I have fibroids. Can I take HRT?

I have fibroids. Can I take HRT?

Fibroids (14) may be present in up to 50% of women although most are small and of no clinical significance. All fibroids are initially small but a few can grow to be quite large (exceptionally reaching the size of a large melon). At one time, the only way that we could diagnose fibroids, other than at surgery, was to feel enlargement and irregularity of the uterus during pelvic examination. Unless you are less than average weight, it is unlikely that your doctor would be aware of a fibroid during examination if it is smaller than four centimetres.

Ultrasound has revolutionised our ability to diagnose fibroids. It would seem that about 50% of women having ultrasound have evidence of small fibroids and most of these would not have been detected by routine clinical examination. These small fibroids should not be considered as reason to withhold HRT.

We have been rather cautious about prescribing HRT when there are larger fibroids. We know that fibroids tend to shrink after the menopause suggesting a hormone link. There are times when gynaecologists temporarily suppress oestrogen to menopausal levels. An example would be before removing a large fibroid. The temporary reduction of oestrogen reduces the size of the fibroid and simplifies surgery. This temporary suppression of oestrogen may be for several months and many younger women find this difficult to cope with. In these circumstances, we would also provide HRT (add-back therapy) to control the oestrogen deficiency symptoms: this does not adversely affect the fibroids probably because the amount of hormone in the HRT is less than that in natural cycles. This suggests that our previous anxiety about HRT with regard to fibroids was overstated.

If you have fibroids, you can take HRT but the size of the fibroids should be monitored regularly.  

Related Medical Abstracts - Click on the paper title:-

• The role of hormone replacement therapy in women with a current or past history of endometriosis. (2000)
• The effects of hormone replacement therapy on uterine fibroids in postmenopausal women (1996)

Please click on the required question.

• 1 HRT help me with the psychological difficulties that I am experiencing around?
• 2 HRT help my mental ability?
• 3 Can HRT reduce my chance of developing heart disease?
• 4 How does HRT protect against coronary heart disease?
• 5 If I am at particular risk of heart disease, can HRT still help?
• 6 Do progestogens taken in combination with oestrogen replacement therapy have an adverse effect on heart protection?
• 7 How long should HRT be taken to reduce the risk of heart disease?
• 8 Is there any evidence that HRT will protect my bones?
• 9 Would the dose (strength) of my HRT influence its ability to protect my bones?
• 10 Are there other treatments apart from HRT for osteoporosis?
• 11 Would HRT help my skin?
• 12 Can hormone replacement therapy cure all my menopausal symptoms?
• 13 How prevalent is cancer of the breast?
• 14 What factors influence the chance of breast cancer developing?
• 15 What is the relationship between HRT and breast cancer?
• 16 I have benign breast disease. Can I take HRT?
• 17 Does a history of breast cancer mean that HRT is absolutely contraindicated?
• 18 If I started HRT early (aged 30 to 45), does this influence my chance of developing breast cancer?
• 19 Does hormone replacement therapy increase the risks of cancer of the womb?
• 20 I have had endometrial cancer and now have menopausal problems. Can I take HRT?
• 21 Does HRT have a relationship to ovarian cancer?
• 22 How does HRT relate to a blood clot (DVT - deep venous thrombosis or pulmonary embolism)?
• 23 I have varicose veins. Can I take HRT?
• 24 Should HRT be discontinued before I have a major operation or leg surgery?
• 25 Does HRT increase life-expectancy?
• 26 I am still seeing periods. Could HRT have any benefits for me?
• 27 I have been told that I have fibroids. Can I take HRT?
• 28 What happens if I decide not to take HRT?
• 29 Doctors seem to promote HRT but the media cause me anxiety. Who is right?
• 30 Support Groups.

Thank you for choosing to visit us.

This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.

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