Fibroids, endometriosis, PCOS and dyspareunia: A primer on these common reproductive problems

The human body is incredibly complex, to say the very least. And while many of us have a general understanding about what goes on in there, it can be a bit baffling at times, and not always an easy topic to broach when things appear to be irregular. Dr. Vivien Brown knows that this is particularly true when it comes to conversations surrounding women's reproductive health. Many women aren't comfortable talking to their doctors about certain issues they may be experiencing "down there", but she knows that communicating with your doctor is key and educating yourself is important. So she stopped by The Goods to shed some light on four reproductive health issues that many women face.

Uterine fibroids

Uterine fibroids affect about 20-25% of all women, and are increasingly more common in women over the age of 30. Dr. Brown explained that fibroids are a benign tumour in the lining, the wall or the endometrial layer of the uterus. According to the Canadian Women's Health Network, "black women are 3 times likelier to have fibroids", and they are also more common in women who are significantly overweight or haven't given birth. Dr. Brown noted that scientists don't know exactly why this is, but advised that educating yourself can potentially help you catch an issue early on. She explained that doctors often leave uterine fibroids alone if the tumours are small and out of the way, but will treat them if they are growing rapidly, impacting fertility, or causing pain or heavy bleeding.

Endometriosis

According to the Society of Obstetricians and Gynaecologists of Canada, endometriosis is a "common occurrence in women, affecting up to 10% of all women." It is a chronic condition involving the tubes, ovaries and abdominal cavity — specifically, the lining of the uterus, which is the endometrium. Dr. Brown explained that endometriosis occurs when tiny pieces of that tissue end up in places they don't belong such as the tubes, the ovaries, the abdominal cavity and the vagina. These pieces of tissue are hormone sensitive, meaning that they swell and grow during your cycle and then slough off. But they have nowhere to bleed to because they are internal, which can cause scarring nodules, pelvic pain and infertility. There are a variety of treatments available for this often painful condition, including drug therapies and surgical options that medical professionals can help guide their patients to depending on their specific needs.  

Polycystic ovarian syndrome

Polycystic ovarian syndrome is a hormonal disorder that affects 6%-10% of women. Also known as PCOS, the syndrome occurs when multiple cysts have formed in the ovary, and although symptoms generally start when a woman's menstrual cycle begins, they can also show up years later. Dr. Brown clarified that a syndrome isn't a disease — instead it's a combination of different symptoms. Some of these symptoms can include infrequent or absent periods, thinning hair, weight gain and obesity, and infertility. Dr. Brown explained that it manifests in a variety of ways and not everyone experiences the same symptoms. Some women might only have cysts and not experience anything else. But in other cases, cysts may produce male hormones, leading to symptoms such as hair growth and acne. She detailed one treatment, which is to put the ovaries to rest with birth control pills. This aids to stop ovulation and stop the formation of cysts. Dr. Brown also mentioned that to make this solution even more effective, doctors sometimes put women on extended cycles so that they only cycle every 3 or 4 months. This protects the ovary from producing more cysts, so it will protect their fertility in the long run.

Dyspareunia

Dyspareunia is the medical term for pain during intercourse. Dr. Brown explained that some women experience this because of the conditions and syndromes mentioned above, and others may have painful intercourse because of a muscle-spasm condition called vaginismus. Additional reasons can include lack of lubrication, an issue with a partner and situations including abuse, as well as various emotional factors. Dr. Brown encourages anyone experiencing dyspareunia to talk to their healthcare provider. Although many women may be reluctant to bring it up, a doctor won't be able to discuss treatment options if they're unaware of the issue. The reality is that good communication with both your partner and your physician is essential — there are effective treatments for dyspareunia and women should not suffer in silence.