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|Uterine Fibroid Embolization|
|Female Reconstructive Surgery|
Frequently, my Inbox contains email from women wanting to know about the role of progesterone in the development of fibroids. The following is an example of a question posed not too long ago:
"I'm confused about progesterone. One the one hand, natural progesterone cream is supposed to be good for fibroids, on the basis that it balances an excess of estrogen that seems to cause them to grow. On the other hand, RU-486 shrinks fibroids, and that's a progesterone inhibitor! Does anyone know any more about this?"
With each email, I am reminded of the following:
is a fifth dimension beyond that which is known to man. It is a dimension
as vast as space and as timeless as infinity. It is the middle ground between
light and shadow, between science and superstition, and it lies between the
pit of man's fears, and the summit of his knowledge. This is the dimension
of imagination. It is an area which we call... THE TWILIGHT ZONE."
- Rod Serling
I know Rod Serling was writing about imagination...but I found his opening passage to the Twilight Zone as equally apropos to what we know about uterine fibroids.....and once diagnosed with fibroids it certainly seems like a surreal entrance into a no man's land of limited knowledge and a ridiculous array of less than perfect treatment options.
The science that would clarify the current state of confusion about progesterone doesn't exist. Neither progesterone cream nor RU-486 has, at this point in time, been proven to resolutely shrink fibroids. The information we have on use of progesterone cream is truly theoretical and not well-founded in science. It seems to help some women and make others' situations worse. (It certainly helps my mental disposition -- but doesn't seem to do much of anything for my fibroids.) There are no clinical trials anywhere in the works that I know of that would answer this question either. There are studies underway with RU-486 that may tell us if this therapy works to shrink fibroids but won't tell us WHY, per se, that it works, specifically. Fibroids are receptive to progesterone and estrogen. Tweaking with these hormones has an impact. But is it a consistent impact from one woman to the next? Is it an impact without consequences elsewhere in the body?
To discover the real WHY, we need to tear apart the reproductive engine and then piece it back together again through a lot of biological research. Research on how women respond to medical therapies or surgical treatments give us limited information on the true nature of the disease of uterine fibroids. And, because so many women are in the throes of this disease right now and can't wait for the biological research to turn on the lightbulb to show us the answers, we desperately rely on the treatment option research currently underway or simply turn to old-fashioned guesswork. Lots of guesswork. It's easier than surgery, that's for sure. Try this...try that...eat beans...no, try rice...cut out red meat...stop drinking coffee...lose weight...use progesterone cream...how about castor oil packs...vitex worked for me...
The "science" that floats all around us has us trapped in a net and struggling for our very lives to try just about anything to get out of the physical reality of our situation. Sometimes what a woman tries actually works...and gives us hope that it might work for us as well. Does anyone else, while reading women's posted questions online about fibroid treatment options, ever have the image of a school of beautiful dolphins suddenly entrapped in a fishing net, struggling, crying out to one another urgently but often in vain?
What a desperate lot of women we are. And we number in the millions. We need two kinds of research and we need it now:
Biological research, such as that the NIEHS (National Institute of Environmental Health Sciences) is embarking upon with their Uterine Fibroids Growth Study, may well begin to give us some of the answers we are seeking. Begin. Only begin. And, answers rarely provide an immediate solution.
Therapeutic research, such as that undertaken for mifepristone (RU-486) at Rochester or device materials for specific procedures such as UAE research funded by Boston Scientific will, hopefully, continue to help support the needs of the women who suddenly find themselves swimming with the dolphins on this one. But even this is not therapeutic research based on answers given to us through biological research on uterine fibroids. This research is based on guesswork. I'll take it though. It's all we have for now. And we need more of this kind of research to give us answers to the safest and most appropriate ways in which we can treat our fibroids. Preferably, more research on treatment therapies OTHER than hysterectomy.
I wish I had an answer regarding these questions about progesterone. But I'm as confused as the next person on this one. As clinical trials for women with fibroids become available, I hope that many of you reading this think seriously about joining one and sticking through the data collection process to the end so that we can begin developing some answers. We need to be able to swim free of this one. Big time.
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This page last updated Wednesday, April 10, 2002