Uterine fibroids after menopause, can it be left untreated? 5060 Most Frequently Asked Questions by WomenObstetricians and Gynecologists Jaeman Bae, Wonmoo Lee, Hakyun Jang

 

 

 

 

 

 

 

 

Adenomyosis or fibroids are both benign diseases. You can't compare which one is more dangerous. The main symptoms of adenomyosis* are menstrual cramps and heavy menstrual flow.

 

As menopause progresses, female hormones decrease, causing adenomyosis to shrink in size. The fundamental method of removal is surgery, but it is not necessary to have fibroids or adenomyosis but only if the symptoms worsen and cause a lot of discomfort. If surgery is not a burden, it can be resolved by inserting a Mirena loop.

*Adenomyosis: A disease in which the endometrium grows

*Mirena Loop: A small, T-shaped plastic device that secretes a certain amount of the endometrium daily from a reservoir containing a hormone called levonorgestrel

 

 

Functional cysts* disappear spontaneously on ultrasound, so you can wait, but endometriosis and teratomas should be operated on. If the ultrasound results suggest that the lump is cancerous or has a mixture of white and black cysts, surgery should be performed.

*Functional cysts: Cysts such as corpus luteum cysts and follicular cysts that have a problem in the process of growing and have formed a nodule-like shape.

 

 

Uterine fibroids do not increase in size or rather become smaller when female hormones decrease during menopause, but if they become larger, it may be sarcoma*, so it is recommended to have an ultrasound after 3~6 months to observe the change in size, and regular checkups are helpful in detecting multiple diseases after menopause such as endometriosis, so it is recommended to get it.

*Sarcoma: A malignant tumor that develops in the muscle or connective tissue of the uterus

 

 

Sarcomas, which often lead to death at the time of diagnosis, are difficult to distinguish from fibroids by ultrasound, both in textbooks and in practice. Compared to the common fibroids, which are diagnosed in 1 in 2 people in their 40s, sarcomas are very rare, about 3 in 100,000 people, so it may be rare to diagnose sarcomas even if they are large. There may also be differences in the doctor's ability to see ultrasounds.

 

 

It is necessary to distinguish whether there is blood in the urine or if there is vaginal bleeding or uterine bleeding and the urine is mixed with the discharge, so that an accurate diagnosis can be made. In general, obstetrics and gynecology also see urinary system treatment, so it is recommended to check if it is true hematuria by inserting a catheter into the bladder and receive the right treatment.

 

 

Menstruating about once every three months is a symptom of menstrual irregularities. First of all, you need to go to the hospital to find out what the cause of your menstrual irregularities is, so that you can treat it. Recently, polycystic ovary syndrome* is the most common reason. Typical clinical manifestations include acne, hirsutism, and obesity. However, if you have your period every three months, oral contraceptives are not necessarily recommended.

*Polycystic ovary syndrome: A disease in which abnormally high levels of luteinizing hormone and follicle-stimulating hormone in the blood are secreted, resulting in anovulatory menstrual abnormalities and multiple nodules in the ovaries.

 

 

When menopause occurs, female hormones plummet, so the endometrium cannot become thicker. After menopause, the normal endometrium thickness is about 4 mm. If you are on hormone therapy, it is 5~6mm. If the uterine lining thickens after menopause, there is a clear causative disease and should be examined with aspiration biopsy* to find the exact cause and treat it.

*aspiration biopsy: The act of examining tissue after obtaining it using a needle such as a syringe.

 

 

If you are experiencing discomfort due to menopause, hormone therapy may be a good idea. Hormone therapy has a lot of known side effects due to various media, but it is a very effective treatment for treating symptoms, so you don't have to look at the negative side of it.

 

 

After menopause, it is necessary to have regular checkups to look for endometrial cancer or ovarian cancer, which often occurs after menopause, rather than screening to see adenomyomas. Regardless of adenomyoma, hormones such as Rivial can be taken regardless of menopause.

 

 

During hormone treatment, you may feel uncomfortable because your breasts are enlarged or you have a lot of age spots on your body. If this is the case, you may want to switch to a different type of hormone or stop taking it after consulting your doctor.