I was compensated by MedIQ , supported by Pfizer and Myovant Sciences, Ltd to empower women to seek care and answer for their uterine health. All opinions are my own.
Are you tired of feeling like your body is failing you? You are not alone. As women, there always seem to be some “mysterious” pain that we’re willing to overlook and/or ignore. Severe period pain and heavy bleeding should not be one of them. Women across the world suffer from heavy periods and chronic pelvic pain, but it's time to take back control of our health. Aunt Flo does not have to rule our lives!
During a conversation with Erica E. Marsh MD, MSCI, FACOG (she/her/hers), S. Jan Behrman Collegiate Professor of Reproductive Medicine, and Elizabeth A. Stewart, MD
Fellowship Director, Division of Reproductive Endocrinology we discussed how important it is to empower diagnosed and undiagnosed Uterine Fibroid sufferers to seek a diagnosis for their symptoms and discuss the appropriateness of all available treatment options with their healthcare provider
What Are Uterine Fibroids?
Uterine fibroids are benign tumors, non-cancerous masses that grow in the wall of the uterus. They range in size from very small to the size of a melon or watermelon.
What are the Common Symptoms?
The symptoms a patient experiences are driven by the size of the fibroids and where they are located on the wall of the uterus. Symptoms can range from pressure against the bladder, to the back of the uterus pressing against the bowel or spine, causing low back pain, to the top of the uterus pressing on the abdomen. Roughly 30-40% of patients with fibroids do have symptoms, such as heavy menstrual bleeding, painful periods, infertility, frequency in urination, constipation, lower back pain.
Who is Affected?
Understanding what causes Uterine Fibroids are still uncertain and I think this is why so many suffer in silence. The attitudes of our health care providers when explaining the symptoms often determines next steps. Fibroids are common: 6-7 out of 10 women will have by them by age 50. And that number is even higher among black women, rising to 8-9 out of 10. Women of African ancestry can have more severe fibroids, more complications, particularly at an early age, and disparities in often plays a role in their care.
What Treatments Options are Available?
Your fibroid treatment plan comes down to your symptoms and personal goals and how to map out treatment plan to address symptoms and respect and value your personal goals. Some patients try birth control, some try non-hormonal medication during periods, hormonal IUDs can also be good options. Another option is oral medications, which are more powerful than birth control, and can decrease heavy bleeding and give relief from pain and bleeding. New treatments are GNRH Antagonists, daily tablets, FDA approved, safe, can take them for more than 6-9 months at a time.
Surgical interventions are available and include myomectomy (the removal of fibroids) or hysterectomy. Frequently, these medical procedures can be done in a minimally invasive way through the robotic or laparoscopic technique but keep in mind that fibroids can reoccur. For instance, if you are taking hormonal treatments and then stop the treatment, they are likely to return. With surgery to remove fibroids, there is generally a 50% chance of them growing back.
Fibroids and Me
My personal experience with uterine fibroids occurred after a routine pelvic exam with a new OB/GYN when she calmly asked me the history of my fibroids”. I had no idea they existed and unfortunately, she was not surprised. Since they obviously did not affect my quality of life, no one had thought to mention it. This is where the medical system fails in patient care. No one seems to be concerned about women's health until it cost them money, or they want to control it. And we can’t neglect the disparities that exist in health care.
After the exam, we discussed possible causes of fibroids, my family history, and any noticeable symptoms. I recalled how as I approached my childbearing years (30ish), my menstrual cycle changed, and I would often experience severe pain in my lower abdomen, and frequent urination. Despite mentioning this to my previous doctor, they told me these changes were about getting older and even suggested that I have anemic levels checked. I was lucky in that they were not large and only appeared on the uterine wall. We continued to monitor them in hopes that they would not cause any fertility issues. I became diligent in what I ate and really monitored hormonal changes in my body. I also keep a log of my menstrual cycle. After the birth of my first child, the doctor noticed that they appeared even smaller but reminded me that we still needed to monitor them. There has been no growth and we continue to discuss how they can affect perimenopause.
How Should Patients Advocate for Themselves?
Patients should feel comfortable discussing their menstrual cycle with their healthcare provider and to lead with what’s bothering them: “I am concerned these symptoms may be caused by fibroids.” Be specific with heavy bleeding and volume of products used each month, feeling fatigued, bathroom frequency due to full bladder. Patients should also feel comfortable indicating that they have heard an ultrasound might be helpful in the event they have fibroids.
It is important for a patient to connect with her provider and feel comfortable with them; advocating for themselves and leave with a plan that will help you get on other side of your symptoms.
We can't wait until the month of July (Uterine Fibroid Awareness Month) to shed light on this important topic. More public awareness is needed so women understand that they don't have to suffer or think that major surgery is the only answer.