The need-to-know about your vaginal health.
by brian davies, bsc, nd
Uterine diseases encompass a variety of relatively common conditions, which are associated with many types of uterine irregularities, from heavy menstrual bleeding and abnormal cycles to infertility and cancer. Although the medical causes of many of these conditions remain a mystery, there are strong connections between these conditions and hormone imbalances, so here’s the low-down on what’s down below.
The ones to watch
Uterine fibroids
Affecting more than one in three between the ages of 30 and 50, it is the most common benign tumor found in women. Although typically not symptomatic, fibroids can grow large in size and present heavy menstrual bleeding. Fibroids can be diagnosed with a proper medical bimanual examination, and confirmed by a pelvic ultrasound.
Endometriosis
A condition in which the tissue of the uterus is found to infiltrate other areas of the body. This relocated tissue undergoes cyclical bleeding stimulated by normal monthly hormonal changes leading to severe menstrual pain, and is also strongly associated with infertility. According to the Mayo Clinic, this condition has been found to affect five to ten percent of women in North America. The diagnosis of endometriosis typically requires a laparoscopy, however a pelvic magnetic resonance imaging (MRI) may be sufficient and non-invasive.
Endometrial hyperplasia
A condition in which the uterine lining becomes thickened, typically leading to heavy and atypical menstrual bleeding. This condition is strongly associated with obesity, but being overweight is not necessarily characteristic. The prevalence of endometrial hyperplasia has been found in one study to be between 5.8 and 12.1 percent of overweight women. Other risk factors for endometrial hyperplasia are unopposed estrogen treatment, nulliparity, polycystic ovarian syndrome, hypertension and type 2 diabetes. This condition is typically diagnosed by transvaginal ultrasound, but may require an MRI to rule out cancer.
Uterine Cancer
The most common form of cancer that affects the female genital tract and the fourth most common cancer in women. Although this form of cancer only affects roughly 0.02 percent of Canadian women, it is probably the most preventable form of cancer today according to the Cancer Journal for Clinicians. Certain types of endometrial hyperplasia and the risk factors associated with endometrial hyperplasia are thought to predispose women to uterine cancer, but 90 percent of patients with endometrial cancer have abnormal vaginal bleeding, typically occurring in peri- or postmenopausal women.
Red thread
In general, all of these uterine conditions have one thing in common: estrogen dominance. Characterized by estrogen levels that overpower their progesterone counterpart (the hormone that prepares the uterus for pregnancy), this leads to overstimulation of tissue growth. The best way to characterize estrogen dominance is to have your practitioner assess the estrodiol-to-progesterone ratio on standard blood tests, salivary hormone tests or urine hormone metabolite tests. No matter what, it’s important to be aware and take not of any changes. When in doubt, head straight to your health care practitioner for a proper assessment and examination.
References
1. Lurie S, et alum. Age-related prevalence of sonographicaly confirmed uterine myomas. Journal Of Obstetrics And Gynaecology: The Journal Of The Institute Of Obstetrics And Gynaecology ISSN: 0144-3615, 2005 Jan; Vol. 25 (1), pp. 42-4; PMID: 16147693
2. Lethaby A, Vollenhoven B, and Sowter M. “Pre-operative GnRH analogue therapy before hysterectomy or myomectomy for uterine fibroids.” Cochrane Database Of Systematic Reviews (2000): CD000547.
