Fun Fibroid Follies (Not)

Alright, buckle up for a wild ride through my medical saga!

In April 2021, I went for my routine GYN appointment, thinking it would be just another day. I casually mentioned to my doctor that I was feeling some abdominal pressure and constipation. No biggie, right? Well, during the exam, he found what he thought was an umbilical hernia and referred me to a General Surgeon. The General Surgeon agreed that there was indeed a hernia and suggested repair. We scheduled the surgery, but she ordered an abdominal CT to see what she was dealing with. Surprise, surprise! The CT scan revealed that I had multiple uterine submucosal and subserosal fibroids. These bad boys grow on the outer wall of the uterus and can cause all sorts of trouble. I was sent back to my GYN for an ultrasound and evaluation.

My periods had gotten heavier, but I just chalked it up to getting older. Worse cramps? Meh, part of the package. But the ultrasound revealed numerous uterine fibroids (too many to count), and three of them were pretty large. The biggest one was a “bleeder,” causing my heavy periods and anemia. My doctor recommended treatment and presented me with several options to consider. Many women in my shoes, having completed their families and nearing menopause, opt for a hysterectomy. But I wasn’t ready for that. We decided to monitor the situation.

In the meantime, I stopped relaxing my hair, since there’s a correlation between the chemicals in relaxers and fibroids. Hello, natural hair! Recent studies have suggested a potential link between the use of chemical hair relaxers and the development of uterine fibroids. The chemicals in hair relaxers, such as phthalates, can disrupt the endocrine system and influence hormone levels. This disruption can contribute to the growth of fibroids. One study found that women who used hair relaxers frequently were 1.4 times more likely to develop uterine fibroids. This risk is particularly concerning for African American women, who are more likely to use hair relaxers and are also more likely to develop fibroids at a younger age and with more severe symptoms.  So, while the exact cause of fibroids is still not fully understood, it’s clear that there is a potential connection between the use of chemical hair relaxers and the development of these pesky growths. If you’re concerned about this risk, it might be worth considering alternative hair care methods and embracing your natural hair texture.

Fast forward to April 2022. Things weren’t getting better. My periods were super heavy, always inconveniently timed with travel or big events. This was becoming a real problem for me.  I was having trouble getting out of bed during the first 2 days of my period, due to pain and sheer exhaustion.  But…I still was not sold on the hysterectomy, and I wanted a conservative approach. My doctor recommended a uterine ablation and D&C for relief. Surgery was set for July, and I was cautiously optimistic.  And as a cruel joke from the universe, I got my period the day before the procedure.  Once in the OR, my surgeon discovered they couldn’t do the endometrial ablation due to a fluid deficit.  There was also so much inflammation, my uterine cavity was too enlarged, which was another complication. They needed a hydrothermal ablation, which wasn’t available at the time. Bummer!  While the procedure was not a total success, it did buy me a few months of relief. 

Things gradually got worse, which I was warned could happen.  By October 2023, my symptoms returned with a vengeance. I opted for the wait-and-see approach, hoping that I could buy my time until menopause.  I was prescribed Tranexamic Acid 650 mg for heavy bleeding, which definitely helped with my flow, but did nothing for my pain. During my annual exam in May 2024, my doctor recommended a follow-up ultrasound and blood work, which I procrastinated on.  As time went on, I felt worse and worse—run down, foggy-headed, irritable. I had spells of weakness and passing out. I was cramping so badly, I would vomit. Consistent back and leg pain, poor sleep, migraines lasting three days were my norm.  I just felt like garbage all the time.  I blamed peri-menopause and stress. By February 2025, I was done. I called my doctor for an appointment. Upon exam, he found a polyp on my cervix, which he removed on the spot (biopsy came back benign).  He insisted on me getting my blood work done ASAP and he scheduled me for another ultrasound and hysteroscopy.

My labs showed I was dangerously anemic, causing many of my symptoms. The ultrasound confirmed that I still had multiple fibroids, with the largest ones being the size of a grapefruit and the size of a peach. My uterus was inflamed and twice its normal size. Hormone levels showed I wasn’t close to menopause. The anemia and fibroid symptoms were making me miserable. Now what?

I’m currently scheduled for another D&C and hysteroscopy in April. My surgeon will try to remove the large fibroids. Thermal ablation is off the table due to my uterus size. The hope is this surgery buys me time to go through menopause naturally, which should shrink the fibroids. If not, I’ve given it a fair shot and might go ahead with the hysterectomy. Fingers crossed I won’t have to make that decision!

Now, let’s talk about fibroids, in general, because I can’t be the only one suffering! Uterine fibroids are super common, affecting up to 80% of women by age 50, but most are small and don’t cause any symptoms. Subserosal fibroids, like mine, grow on the outer wall of the uterus and can cause symptoms like heavy periods, pelvic pain, and pressure.

There are several types of uterine fibroids, each with its own quirks and characteristics:

1. Intramural Fibroids: These are the most common type and grow within the muscular wall of the uterus. They can stretch your uterus and make it appear larger.
2. Subserosal Fibroids: These fibroids form on the outside of your uterus, called the serosa. They can grow large enough to make your uterus appear bigger on one side.
3. Pedunculated Fibroids: Sometimes, subserosal fibroids develop a stem, a slender base that supports the tumor. When they do, they’re known as pedunculated fibroids.
4. Submucosal Fibroids: These develop in the myometrium, the middle muscle layer of your uterus. They aren’t as common as other types but can cause heavy menstrual bleeding and trouble conceiving.
5. Cervical Fibroids: These develop on the cervix, which connects the uterus to the vagina. They’re also rare.

There are many treatment options available for uterine fibroids, depending on their size, number, location, and the symptoms they cause. Here are some of the common treatments:

1. Medications: These are usually the first choice for treating fibroids. Some medications help to shrink fibroids, while others treat heavy bleeding and pain. Hormone therapy, such as birth control pills and intrauterine devices (IUDs), can help control symptoms or shrink fibroids before surgery.
2. Gonadotropin-Releasing Hormone (GnRH) Agonists and Antagonists: These medications suppress estrogen, which stimulates fibroid growth. They can reduce heavy periods and shrink fibroids. However, they are not meant for long-term use due to the risk of osteoporosis.
3. Antifibrinolytic Medications: These non-hormonal drugs help curb heavy period bleeding by aiding blood clotting. They are taken only when needed.
4. Fibroid Embolization: This procedure involves injecting polyvinyl alcohol (PVA) particles into the arteries that feed the fibroid, blocking its blood supply and causing it to shrink.
5. Myomectomy: This surgical procedure removes fibroids while preserving the uterus. It is often recommended for women who wish to maintain their fertility.
6. Hysterectomy: This is the surgical removal of the uterus and is considered a definitive treatment for fibroids. It is often recommended for women who have completed their families and are nearing menopause.
7. Endometrial Ablation: This procedure destroys the lining of the uterus to reduce heavy bleeding. It is not suitable for women who wish to maintain their fertility.
8. Hydrothermal Ablation: This is a type of endometrial ablation that uses heated fluid to destroy the uterine lining. It is used when other ablation methods are not feasible.
9. Dilation and Curettage (D&C): This procedure involves scraping the lining of the uterus to remove fibroids and reduce heavy bleeding.

It’s important to discuss these options with your doctor to determine the best treatment plan for your specific situation. I’m fortunate to have a doctor who takes his time with me and allows me to direct the course of my treatment, with his expertise, of course.  I trust him immensely and have been seeing him since I was pregnant with my children.  Who knows what will happen once I get into the Operating Room next month, but fingers crossed that things work in my favor this time.  At least I am now aware of my anemia and understand how it affects me.  I will continue with my Iron therapy, and I am following up with my PCP in a few weeks.  I know some folks will think this is TMI, but women need to be more honest about what goes on with our bodies and know that we are not alone.  And we need to take care of our bodies so that we can continue to take care of each other.