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. 2015 Jun;30(6):493-9.
doi: 10.1007/s10654-015-0016-7. Epub 2015 Mar 18.

Effects of obesity and hormone therapy on surgically-confirmed fibroids in postmenopausal women

Eva M Sommer  1 , Angela Balkwill, Gillian Reeves, Jane Green, Dame Valerie Beral, Kate Coffey; Million Women Study Collaborators
Collaborators, Affiliations

Effects of obesity and hormone therapy on surgically-confirmed fibroids in postmenopausal women

Eva M Sommer et al. Eur J Epidemiol. 2015 Jun.

Abstract

To examine the association between body mass index (BMI), use of menopausal hormone therapy (HT), and incidence of uterine fibroids in postmenopausal women, 610,604 postmenopausal women without prior hysterectomy or diagnosis of fibroids were followed as part of a large United Kingdom prospective cohort study. We used Cox regression models to calculate adjusted relative risks (RRs) of surgically-confirmed fibroids (defined as a hospital admission with uterine fibroids as a primary diagnosis with a related surgical procedure), in relation to BMI and use of HT. During an average of 11.4 years of follow-up, 3561 women were admitted to hospital with surgically-confirmed fibroids. Five-year incidence rates decreased with age, from 0.50% (1 in 200 women) at age 50-54, to 0.11% (1 in 1000 women) at age 75-79. The 5-year rate in postmenopausal women aged 50-54 was about a quarter that seen in premenopausal women of the same age (1 in 200 vs. 1 in 50). Compared with normal weight women, obese women had a RR of surgically-detected fibroids of 1.46 (95% CI 1.33-1.59; p < 0.0001). HT use was associated with a RR of 2.33 (95% CI 2.18-2.49; p < 0.0001) in ever versus never users. When we analysed HT use and BMI together, obese vs. normal weight never users had a RR of 2.00 (95% CI 1.77-2.26): the highest risks were seen in women who were obese and had ever used HT, RR = 3.30 (95% CI 2.88-3.79). Uterine fibroids continue to occur in postmenopausal women; obesity and hormone therapy use are important modifiable risk factors.

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Figures

Fig. 1
Fig. 1
Five-year incidence rates per 100 women of surgically-confirmed fibroids in postmenopausal women aged 50–79, by 5-year age group
Fig. 2
Fig. 2
Five-year incidence rates per 100 women of surgically-confirmed fibroids by body mass index and menopausal hormone therapy use
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