Topics of Interest

Predicting Fibroid Growth: Two Studies

Growth of uterine leiomyomata among premenopausal black and white women.

Journal: Procedings of the National Acadamy of Science U S A. 2008 Dec 16;105(50):19887-92.

Authors: Peddada SD, Laughlin SK, Miner K, Guyon JP, Haneke K, Vahdat HL, Semelka RC, Kowalik A, Armao D, Davis B, Baird DD.

Study from: National Institute of Environmental Health Sciences, NC

Problem: Fibroids are the leading cause of hysterectomy in the United States. Black women have a greater fibroid burden than whites, yet no study has systematically evaluated the growth of fibroids in blacks and whites.

Study: The authors tracked growth of 262 fibroids (size range: 1-13 cm in diameter) from 72 premenopausal participants (38 black and 34 white women). Fibroid volume was measured by computerized analysis of up to four MRI scans over 12 months.

Results: The average growth rate over 12 months was 9%, but the difference among women was very large: from -89% to +138%.  Seven percent of fibroids got smaller (>20% shrinkage). Fibroids from the same woman grew at different rates.

Black and white women younger than 35 had similar fibroid growth rates. However, growth rates declined with age for white, but not for black women.  Growth rates were not dependant on initial fibroid size, location in the uterus, women’s weight, or number of children.

 

Most fibroids did not grow (0% change), but other fibroids either grew or got smaller.

Authors’ Conclusions: 1) fibroids can get smaller; 2) fibroids from the same woman grow at different rates, despite exposure to the same hormones in the blood; 3) initial fibroid size does not predict its growth rate; 4) as black women age, they do not experience slower fibroid growth which may explain why black women have more fibroid-related symptoms.

Dr. Parker’s Comments: This is the first study to accurately track fibroid growth, both in different women and different fibroids in the same woman. I (and other gynecologists) have been telling women for 30 years that fibroids do not get smaller until after menopause – this study proves that idea wrong.  I have also been telling women that fibroid growth is unpredictable, some fibroids grow slowly, others fast and others go through growth spurts and then slow down (see next study below).  This idea turns out to be correct.  We do not understand what makes fibroids grow (or shrink), but it is clearly NOT estrogen excess.  If this were the case, as specifically addressed in this article, all fibroids in the same women, and thus exposed to the same hormone levels, would either grow or not grow.  And, that clearly does not happen.  Unfortunately, we still have a lot to learn about fibroid growth.

 

Short-term change in growth of uterine leiomyoma: tumor growth spurts.

Journal: Fertility & Sterility. 2011 Jan;95(1):242-6.

Authors: Baird DD, Garrett TA, Laughlin SK, Davis B, Semelka RC, Peddada SD.

Study from: National Institute of Environmental Health Sciences, North Carolina

Problem: No one has ever followed fibroid growth closely enough to see what happens over 3 month periods.

Study: 18 black and 18 white premenopausal women had 101 fibroids measured with MRI at the study beginning and again at 3, 6, and 12 months. Growth spurts were defined by growth rates greater than 30% in 3 months.

Results: Growth spurts were seen in 37 of the 101 fibroids. Fibroids from the same woman did not have similar growth, nor were age, race/ethnicity, number of children or a woman’s weight related to growth spurts.  However,fibroids smaller than 5 cm went through growth spurts more often than larger fibroids.

Authors’ Conclusions: Short spurts of growth are common for fibroids.

Dr. Parker’s Comments: As noted above, we do not understand what causes fibroids to grow, but these two studies show that fibroid growth is unpredictable and that small fibroids are likely to grow more quickly than larger (>5 cm) fibroids.

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Disclaimer: The ideas, procedures and suggestions contained on this web site are not intended as a substitute for consulting with your physician. All matters regarding your health require medical supervision.

Fibroid Doctor William H. Parker

Dr. William H. Parker is a board-certified Fellow in the American College of Obstetricians and Gynecologists. Dr. Parker is an internationally recognized expert in fibroid surgery and research. Based in San Diego, California, he is considered one of the best fibroid surgeons for abdominal and laparoscopic myomectomy in the United States and abroad. He has been chosen for Best Doctors in America and Top Doctors every year beginning in the late 90's.

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