Is there any reason to think if when you formerly do reach menopause that fibroid indications can either dissipate kind of go away on their own will these fibroids wince what happens? The fibroids generally once the hormones altered with menopause fibroids generally tend to retract and regress in immensity and manifestations at that point will diminish significantly now some women still have manifestations after menopause because they take hormonal replacing but for the most part our goal in care if if we’re not if the fibroids aren’t being removed is just to get the women it’s a connect to menopause because once a woman reachings menopause those symptoms basically go away.We talked earlier about the perimenopausal tide and sometimes in some females especially as Jim has said with the the hormonal replacement therapy you stay it’s estrogen actually that is stimulating these fibroids and then there’s also a small subset of women there elements actually in overweight cells that induce the effects of estrogen so we do we tell patients if they’re if they come to our department in their perimenopausal we say that’s let’s try and wait let’s see if we could do wait watchful waiting and get you through this but then you do encounter some patients over season a marry years later and their indications haven’t gone away we get an MRI they’re still active fibroids and they do need management and so while almost all the time they do go away there is a small subset of women who still do better formerly they’re analyse even postmenopausal.

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