Hi Dr. V.,
I am a 45-year old fairly healthy Black woman. I am iron deficient and have anemia, an enlarged uterus with multiple masses and the ovaries can’t be seen. My doctor suggested I have a hysterectomy. My doctor did tell me about birth control, however I’m not interested in birth control. What do you suggest? Are there natural alternatives?
Thank you for your question. Fibroids are a common issue many African-American women suffer from, so don’t think you are alone! The size, location and symptoms of your fibroids direct what medical management your doctor will suggest. One of the reasons you doctor may have suggested a hysterectomy may be due to the:
• Symptoms you suffer from: heavy bleeding, pain, swollen abdomen
• Fibroids growing rapidly
• Fact that the presence of large fibroids can interfere with your doctor’s general assessment of your uterine and ovarian health. This means that it may be hard for your doctor to feel the ovaries and determine whether they are healthy which is of significant concern in women over the age of 40.
Let’s talk about your treatment options. They depend upon your age, type of symptoms you are experiencing, and whether or not you plan on having children in the future.
I won’t discuss birth control as an option since you expressed you are not interested in this treatment option.
Medical Treatment: There are some drugs that shrink fibroids such as Lupron.
• It must be taken regularly by nasal spray or injection once a month or once every three months.
• Once you stop taking it the tumors grow back rapidly.
• Side effects include: hot flashes, mood swings similar to menopause and these drugs can decrease bone density and possibly lead to osteoporosis.
• Usage of these medications is usually limited to 6 months.
Most commonly women undergo surgical treatment for fibroids that include: myomectomy and hysterectomy
Myomectomy:
• Surgery to remove as many of the fibroids as possible without taking out uterus
• Option for women who have not finished having children as this treatment option preserves fertility
• If you opt for myomectomy, the fibroids could come back.
• Risks include: blood loss, scarring of the pelvic region that make future pregnancy difficult.
Hysterectomy:
• Option for women who have completed their families.
• Also considered when fibroids grow to the size of a 12 week fetus, the bleeding is heavy, or the fibroids are causing problems with other organs.
• If you have a hysterectomy prior to surgery you and your doctor can discuss the option of leaving the ovaries intact so that you don’t enter into menopause after the operation.
Uterine Artery Embolization:
• Minimally-invasive procedure (not a surgery) where a physician usually an interventional radiologist injects particles through a catheter into the arteries that supply blood to the fibroids, blocking blood supply to the fibroids, leading to death of the fibroid tissue, shrinkage of the fibroids, and relief of symptoms
• Takes about 1-2 hours and patients usually go home the same day or one day after the procedure
• No need to remove the uterus or ovaries
• Ask you physician if this may be an option for you.
• Make sure you also realize that similar to any procedure this one too carries risks including infection, clot formation, injury to the uterus or ovaries.
You also asked about natural remedies for fibroids:
Natural Remedies:
• Exercise: it decreases the severity of fibroids, and relieves stress so that your hormones balance out
• Weight loss/control: Fibroids are tumors that respond to estrogen, and all fat cells make estrogen, if you can lose weight it may aid in shrinking the fibroids, but this may not CURE your problem
• Low estrogen diet: Diet low in
Animal fat – meat and dairy
Pesticides and other chemicals that mimic estrogen in the body (environmental estrogens)
• Improve your liver function: Take B vitamins, evening primrose oil, vitamin E, vitamin C, and bioflavonoids, bitter greens such as endive, escarole, radicchio all improve liver function and digestion
• Hot castor oil packs applied to abdomen 3-5 times a week may help improve regularity and draw toxins out of the body
If you are interested in reading more about a natural cure for your fibroids check out the book: Healing Fibroids: A Doctor’s Guide to a Natural Cure by Allan Warshowsky, MD.
I encourage you to discuss ALL of your treatment options with your doctor and then together decide upon a treatment plan. And do not start taking any supplements or vitamins without first consulting your doctor. Also please know that all treatment options including natural remedies have risks, benefits and side effects, and you should be well informed about your treatment choice.
I hope this information helps, and best of luck with your decision. Check back in with me and let me know how things go.
Be Healthy,
Dr. V