Author: Houston Fibroids

New Hope for Women who Experience Painful Sex

For some women with fibroid tumors, sexual intercourse can be painful. Fibroids come in different sizes, and fibroids can also form in different portions or layers of the uterus. When fibroids are located near the cervix, they can cause so much pain  that a woman will avoid certain sexual positions or avoid having sex entirely. In some cases, fibroids near the cervix may also cause women to experience post-intercourse bleeding. Females friends conversing

 

New Relief for Painful Intercourse

Of course, women with fibroids are not the only ones who experience painful intercourse. According to a new study in the Journal of Obstetrics and Gynecology, evidence suggests that women with chronic sexual pain who were given Gabapentin (a fibromyalgia drug also used to target oral nerve pain) experienced relief from sexual pain. 

The women included in this study had a condition known as vulvodynia, a chronic problem characterized bu stinging, burning and itching at the entry to the vagina. The condition is often worsened by sexual intercourse, or even by the use of tampons. 

With the fibromyalgia drug Gabapentin, the 230 women included in the stuy experienced less pain; their arousal and sexual satisfaction levels also improved. Of course, the pain of vulvodynia does not have the same underlying cause as the pain of fibroids, but one factor does unite the two issues: tightness and discomfort in the pelvic region. Gabapentin appears to help women by alleviating pelvic pain, a symptom experienced by many women with fibroids. 

 

Pain Management Vs. Problem Solving

Not all women are ready to treat their fibroids immediately after receiving a diagnosis. Wisely, they want to research all their treatment options, and decide which course of action is best for their long term health and fertility goals. For women like these, who decide to lay surgical or non-invasive fibroid treatments like UFE, finding new ways to manage symptoms like painful intercourse will be very important. 

UFE Gives Better Fibroid Outcomes, Study Proves

According to a new Mayo Clinic study, minimally invasive uterine fibroid treatments offer better results than surgical options. According to findings published in the American Journal of Obstetrics and Gynecology, women who treated fibroids with UAE (uterine artery embolization) were less likely to need a second procedure than women who were treated with MRI focused ultrasound surgery (MRgFUS). 

The study found that, both treatments reduced women’s fibroid treatments, but UFE offered a greater symptom reduction.

Of course, the study proved that both procedures were minimally invasive, making them viable alternatives to hysterectomy (the complete removal of a woman’s uterus.) This is great news for all women, since fibroids lead to about 200,000 hysterectomies each year in this country.  While hysterectomies can “cure” women of fibroids, removing a woman’s uterus has been shown to increase a woman’s risk of long term health complications, including weight gain and heart disease.

What’s important about this new study is that, finally, alternatives to hysterectomies are being compared to one another to see which is the best option. And in this study, called FIRSTT Fibroid Interventions: Reducing Symptoms Today and Tomorrow, Mayo Clinic, Duke University and University of California, San Francisco,  researchers compared MRgFUS to UAE to determine effectiveness.

During the study, 83 participants were randomly assigned to receive one of the two treatments: UAE or MRgFUS. Over the next four years, researchers compared the outcomes of the two procedures in 70 women who underwent MRgFUS and 62 who were treated by UAE. Of the MRgFUS women, 30 percent underwent a second fibroid procedure; only 13 percent of the women who were treated with UAE needed a second procedure.

For interventional radiologists like Dr. Fox and Dr. Hardee, this study is heartening. What it proves to us, and to our patients, is the fact that not only are alternative hysterectomy treatments effective, some are more effective than others. It emphasizes the importance of considering all your options before deciding how to deal with your fibroid diagnosis.

How Fibroids Can Affect Your Fertility

Those non-cancerous tumors made up of cells and muscle known as fibroids can be a quirky lot. Many women with uterine fibroids have no symptoms whatsoever, and some never even know they have them. Others have painful and heavy periods and struggle with discomfort. With all these disparate situations you may be wondering if and how fibroids can affect your fertility.

Continue reading “How Fibroids Can Affect Your Fertility”

Even Penguins Get Fibroids!

Fibroids (non-cancerous growths that develop in the uterus) are very common: in fact, about 80% of all women will develop one or more fibroids by the age of 50. While that statistic may seem surprising, here’s something you may find even more unexpected: fibroids are a problem in the animal kingdom, too! 

Take Bette, an 18-inch African penguin living at the National Aviary in Pittsburgh, PA. recently, she had to have surgery to remove a mass from her abdomen as well as several fibroid tumors from her uterus. 

While any kind of uterine surgery can be complicated, the process is particularly trying on a penguin: the compact bird’s body is protected by thick feathers (her surgeons used a mustache clipper to get through and make an incision) and three separate layers of skin and blubber, each of which required its own stitches. 

Thankfully, Bette recovered well from her surgery. Just days after the procedure, she was hopping around her recovery enclosure, ready to play with toys. Her full recovery was expected to take 10 days, at which point Bette will return to her long time penguin mate, Sidney, and their babies, Sunshine and D.J.

Unfortunately, human patients don’t bounce back from surgery as quickly as penguins. In fact, according to recent studies, women who treat their fibroids via hysterectomy will face long term health consequences, including an increased risk of obesity and heart disease! 

That’s the bad news…but here’s the good news. Unlike penguins, humans with fibroids have access to non-surgical treatment options. Minimally invasive fibroid treatments like embolization make for quicker recovery times with less complications down the road. So, if you’re dealing with a fibroid diagnosis and want to explore minimally invasive treatment plans, reach out to Dr. Fox and Dr. Hardee, your Houston area fibroid specialists! 

Adenomyosis: What You need to Know

Adenomyosis is a condition that causes many symptoms—like pelvic pain and heavy bleeding—that mimic fibroid symptoms. This condition is the result of endometrial cells (from the uterine inner lining) that migrate into the middle, muscular wall of the uterus, the myometrium, where they stay put. The newly lodged cells then increase the mass of your uterus. 

What Causes Adenomyosis?

Unfortunately, we still don’t understand the exact cause of this condition, although different the

pain from uterine fibroids

ories exist. One suggests that it’s caused by genetic changes in endometrial cells. Another proposes that, in fact, cells inside your myometrium actually convert into endometrial cells. We also believe that hormones like estrogen trigger the condition since its symptoms go away after menopause. Female levels of estrogen go down in the first year after menopause and the symptoms dissipate as well.

How is Adenomyosis Diagnosed?

This condition is sometimes diagnosed with an ultrasound scan, but it can be difficult to spot lodged cells, so an MRI is often needed for confirmation. Often, adenomyosis is detected while your doctor is screening for fibroid tumors.   

What Are the Symptoms of Adenomyosis?

While a good portion of women—as many as 30%–won’t experience any symptoms, women with adenomyosis typically experience:

  • Heavy bleeding
  • Intense pelvic pain and pressure
  • Cramping
  • Pain that radiates to your legs and back
  • Distended stomach
  • Blood clots in the pelvis and legs
  • Prolonged menstrual cycles
  • Spotting between cycles
     

How is Adenomyosis treated?

The only way to cure this condition is to undergo a hysterectomy. For many women, this will be too drastic an option—especially since we now know that hysterectomies leave women at risk for cardiac and metabolic problems.

So, while we can’t stop the problem without removing your uterus, we can help manage symptoms with less invasive treatment options. The best option for you will depend on the severity of your symptoms and your overall health:

  1. Anti-inflammatory medications like ibuprofen can help with the pain and reduce the blood flow. For best results, start taking medication several days prior to the start of your cycle.
  2. Taking birth control pills and other hormonal supplements can help manage the condition.
  3. Endometrial Ablation is a minimally invasive procedure that destroys the uterine lining, so no cells can migrate into the muscle wall. The success of this option will depend on how deeply endometrial tissue has penetrated into the wall of your uterus.
  4. UAE or Uterine Artery Embolization is a technique commonly used to treat uterine fibroids. When treating adenomyosis, particles are injected into the uterine artery to block the blood flow to the specific problem area. The goal is to deprive the tissue of both blood and oxygen so the condition will abate. Unlike UFE for fibroid treatments, UAE for adenomyosis involves an overnight stay in the hospital. As we evolve our technique, UAE has earned an 80% effectiveness rating in abating the symptoms of adenomyosis, making it an excellent short term solution to this painful condition. 

 

Warning: Hysterectomies Lead to Long Term Health Issues

Many women believe that undergoing a hysterectomy (the surgical removal of the uterus) will cure their fibroid problems. And while that may be true, a new study from the Mayo Clinic says that, in doing so, women set themselves up for more serious problems down the road. 

In fact, according to the study, women who undergo hysterectomies–even if their ovaries are preserved–have a big increase in their risk of many metabolic and cardiovascular conditions. Dr. Shannon Laughlin-Tommaso, who authored the study, says, “This is the best data to date that shows women undergoing hysterectomy have a risk of long term disease…while women are increasingly aware that removing their ovaries poses health risks, this study suggests hysterectomy alone has risks, especially for women who undergo hysterectomy prior to age 35.” 

To reach these conclusions, researchers followed 2094 women who’d undergone hysterectomies, with ovary preservation, between 1980 and 2002. Each of these women was then compared to a woman her same age, in her same county of residence, who had not undergone a hysterectomy. What they found was frightening: the women who’d had hysterectomies were 14% more likely to have lipid abnormalities, 18% more likely to be obese, 13% more likely to have high blood pressure, and had a 33% increase in risk of coronary artery disease. These risks increased in the women who’d had their hysterectomies before the age of 35. 

For years, hysterectomy was thought of as the best way to treat fibroid tumors. Many women are still told that this is the right treatment choice, even though other, less invasive, options are now available. In the light of this research, however, the reasons for seeking alternative fibroid treatments is abundantly clear.

As Dr. Laughlin-Tommaso says, “Hysterectomy is the second most common gynecologic surgery, and most are done for benign reasons, because most physicians believe that this surgery has minimal long-term risks. With the results of this study, we encourage people to consider nonsurgical alternative therapies fro fibroids, endometriosis and prolapse, which are the leading causes of hysterectomy.”

#WCW: Bravo Star Talks Fibroids and C-Sections

If the name Kenya Moore, star of Bravo’s Real Housewives of Atlanta, is becoming familiar to you, that’s because she’s been our Woman Crush Wednesday a few times already: she’s been incredible about sharing her difficulties in becoming and staying pregnant due to her fibroids. Well now, once again, she’s earning a #WCW spot of honor as she publicly addresses another potential fibroid obstacle: delivering your baby while you still have uterine fibroids. 

Back in October, pregnant Moore was hospitalized. Shortly afterwards, she reveled that she’d need to deliver her daughter, Brooklyn, early because she had preeclampsia, a condition that causes pregnant women to develop extremely high blood pressure. While that diagnosis was challenging enough, Moore revealed is now revealing that her delivery was also difficult.

In a new interview with People magazine, Moore explained that she had to have a three-hour emergency cesarean section and, because she had uterine fibroids, she couldn’t get away with a discreet incision: instead, doctors had to create both horizontal and vertical incisions

“They couldn’t get the baby out,” she shared. “There were all these complications and they knew if they cut into a fibroid, I could potentially bleed out and die. So they ended up cutting me vertically, too, to just get the baby out and make sure I survived the surgery. They were so scared they were going to lose me.”

Even worse? Moore revealed that her epidural ran out at one point, so she needed to go under general anesthesia to avoid excruciating pain. “When it was all over, my doctor said, ‘This was one for the books,’” Moore said. Thankfully, despite being delivered six weeks ahead of schedule, Brooklyn is healthy, and Moore has recovered enough to tell her story. 

Pregnancy and Delivery with Fibroids

Unfortunately, pregnancy and delivery complications are not uncommon in women with fibroids.

These benign, muscular growths develop in and on your uterus, causing many potential side effects (including pain, heavy periods, vaginal bleeding when you’re not on your period, painful sex, and problems conceiving or carrying a child to term.) 

While some women experience completely typical pregnancies, women with fibroids are more likely to need a C-section, to have a breech baby , to have non-progressive labor, to have their placentas break away from the wall of the uterus before delivery (placental abruption), or to deliver their babies prematurely.

Women with fibroids that block their cervix will almost always have to deliver babies via c-section–their fibroids block the fetus’ only other exit strategy. And, as Moore demonstrates so vividly, fibroids can make c-sections a little more complicated. 

C-Sections with Fibroids

Fibroids often get bigger while you’re pregnant, and large fibroids can make it difficult for doctors to enter the uterus to deliver your baby. Also, because fibroids have a significant blood supply that feeds them, cutting a fibroid during surgery can make a women lose even more blood, which can become a life-threatening condition during delivery. 

Fortunately, if you’re aware of your fibroids–and the potential complications they may cause during delivery–you should still be able to deliver a healthy baby, just like Kenya Moore. The important thing is to discuss your options, and potential outcomes, with your physicians so you can come up with the safest possible delivery plan for you and your child.

5 Fibroid Warning Signs to Watch For

Fibroids in different locations may cause your body to experience different symptoms.

Uterine fibroids are more common than you think, and, while many women will develop these non-cancerous tumors, a lot of them will do so without realizing the change in their body! In fact, about 2/3 of women with fibroids never experience ‘typical’ symptoms, making it harder to diagnose and treat the problem. Adding to the complicated diagnosis process? Many fibroid symptoms mimic the effect of other conditions, which is why it’s important to know and discuss any potential symptoms with your doctor. 

 

Once the tumors are on your radar, fibroids can be diagnosed with a routine pelvic exam or with an ultrasound. If you suspect you might have fibroids, monitor your symptoms carefully–both the ones on this list and any other changes in your body’s natural cycles. Discuss any concerns with your ObGYN so you can receive an accurate diagnosis and appropriate treatment plan.  

5 Common Symptoms of Fibroids

  1. Heavy periods
    Heavy periods often accompany fibroids, especially the ones that grow inside your uterus. Of  course, heavy periods can be a sign of other changes in your body, or just your cycle’s natural progression as you age, but if your flow is heavy enough to change your daily activity, it’s worth discussing with your doctor, even if you don’t have fibroids!
  2. Frequent Urination
    Fibroids can press on our bladder, especially when they grow outside your uterus. As they get larger, your need to pee will become more frequent and urgent.
  3. Pain during sex
    When fibroids are located on or near your cervix, they can cause you to experience pain or bleeding during sex. Fibroids in the uterus can also make the additional pressure of sex feel painful. This discomfort may happen during or immediately after intercourse. 
  4. Constipation
    Just as fibroids put pressure on your bladder, they can also stress out your rectum. As fibroids press on your rectum, it becomes more difficult to expel waste–that’s when constipation sets in. Typically only larger fibroids lead to constipation, so you should definitely address this symptom quickly.
  5. Lower back pain
    If large fibroids grow near your spine, they can cause lower back pain. Also, due to their location, you may need an MRI to complete your diagnosis. When fibroids are causing back pain, shrinking or removing fibroids may be your only choice for relief.

As you can see, many fibroid symptoms mimic other conditions. When you talk to your doctor about changes in your body, he or she can help you put the pieces together and solve the fibroid puzzle. That’s why our Houston fibroid specialists encourage all women to speak up about what’s going on in their bodies. Any change that bothers you is a change worth discussing with your medical care giver! 

#WCW: Raquel K Finds an Alternative to Fibroid Surgery

Many times, we feature celebrity fibroid warriors as our Woman Crush Wednesday, but this week we get to draw from our own patient pool. We welcomed Raquel K. recently to our Houston area fibroid practice; as she explains, she came to us because she was, “looking for an alternative to having surgery due to fibroids.” 

Like many African American women, Raquel was diagnosed with fibroids and was facing scary treatment options like surgical removal of her tumors or even of her uterus (hysterectomy.) When she discovered our practice and scheduled her first appointment, she says, “Dr. Fox and his team took time to explain the UFE procedure and made me feel very comfortable.” UFE (Uterine Fibroid Embolization) is an alternative treatment for fibroids that is minimally invasive and is performed as an out-patient procedure. Our doctors insert a catheter through our patient’s femoral artery, in your upper thigh. Next, we guide the catheter to the uterine artery until we get close to your fibroid tumor. Finally, we inject an embolic substance into the catheter. The embolic material is designed to block the vessels around the fibroid, depriving it of the blood and oxygen it needs to grow. The blood and oxygen deprivation results in the shrinking of your fibroids, and the embolic material remains permanently in the blood vessels at the fibroid site. 

After Raquel successfully underwent her UFE procedure, she turned to our practice Facebook page to share her story, helping other patients learn about UFE. In telling her fellow fibroid patients, “My quality of life has improved greatly since my UFE and I am very happy with my results,” she’s helping spread the word about this alternative #FibroidFix. And, in our well-versed hashtag books, that earns her a spot on the #WCW list, as well!