DR. HOOK- Female trouble: Those awful 'fire balls'!

Jerry Lee Lewis sang a hit song, "Great Balls of Fire," that became an international sensation. He also became an international "defamation" as quickly as he rose to the top, poor guy. Every time I hear a patient mispronounce their uterine fibroids, I think of the title of his song: "I have some 'fire balls' in my womb," they say, "and the gynecologist said I need to get them taken care of."

Women mispronounce fibroids. (Men have problems, too– they mispronounce "prostate" as "prostrate.") Should the medical community rename fibroids "fire balls"?

It's even more difficult to say the actual medical terminology: uterine leiomyomas. Fibroids are non-cancerous tumors from the smooth muscle cells of the uterus (womb). (Note: less than one percent can become cancerous: leiomysarcoma.)

Fibroids tend to appear in women in their 30s and 40s. (How old is Condoleezza Rice? She had one recently.) About 25 percent of reproductive-age women have fibroids, and black women have them two to three times more often than white women.

Risk factors for getting fibroids include multiple pregnancies, a red-meat diet, family history, and beer. Sounds like Roseanne Barr-Arnold-Whatever.

Uterine bleeding is the biggest problem for women who suffer from fibroids. Menstrual period bleeding is heavier, lasts longer, and can often cause iron-deficiency anemia. My patients complain of fatigue due to their anemia and distress over having periods-from-hell.

"Doc, I've have had four periods in the past six weeks. All of them have lasted 7-10 days, and I even have blood clots. I'd be a millionaire by now if I'd invested in Tampax."

Lower pelvic or abdominal pain/pressure can often lead to early intervention because the pain is that bad. Some women say it feels like a menstrual cramp– especially if they're having abnormal bleeds. The severe pain of fibroids can even lead to an ER visit.

Most women complain to me about a persistent nagging pressure, and they can even feel the fibroid with their hands when pushing down on their pelvis. An anti-inflammatory like aspirin and ibuprofen often can alleviate this pain.

If the fibroids grow into the uterus instead of out of the uterus, miscarriages or infertility can result– but don't fret! There are great treatment options today. Myomectomy and laparoscopic myloysis are surgical options for women who want to keep their uterus– such as those who want to get pregnant. This procedure spares the woman a hysterectomy (complete removal of the uterus) by simply removing only the fibroid(s). This is the opposite of throwing the baby out with the bath water.

Uterine artery embolization (UAE) is another non-surgical option to preserve the uterus. I think Condi chose this route. In UAE, the blood supply to the fibroid is cut off so the fibroid essentially "starves" to death.

Menopause can be a great cure for those with fibroids, because the fibroids shrink and stop bleeding. However, many women aren't near menopause. The good news is that most fibroids are small, so yearly exams can make sure they aren't growing quickly. If they do become large, ultrasound is usually prescribed.

For those who choose drug therapy to manage their fibroids, birth control pills can control the bleeding. Long-acting gonadotropin-releasing hormone can actually cause a drug-induced menopause to shrink the fibroid– but also it can lead to osteoporosis. (If it isn't one thing, it's another.)

Women with fibroids should talk to their primary care physician or gynecologist, just being sure to pronounce it correctly. I guess mispronouncing fibroids as "fire balls" is better than "fiberoids," which sounds like a hemorrhoid resulting from eating too much bran.

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