That Pain in Your Side Could Be Telling You Something

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During their monthly menstrual period, many women experience various physical symptoms brought about by hormones and by cramping of the uterus. These symptoms seem to vary from woman to woman and from cycle to cycle, but often include abdominal cramping. Regardless of what you experience, pay attention to your monthly period because what you perceive as ordinary menstrual cramps may in fact be something else. That nagging pain in your side or those persistent cramps may be a warning sign of a developing problem.

For many African–American women, persistent menstrual pain means uterine fibroid tumors. It is estimated that 40 percent of African–American women before menopause suffer with fibroid tumors–this in contrast to less than 20 percent for White women. In fact, according to Nelson H. Stringer, M.D., an obstetrician/gynecologist at Rush–Presbyterian–St. Luke’s Medical Center in Chicago, "almost every Black woman you know has a fibroid, but before you rush to your [doctor] in a panic, understand that fibroids are a common, perhaps even a natural, occurrence in most women". Uterine fibroids (myomas) are the most common of the female genital tract. In fact, he says that if you could remove the uterus of every woman in the world, you would find fibroids in almost 80 percent of them. However, Dr. Stringer emphasizes that the majority of fibroids do not cause problems. And those that do quite often can be remedied without sacrificing the uterus, if they are detected early.

Doctors are not sure why African–American women suffer with fibroids more than other ethnicities. Many believe the problem and solution lie in poor diet, lack of exercise, and the overall lifestyle of African–American women. Heredity also appears to be one factor. If troublesome fibroids run in your family, your chances of having them are greater. And, for some unknown reason, African–American women tend to suffer with longer menstrual periods; they have heavier bleeding; bloat severely; and tend to suffer with tremendous pain. Many women suffer for years under this torment. Over time, fibroid tumors can lead to anemia. They can also cause increased vaginal discharge and pain during sexual intercourse, discomfort during urination, constipation, backache, kidney obstruction, and miscarriages.

So, what are fibroids?

Fibroid tumors are usually benign (non–cancerous) tumors found, most often, in the uteruses of women in their 30’s and 40’s, although they occasionally develop on other organs which contain smooth muscle cells. Fibroid tumors are solid tumors which are made of fibrous tissue, hence the name ’fibroid’ tumor. Most often fibroids occur as multiple tumor masses which are slow–growing and often cause no symptoms. The size of fibroids varies immensely among women and some are so small that a microscope is required to see them. However some women experience a single large fibroid tumor the size of a grapefruit or a fibroid which is so large it encompasses the entire abdominal area.

No one is sure why fibroid tumors develop, but some facts are quite clear. They do not develop before the body begins producing estrogen during the onset of menstruation. Estrogen, such as in birth control pills and taken for menopausal symptoms, does cause fibroid tumors to grow and fibroid tumors will grow very quickly during pregnancy when the body is producing extra estrogen. They often shrink and disappear after menopause when the body stops producing estrogen, and a woman rarely develops fibroid tumors after menopause. Although the estrogen connection appears obvious, there are still some who question it because women with fibroids often normal amounts of estrogen in their blood. If your fibroid tumors are severe enough that they cause certain symptoms, surgery is often the required treatment. Symptoms which justify surgery include: extremely heavy bleeding during your menstrual cycle, which causes anemia that does not respond to treatment; pain, which has become intolerable to the woman or discomfort caused by the pressure of the fibroids on another organ; or when the location of the tumors is likely to cause further problems.

Surgery for fibroid tumors usually includes a myomectomy or a hysterectomy. A myomectomy is the surgical removal of each individual tumor without damage to the uterus, preserving a woman’s ability to conceive. However, fibroids will often grow back and although it is possible to have a myomectomy repeated, multiple myomectomies can cause other problems such as the walls of the uterus sticking together due to scarring.

The sad fact is that because fibroids often do grow back, most women with this problem eventually need a hysterectomy. Removing the uterus is the only permanent way to effectively relieve most women of fibroids. A hysterectomy is most often the procedure of choice for fibroid tumors for a woman with severe symptoms; who has completed her family; when her uterus has grown to the size of a uterus at twelve weeks of pregnancy; with excessively large fibroid tumors; when severe abnormal bleeding occurs; or when the fibroids are causing problems with other organs such as the bladder and bowels.

An alternative to surgery may be a uterine artery embalization–a non–surgical procedure that prevents the fibroids from receiving the constant blood supply they require and causes the fibroids shrink over time. Almost immediately the symptoms of heavy bleeding and pelvic pain are significantly reduced. This procedure leaves the uterus intact.

Modern medicine continues to evaluate other options for treating fibroids, including the use of Lupron, which may be beneficial for those who want to become pregnant or for women approaching menopause when fibroids often shrink naturally. Lupron shrinks fibroids in most women with continued use, but one drawback is that the fibroids will quickly grow back once treatment is stopped.

If you are diagnosed with fibroid tumors, investigate your options before deciding on a treatment. Remember, there are alternatives to a hysterectomy.

For more information on uterine fibroid tumors, menstruation, and menopause, contact the National Caucus and Center on Black Aged, Inc. at 202–637–8400 or visit www.ncba–

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