Fibroids and Midlife: What Your Doctor Might Not Be Telling You
Fibroids and Midlife: What Your Doctor Might Not Be Telling You
Let’s talk fibroids. These non-cancerous growths in the uterus—also called myomas—are incredibly common, especially for women in their 30s and 40s. And while mainstream medicine often tells you they’re “no big deal,” the truth is more complex—especially once hormones start to shift in perimenopause.
Fibroids are affected by hormones. More specifically, they’re highly sensitive to estrogen and progesterone—the same hormones that fluctuate wildly (and often crash) during perimenopause. That’s why fibroids often grow during your reproductive years, worsen in your 40s, and tend to shrink after menopause.
But here’s the thing: “common” doesn’t mean “normal”—and it certainly doesn’t mean “nothing to worry about.”
What Are Fibroids, Really?
Fibroids are benign (non-cancerous) tumors that grow in or around the uterus. They can be as small as a seed or as large as a grapefruit, and you can have one—or many. They’re fueled by hormones, and often grow faster during:
Pregnancy (thanks, estrogen)
Perimenopause hormone swings
Hormonal birth control (in some women)
Why Do Fibroids Happen?
The exact cause isn’t nailed down, but estrogen dominance plays a big role. When estrogen isn’t properly balanced by progesterone—or when your body isn’t clearing estrogen efficiently—fibroids can grow.
Other contributing factors:
Genetics (family history matters)
Early onset of menstruation
Vitamin D deficiency
Poor liver detox pathways
Chronic inflammation
Xenoestrogens from plastics, pesticides, and personal care products
If you’re in your 40s and still cycling, and your estrogen is high or unopposed, you’re in prime fibroid territory.
Symptoms of Uterine Fibroids
Some women don’t feel a thing. Others deal with daily discomfort. Here’s what to watch for:
Heavy or prolonged periods (hello, anemia)
Pelvic pain or pressure
Bloating or a “full” feeling in your abdomen
Painful sex
Frequent urination or constipation
Lower back pain
Fibroids can press on the bladder or bowel, mess with your hormones, and seriously disrupt quality of life.
Fertility & Fibroids: What You Should Know
Fibroids can affect fertility—but not always. It depends on their size, number, and location. Submucosal fibroids (inside the uterine cavity) are the biggest fertility disruptors, but large fibroids pressing on the uterus can interfere with implantation or increase miscarriage risk.
If you’re trying to conceive and have fibroids, it’s worth investigating further.
How Are Fibroids Diagnosed?
Most are found during a pelvic exam or follow-up imaging. Common diagnostics include:
Ultrasound
MRI
Hysterosonography (saline-infused ultrasound)
Hysterosalpingography (X-ray of uterus/fallopian tubes)
Do Fibroids Always Need Treatment?
Not necessarily. If they’re small and symptom-free, your doctor may recommend watchful waiting. That said—you don’t have to “just live with it” if your periods are wrecking your life, your hormones are out of whack, or your sex life is on hold because of pain.
Functional Medicine & Fibroid Management
We don’t just shrink fibroids—we ask why they’re there in the first place. That means we evaluate:
Estrogen and progesterone balance
Liver detox capacity (are you clearing hormones or recycling them?)
Thyroid function
Nutrient deficiencies
Exposure to environmental toxins
Then we address the root cause, not just the symptoms.
Treatment Options
Depending on size, symptoms, and your fertility goals, options include:
Non-surgical
Bioidentical hormone therapy to balance estrogen/progesterone
Nutraceuticals like DIM, calcium d-glucarate, or curcumin
Anti-inflammatory diet
Vaginal progesterone or oral cyclic support
Medical or minimally invasive
Uterine fibroid embolization (UFE) – blocks blood flow to shrink fibroids
Laparoscopic myomectomy – removes fibroids, keeps uterus
Endometrial ablation – removes uterine lining, stops heavy bleeding
Surgical
Abdominal myomectomy – removes large or multiple fibroids
Hysterectomy – last resort if fibroids are severe and childbearing isn’t a factor
Bottom Line
Fibroids are common—but they’re also hormonal. And if you’re in your 40s or early 50s, chances are your shifting estrogen levels are playing a major role. You don’t have to “watch and wait” while your symptoms worsen.
Let’s look at your hormones, clear the root causes, and restore balance before surgery becomes the only option.
Your Next Step
If fibroids are disrupting your life—or if you’re just tired of guessing what your hormones are doing—it’s time to get answers. We’ll test, assess, and map out a plan using bioidentical hormone therapy and functional medicine principles tailored for you.
