine muscle (intramural) or outside the uterine lining (subserosal.) Submucosal fibroids may increase the area of the lining, which gives you more blood to shed each month. These fibroids may also hinder your body’s ability to stop bleeding once it starts.
Intramural fibroids can increase the blood flow that reaches your uterus. They can also expand the size of your uterine cavity, thereby increasing bleeding.
If fibroids are causing your heavy flow, you’ll have to treat your fibroids them to stop the excessive bleeding. Be sure and discuss all your treatment options, both surgical and minimally invasive, when deciding how best to address your fibroids and heavy mentrual flow.
Sources: semcor.ubc.ca, The Center for Menstrual Cycle and Ovulation Research, cdc.gov, The Centers for Disease Control
..When you’re living with fibroids, getting your period can be painful. Really painful. Plus, they may be long and heavy. In fact, periods can be so disruptive when you have fibroids that you may start planning your life around your monthly cycle. And, while our Houston fibroid specialists provide minimally invasive treatments so you don’t have to do that, we did want to share one woman’s theories about planning your activities around your period. Check out what she had to say.
Health Educator Thinks Women Should Plan Life around Their Cycles
Recently, Mayella Almazan, a menstrual health educator in Northern Ireland, told the Daily Mail why women should plan around their periods. Her theory is that, if you really understand your monthly cycle and plan around it, you can reach your full potential.
And she divides each month into four distinct phases: menstruation, pre-ovulation, ovulation and pre-menstruation. Depending on the length of your cycle, she says, each phase should last between three and seven days. Of course, if fibroids have made your period longer, this would affect the length of each of these ‘phases.’
Still, it’s not the length of each phase that’s important, according to Almazan. What really matters, she says, is what you’re up for in each phase of the month. As Almazan explains, “So many women don’t understand their bodies and it’s such a shame. Most of us expect to feel tired or fragile on our periods, and we know about PMS, but that’s where it ends. Instead of seeing our periods as a barrier to our success, I’d love to see more women feeling empowered to use their monthly fluctuations to their advantage.”
Apparently, Almazan practices what she preaches. She says, “I organize my life around my menstrual cycle and it really works. I know when to take on a new project and push myself, and when to give myself a break…create a monthly chart and pin it to the wall. That way everyone [will know] what to expect!’
Almazan’s Four Distinct Menstrual Phases
These are the four distinct phases of your monthly cycle, as Almazan sees them:
DAYS 1-7: MENSTRUATION
Your cycle starts on the first day of your period, and typically lasts around seven days. During this time, your estrogen and progesterone levels are low. During this time, many women have cramps, back aches, headaches or even nausea. Sometimes, your energy levels drop during your period. And for women with fibroids, these symptoms are likely to be worse.
During this phase, Almazan says: “Day one or two of your period will be your lowest physically energetic days of the month, so give yourself a break and don’t feel guilty… You need lots of rest and self-care. But it can be active rest; it’s a great time for quiet reflection. You could bring those reports home from work to read, do some brainstorming and prepare for the month ahead so that when you enter the next phase, which is very productive, you’re all set to make the most of it. It could also be an opportunity to enjoy quality downtime with your family; snuggled up on the sofa reading or watching movies with your partner and kids. Go easy on yourself wherever possible.”
DAYS 7-14: PRE-OVULATION
During this phase, you’ve finished your period; your estrogen and testosterone levels are rising as your body prepares to release an egg. During this phase, many women feel a burst of energy.
That’s why, Almazan suggests, “This is the time of the month to go for it! If you’re an athlete, you will be at your peak…It’s certainly the time to begin or step up a training regime though. The number one issue women who come to me complaining of is exhaustion, so I tell them to make the most of this pre-ovulation time. If you can control your diary, this is the time to schedule your busiest or most demanding days. Your mental focus and analytical skills will be strong. It’s also the time you’ll be feeling most capable; so tackle things you find difficult now.”
DAYS 14-21: OVULATION
When you release your egg (ovulate) your discharge may look different and you may have pain in your side. Your estrogen and testosterone levels will reach their peak. Your Luteinizing Hormone (LH) will suddenly surge, triggering ovulation. And, immediately afterwards, your estrogen starts dropping as your progesterone rises. Your energy may wane again, and you may experience breakouts and breast tenderness.
Almazan says, “This is the time to do teambuilding or networking exercises at work, hold mentoring sessions or take a more listening, supportive role. ‘You may find you have a softer, warmer approach during this time, so it could be a great opportunity to try to solve problems and solve conflicts. It’s also a great time to socialize and cook for friends. If you have a partner, schedule a date night or two. If you’re single, socialize and strengthen your connections with friends.”
DAYS 21-28: PRE-MENSTRUAL
During this phase, your progesterone levels hit their highest point before dropping. Your estrogen will briefly rise, then drop again. It is this hormonal imbalance that can cause premenstrual symptoms such as irritability, anxiety, bloating, depression and mood swings.
Says Almazan: ‘We all know the negatives associated with PMS, but don’t write off this time completely. As your body prepares to shed the uterus lining, you may also find your observation skills are heightened and perceptions are more acute. ‘You can utilize these skills at work; now might be a great time to tackle the reading of a tricky report or something that requires discerning skills. Or at home you could make a list of things you would like to throw out or change. If you find yourself getting emotional, angry or frustrated, don’t dismiss these feelings. Pay attention to your thoughts and write down things that are upsetting you. Once you’re feeling calmer these journals can offer real insight. Some of your thoughts and feelings may have been overreactions, but others could be really useful, so don’t throw the baby out with the bathwater. You can use your down time during your period to take stock of any issues thrown up during this pre-menstrual period and think of ways to tackle them. Then you’re ready to begin the cycle again.”
While this is an interesting approach to your typical menstrual cycle, there’s one thing you shouldn’t have to do: stay home during your period because you’re in too much pain to go out. If that’s what planning around your period looks like for you, it’s time to consider treating your fibroids.
Even though 70-80% of women can have fibroids during their life, many women don’t know what uterine fibroids are, and sometimes don’t learn about all of their treatment options. Here are a few myths and misconceptions about fibroids explained by our interventional radiologists who specialize in treating fibroids.
Myth 1: Fibroids, Tumors, Polyps, and Cysts are the Same
In a recent blog post, we discussed the differences and similarities between fibroids and polyps in the uterus. But, you may hear other similar terms, like tumor or cyst. Many people don’t know whether these terms mean the same thing, or they all refer to different conditions.
A fibroid is a benign growth and is rarely associated with cancer. These growths develop from the muscle tissue of the uterus. You may hear a fibroid referred to as a “fibroid tumor” even though it is benign.
A polyp is made of endometrium tissue and is usually benign.
A cyst will develop on the ovaries and can be malignant.
The phrase “uterine tumors” typically signifies uterine fibroids, and are benign. Uterine cancer, however, refers to a malignant growth of cells in the uterus.
Myth 2: A Fibroid Tumor is Cancerous
Fibroids are almost always benign and rarely turn into cancer. The difference in symptoms between cancer and a benign fibroid will help your doctor diagnose a growth as malignant. Cancer is sometimes diagnosed during surgery for what is thought to be benign fibroid tumors.
Myth 3: Fibroids Have Consistent, Defined Symptoms
There is no one symptom that will alert you to the fact that you have uterine fibroids. Many women have uterine fibroids at some point during their life, but most don’t have any symptoms. The most common symptoms include heavy menstrual bleeding, prolonged periods, or pelvic pain, but there are other symptoms that women can experience.
Myth 4: Surgery is Your Best Option
If you don’t experience symptoms, treatment isn’t necessary, and many fibroids will shrink after menopause. There are a variety of treatment options available if you do experience symptoms. For women who want a non-surgical alternative, want to preserve their uterus, or want a quicker recovery period, Uterine Fibroid Embolization may be recommended.
Myth 5: Fibroids Continue to Grow, and will Grow Back after Treatment
Fibroids typically grow in alignment with hormone levels, which is why symptoms worsen during menstruation. This is also the reason fibroids may grow during pregnancy, but shrink after menopause. We cut off the existing fibroid’s blood flow during UFE, and it is very rare for them to regrow. In one study, only 5% of women needed additional treatment after UFE.
When you’re living with fibroids, your main concern is treating your symptoms. You just want to feel like yourself again. As soon as possible. But sometimes, in your rush to find a cure, you don’t think about the consequences of the treatment option you select. Now, a new study is pointing out the toll that may take on your long term health.
Surgically Induced Menopauses and Heart Disease Risk
So many women with fibroids choose to treat their tumors by having a hysterectomy. With this choice, you remove your uterus, automatically putting yourself into menopause. And once you enter menopause, especially if you do it before you turn 40, you’re at greater risk of osteoporosis, coronary artery disease, heart failure, and stroke.
Those conditions are all pretty scary, but they don’t even pain your complete risk picture. In fact, according to researchers at Harvard Medical School, your risk goes up even more if your early menopause is brought on by surgery.
To reach this conclusion, researchers spent six years studying 144,260 women between the ages of 40 and 69. At the beginning of the study, the women completed a questionnaire about the details of their reproductive health. And, throughout the study period, researchers noticed the rate of coronary artery disease, heart failure, stroke, deep vein thrombosis, and narrowing of the arteries for all the women. They also checked up on the women’s blood pressure, cholesterol levels, rates of diabetes, and any other health diagnoses.
What they found was startling. All women who entered menopause before turning 40 had higher rates of cardiovascular problems. But the women whose menopause was trigger by surgery were even more likely to develop heart health issues.
For some women, hysterectomies are medically necessary—especially if you are also dealing with a cancer diagnosis. But, for many women with fibroids, non-surgical treatments like Uterine Fibroid Embolization will be equally effective—and cause fewer additional health problems. So, before you choose hysterectomy, we urge you to explore all your fibroid treatment options. Especially the ones that won’t send you into menopause.
Sources: Journal of the American Medical Association
If you have fibroids or adenomyosis, you may have heard you need a hysterectomy (the complete removal of the uterus.) But, in many cases, you have other treatment options, so it’s important to research all your choices. After all, 44% of Americans don’t know what’s really involved in this procedure. So, if you are seriously considering surgery, here are three important things you need to know about hysterectomies.
Your Guide to Understanding Hysterectomy
Here are some facts you need to know about this surgery’
There’s more than one type of hysterectomy. In fact, there are 3 kinds: Supraservial (removing just the upper portion of your uterus) Total (removing the entire uterus and cervix.) Radical (taking out your uterus, its side tissue, your cervix, and the upper portion of your vagina. This option is typically for cancer patients only.)
A hysterectomy comes with a serious recovery period. Because hysterectomy is a surgical procedure, you will need to stay in the hospital, likely for at least 24 hours, afterwards. Many women will be unable to drive for at least two weeks following a hysterectomy. And most women will have to refrain from heavy lifting, bending over, sex and exercise for at least six weeks after surgery. For all of these reasons, you need to carefully consider your options before undergoing hysterectomy: there are less invasive options, like myomectomy or uterine fibroid embolization, that can help manage symptoms of certain conditions, like fibroids.
Hysterectomies come with long term health complications. Not only will a hysterectomy permanently end your chances of becoming pregnant, this surgery comes with other risks. Young women who have hysterectomies are at higher risk of obesity and cardiovascular disease, just to name a few health concerns. It is not a treatment decision to be made lightly, as you will feel the impact of this surgery for years to come.
Now that you are armed with the facts about hysterectomies, it’s time to get educated about alternative treatments. To find out if you are a good candidate for our minimally invasive fibroid treatments, feel free to schedule a consult with our Houston-area specialists.
Pretty much every woman on earth has experienced cramps at some point. You know the feeling: that throbbing pain in your lower abdomen, ranging from mildly uncomfortable to something severe enough that it keeps you from your daily life.
Typically, women experience cramps before or during their periods. These Cramps are directly tied to your hormones: they set it caused when Prostaglandin (a lipid hormone) causes your uterine muscles to contract. Called primary dysmenorrhea, the purpose of these types of cramps is to help your body get rid of its unfertilized egg and your uterine lining. And while uncomfortable, these primary cramps don’t last long—they typically resolve between 48 and 72 hours after they first begin.
But sometimes, you get cramps after your period is done; other times, cramps start up, but no period follows. These cramps are obviously not connected to menstruation, so they are known as secondary dysmenorrhea. Sometimes, these secondary cramps are no big deal—it could be a sign of a minor stomach bug or other irritation. But other times, secondary cramps are a sign of an underlying medical condition. And, today, we’ll focus of one possible cause of secondary dysmenorrhea: uterine fibroids.
Non-menstrual Cramps and Fibroids
Before explaining the connection between cramps and fibroids, you need to know exactly what fibroids are (and aren’t. Fibroids are tumors that can form anywhere in your uterus. They are NOT cancerous, although a small minority of women will discover they also have cancer when treating their fibroids.
Some women’s fibroids aren’t symptomatic. Other women experience a range of symptoms. How many or how severe those symptoms will be have a lot to do with the, size, location and number of tumors developing in your uterus.
Heavy menstrual periods, some severe enough to require transfusions
Pelvic pain or pressure
A frequent need to pee, and/or difficulties when you go
For some women, becoming or remaining pregnant will also be difficult with fibroids.
Fibroids can cause many painful symptoms, in addition to cramping, which is why so many women choose to treat their tumors. And, for many women, non-invasive treatment options like Uterine Fibroid Embolization will provide relief from symptoms! Call out Houston fibroid specialists to see if UFE is right for you!
As fibroid specialists in Houston, we know that a fibroid diagnosis doesn’t have to change your entire life. But we also know how scary it can be to learn you have tumors in your uterus—even though they aren’t cancerous. So that’s why his week’s Woman Crush Wednesday is our choice of honoree—she’s getting very real (in a very public way) about her fears over a fibroid diagnosis. Here’s to you, Shay Johnson, for sharing your fibroid story on Love & Hip Hop.
Women Need to Talk About Their Fibroids
About a year ago, Shay took to her social media accounts, sharing images of her in a hospital bed. She’d been admitted for a blood transfusion. But, at the time, she didn’t explain why she needed that transfusion.
Recently, however, she changed all that. Shay explained to her fellow cast member, Michelle Pooch, “There’s a few things going on with me medically that I haven’t told you about. I’m not dying, [but] I do have a medical condition called fibroids.”
In fact, she continued, she has two fibroids—one of them that has grown so large, it’s now the size of the grapefruit. And this, it turns out, was the explanation for last year’s transfusion.
As Shay explained to Michelle, one of her fibroid symptoms is that she has, “heavy menstrual cycles for longer than 15 days, [and] on top of that, I’ve been fainting because I’m losing so much blood.”
Because of her severe symptoms, Shay’s doctor suggested she remove her fibroids surgically (myomectomy.) In telling Michelle about this suggestion, Shay admitted that she was scared—both about her upcoming surgery and about what her monthly periods would look like afterwards.
Providing Women with Other Fibroid Treatment Options
Like many African-American women (who are disproportionately affected by fibroids), Shay has opted to treat her fibroids surgically. And that may well be the treatment option that’s best for her. But, many women aren’t told they have non-surgical options, too. Procedures like Uterine Fibroid Embolization (UFE) can help women with severe fibroid symptoms. Typically, the relief they experience will be equal (or even superior to) that of women who’ve had fibroid surgery.
But, in order to experience relief and avoid surgery, women need to know their options. So, while we commend Shay in this post, we also ask for help spreading the word: there are non-surgical treatment options for fibroids. Now, will you help us help women #ask4UFE? If you do, you just might earn a spot in our #WCW hall of fame!
As women, we know that we have a uterus. We may know a few things about this organ, like it’s function and vague location, but there’s lot’s more to learn! With that in mind, here are five fascinating facts about the uterus we bet you haven’t yet discovered!
The uterus is usually pear-sized, but it can expand to the size of a watermelon. When you aren’t pregnant, your uterus is only about 3 inches long and 2 inches wide, although this size varies among women. Of course, if you do become pregnant, it starts to stretch, expanding to accommodate your growing fetus (it can reach the size of a large watermelon!) Given its ability to stretch, factors other than a baby can affect the size of your uterus. Fibroid tumors, for example, can cause your uterus to expand, mimicking the look of pregnancy even without conception.
You Can Have Multiples
Yup, that’s right! Some women are born with more than one uterus. Although very rare, some women do have uterus didelphys, a congenital condition where two distinct uteruses develop (this was recently brought to life on a 2019 episode of Grey’s Anatomy.) Some women with this condition may also have two cervixes and two vaginas, but others may not have any external reflection of this condition, making it unlikely to be diagnosed until that woman wants to or becomes pregnant.
It’s Not All Smooth Sailing
Sometimes, the uterus has bumps and tilts. Known as bicornuate or retroverted, some women have a uterus with two bumps that make it resemble a heart; others have a uterus that tilts forward or backward instead of straight up and down. Women with a heart-shaped (bicornuate) uterus are unlikely to experience symptoms, although carrying a baby to term may be more difficult. A retroverted uterus also shouldn’t effect your period or fertility, but sometimes it’s a symptom of another condition, like endometriosis or an infection.
Your Uterus Could Be At Risk
Your uterus is vulnerable to cancer. Uterine cancer is the fourth most common cancer in the United States. It’s also the seventh most common cause of cancer-related death in this country. And, according to the CDC, it’s becoming even more common: in fact, women who carry extra weight are up to four times more likely to develop uterine cancer, and we all know that obesity has become a national concern. Why does weight increase your risk of uterine cancer? Obesity effects your hormone levels, because fat cells have high levels of estrogen, and estrogen increases your risk of this kind of cancer.
You Can Avoid Hysterectomy
Removing your uterus is not always the answer. Even if you’re dealing with non-cancerous conditions like fibroids or adenomyosis, you might be referred for a hysterectomy. But removing your uterus can affect more than just your reproductive health. So, before undergoing this major surgery, you must explore less invasive treatment options like Uterine Fibroid Embolization.
If you have fibroids—non-cancerous tumors that grow in your uterus—you may be worried about your fertility. Will you be able to get pregnant? Or, if you get pregnant, will the fibroids affect your baby’s growth and birth? Unfortunately, fibroids can impact your ability to become pregnant or deliver a healthy baby. But that doesn’t mean your dreams of having a family will never come true. Let’s take a closer look.
Will fibroids affect my fertility?
Depending on the size and location of your fibroids, the tumors can block sperm from reaching and fertilizing one of your eggs. Fibroids can also make it more difficult for a fertilized embryo to implant in your uterus. And, if you do become pregnant, fibroids may impact fetal development if they are located in a spot where your baby should be growing. For these reasons, you may want to treat fibroids before becoming pregnant. But your doctor can better advise you regarding fibroids and your fertility options.
What fibroid treatments should I choose to help my fertility?
Thankfully, you have many treatment options when it comes to fibroid tumors. It’s important to talk to a fibroid specialist about your family goals so you can choose the one that’s best for you.
In our Houston fibroid practice, we offer a treatment known as Uterine Fibroid Embolization (UFE). It is a minimally-invasive, non-surgical option that shrinks and kills fibroids by cutting off their blood supply. The procedure is performed through a catheter inserted through your arm. Particles are injected to the catheter to block the artery feeding your fibroids. Many women who undergo UFE go on to have healthy pregnancies.
Some women who still want to get pregnant may prefer a myomectomy—the surgical removal of your fibroid. If that’s the treatment option you select, you’ll need to give your uterus three to six months of healing time before trying to get pregnant.
One final word of warning, to help you manage your expectations: if you’ve had six or more fibroids removed surgically, research shows that you have a lower chance of getting pregnant than women with fewer fibroids. It’s also important to note that myomectomy may weaken your uterus, so it may be safer to deliver your baby via C-section following this fibroid treatment option.
While this information may seem frightening, it’s important to remember: pregnancy is possible, with and after fibroids. Stay positive, and be sure to discuss all your treatment options with your healthcare provider.
Sources: Clevelandclinic.org, Journal of Minimally Invasive Gynecology
So many women in this country get unnecessary hysterectomies! That’s scary news, since a hysterectomy (the complete removal of your uterus) is a really big deal. But are there cases when hysterectomies are a must? Let’s take a closer look!
What’s a Hysterectomy?
As we said, with a hysterectomy you lose your uterus. In an oophorectomy, doctors remove your ovaries. And with salpingectomy, you only lose your fallopian tubes. Need a hysterectomy with bilateral salpingo-oophorectomy? That means your uterus, fallopian tubes and ovaries all have to go.
You may need a partial, total or radical hysterectomies. Partial hysterectomies preserve your cervix. Total hysterectomies don’t. And radical hysterectomies take your whole uterus, cervix and the top part of your vagina.
When Do You NEED a Hysterectomy?
Hysterectomies are appropriate when you’re facing a life-threatening condition. So, if you have cancers of the uterus, fallopian tubes, cervix or vagina, you may need one. It may be necessary if a woman’s uterus ruptures during childbirth, or if her post-delivery bleeding is life threatening. In some cases, women with severe PID (pelvic inflammatory disease) will need this surgery.
So, that’s when you really need a hysterectomy. But there are other times when hysterectomies are also considered. Many women with fibroids and endometriosis are told they need to remove their uterus to get relief. And, while this may sometimes be true, other women can avoid this major surgery with less invasive treatment options. In our opinions, as Houston fibroid specialists, if there are treatments that could help women avoid hysterectomies, that should be the first line of defense. Except in cases of emergency, hysterectomies should be the last option your physician recommends.