Overview

Menopause doesn’t cure uterine fibroids. Uterine fibroids, also known as leiomyoma, are types of small tumors that grow in the wall of a woman’s uterus. These tumors are nonmalignant, meaning they aren’t cancerous. They can cause pain and other uncomfortable symptoms, however.

Fibroids are the most common types of nonmalignant tumors in women. They most often develop in women who are at childbearing age. You may also continue to experience them during and after menopause, or develop them for the first time during this period.

Learn more about uterine fibroids and their link to menopause.

Fibroids and hormones

Estrogen and progesterone can increase the risk for fibroids. When these hormone levels drop during menopause, your risk for new fibroids decreases. The drop in hormones may also help preexisting fibroids decrease in size.

Some risk factors can increase your chance of fibroid development after menopause. Some of these risks include:

  • high blood pressure, also known as hypertension
  • low vitamin D levels
  • family history of fibroids
  • obesity
  • no history of pregnancy
  • long-term, extreme stress

Postmenopausal women over the age of 40 and African-American women are at a higher risk of getting fibroids.

Symptoms

Fibroids can affect premenopausal and postmenopausal women in different ways. Sometimes there aren’t any symptoms of the fibroids at all. Your doctor may detect fibroids during an annual pelvic exam.

Women who are postmenopausal could experience the following symptoms of uterine fibroids:

  • heavy bleeding
  • frequent spotting
  • anemia from significant loss of blood
  • menstrual-like cramping
  • fullness in the lower belly
  • abdominal swelling
  • lower back pain
  • frequent urination
  • incontinence or urine leakage
  • painful intercourse
  • fever
  • nausea
  • headaches

Many of these symptoms are directly caused by a fibroid or a cluster of fibroids pushing against the uterine wall. For example, pressure from fibroids on your bladder can cause more frequent urination.

Read more: What causes cramps after menopause? »

Treating fibroids after menopause

Fibroids can be difficult to treat. Currently, oral contraceptives, also known as birth control pills, are the preferred drug treatment. Your doctor may recommend surgical removal of your fibroids, a procedure called a myomectomy. Surgical removal of your uterus may also be considered as the best treatment measure. That’s known as a hysterectomy.

Birth control pills

Taking birth control pills is one possible method of fibroid management. The main goal of oral contraceptives is to decrease existing fibroids. These hormones could also prevent future fibroid development.

Only certain types of birth control pills work in this situation. When considering birth control pills for fibroids, you may benefit from progestin-only pills. Progestins can also alleviate other symptoms of menopause. They may make hormone replacement therapies more effective.

Myomectomy

Sometimes a myomectomy is performed before a hysterectomy is considered. This type of surgery targets fibroid removal. It also leaves your uterus intact.

During a myomectomy, your doctor will make an incision in your lower abdomen. The size and location of the incision is similar to an incision used for a cesarean delivery. Full recovery will take four to six weeks.

Your doctor may also be able to perform the surgery laparoscopically. During laparoscopic surgery, a smaller incision is made. Recovery time for laparoscopic surgery is shorter, but this type of surgery is usually only recommended for smaller fibroids.

If fibroids come back following a myomectomy, your doctor may recommend a hysterectomy.

Hysterectomy

For severe symptoms related to large, recurring fibroids, a hysterectomy may be the best option. This is a type of surgery that removes all or some part of your uterus. Hysterectomies are generally only recommended for women who are close to menopause or already postmenopausal.

There are three types of hysterectomy:

  • Total: This type removes your entire uterus, as well as your cervix. In some cases, a doctor may recommend removing your fallopian tubes and ovaries too. This option might be best if you have large, widespread fibroid clusters.
  • Partial/subtotal: With this surgery, only your upper uterus is removed. Your doctor may recommend this option if fibroids are a recurring problem in this region of your uterus. This may be confirmed through imaging tests.
  • Radical: This is the most significant form of hysterectomy, and it’s only used in the most extreme cases of fibroids. It’s also sometimes recommended for certain cancers. With this surgery, a doctor removes your uterus, upper vagina, and cervix.

A hysterectomy is the only way to completely cure uterine fibroids, and approximately 200,000 women seek this surgery for fibroids every year. Together, you and your doctor can determine whether this surgery will be the best for you in terms of fibroid treatment.

Outlook

Uterine fibroids are more common in premenopausal women, but you can develop fibroids during menopause.

Talk to your doctor about ways you can manage fibroid symptoms, and whether surgery is the right option for you. Fibroids that don’t cause any symptoms may not require any treatment at all.