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Category: News

New Study Aims to Cut Back on Fibroid-Related Hysterectomies

 

Too many women with fibroids—non-cancerous tumors of the uterus—get hysterectomies. In fact, fibroids are the top reason women in the U.S. get hysterectomies. Because it’s such a serious surgery, many women opt for less invasive fibroid treatments. But now, researchers at Michigan State University are trying to figure out why fibroids form in the first place. And, in doing so, they hope to keep every woman from being pushed towards hysterectomy because of fibroid tumors.

Genes and Fibroids: The Newly Discovered Connection

In the course of this study, researchers at MSU’s College of Human Medicine discovered that HOXA13, a gene associated with fibroids, was connected to a process, known as homeotic transformation, that causes uterine muscle cells to turn into cells more typically found inside your cervix.

“It’s a cell type in a position where it doesn’t belong,” explained lead researcher Dr. Jose Teixeira said. “This was a surprise.”

Katy Fibroid Clinic
New research on fibroids could drastically reduce the number of women who are treated with hysterectomies.

But this discovery isn’t just informative: it could change the way we treat fibroids. Specifically, new treatments could target the chain of events that causes your cells to change. That way, you could treat existing tumors with less invasive treatments, such as Uterine Fibroid Embolization. Then, you could use molecular therapy to prevent any  new tumors from forming.

As Teixeira explains, “The discovery that fibroid tumors have characteristics of cervical cells could be a key to better treatments. For example, among pregnant women, the cervix typically softens just before delivery. Figuring out what causes the cervix to soften could suggest new therapies that soften the fibroid tumors and prevent or inhibit their growth.” And, if that works out, you could eliminate any hysterectomy discussions!

What’s Next for Fibroid Research?

While new therapies are still going to take a while, this research is already changing the way scientists study fibroids. Now, the National Institutes of Health (NIH) is funding a follow-up fibroid study.  It’s focus? Texeira says he wants to discover: “Is there a place where we can intervene? That’s the follow-up. If we can find out what’s causing the cervical softening, then we might be able to investigate treatment.” And that could stop fibroid growth before a tumor ever forms.

Sources: Cell Reports Journal

Warning: Menopause Ups Your Risk for Endometrial Cancer

If you have fibroids, your healthcare provider may say that you need a hysterectomy. But if you decide surgically remove your uterus, you will automatically enter menopause. And, according to new research, when your body enters menopause, your risk for endometrial cancer rises significantly.

The Connection between Menopause and Cancer woman researching online

In a study in Scientific Reports, Mayo Clinic researchers identified a connection between menopause and cancer. Specifically, they discovered that menopause changes your vagina’s microbiome, increasing your endometrial cancer risk. (A microbiome is simply a description of the micro-organisms in any environment.)

In the U.S., endometrial cancer is fourth most common among women. And, unfortunately, this cancer’s rates are rising. What that suggests is that changes in our environment, including diet, lifestyle, and the vaginal microbiome, may be responsible for this uptick.

Marina Walther-Antonio, Ph.D., lead author of the study, explains. “If the (vaginal) microbiome does play a role in endometrial cancer, beyond being a marker for it, this could have important implications for endometrial cancer prevention.”  

In the wake of this discovery, researchers can now identify several main risk factors for endometrial cancer. They include: Obesity, post-menopausal status and—the newest addition to the list—a high pH level in your vagina.

Dr. Walther-Antonio says, “We have determined that all of these factors impact the reproductive tract microbiome, further identified post menopause as a key factor, and are looking ahead to discuss potential translational applications of this knowledge, which may bring new approaches to address current health disparities in endometrial cancer,” says Dr. Walther-Antonio.

The goal of the study was to understand how endometrial cancer risk factors alter the reproductive tract microbiome and endometrial cancer risk. We now clearly see that menopause is a factor in your endometrial cancer risk. Which means that you should carefully consider all your fibroid treatment options before choosing one that will prematurely trigger menopause. For more information on less invasive fibroid treatment options, we invite you to schedule a consult with our Houston area fibroid specialists.

Sources: The Mayo Clinic, Scientific Reports

5 Facts You Need to Know About Your Uterus

As women, we know that we have a uterus. We may know a few things about this organ, like it’s function and vague location, but there’s lot’s more to learn! With that in mind, here are five fascinating facts about the uterus we bet you haven’t yet discovered!

Size Matters 

The uterus is usually pear-sized, but it can expand to the size of a watermelon. When you aren’t pregnant, your uterus is only about 3 inches long and 2 inches wide, although this size varies among women. Of course, if you do become pregnant, it starts to stretch, expanding to accommodate your growing fetus (it can reach the size of a large watermelon!) Given its ability to stretch, factors other than a baby can affect the size of your uterus. Fibroid tumors, for example, can cause your uterus to expand, mimicking the look of pregnancy even without conception.

You Can Have Multiples

Yup, that’s right! Some women are born with more than one uterus. Although very rare, some women do have uterus didelphys, a congenital condition where two distinct uteruses develop (this was recently brought to life on a 2019 episode of Grey’s Anatomy.) Some women with this condition may also have two cervixes and two vaginas, but others may not have any external reflection of this condition, making it unlikely to be diagnosed until that woman wants to or becomes pregnant.

It’s Not All Smooth Sailing

Sometimes, the uterus has bumps and tilts. Known as bicornuate or retroverted, some women have a uterus with two bumps that make it resemble a heart; others have a uterus that tilts forward or backward instead of straight up and down. Women with a heart-shaped (bicornuate) uterus are unlikely to experience symptoms, although carrying a baby to term may be more difficult. A retroverted uterus also shouldn’t effect your period or fertility, but sometimes it’s a symptom of another condition, like endometriosis or an infection.

Your Uterus Could Be At Risk

Your uterus is vulnerable to cancer. Uterine cancer is the fourth most common cancer in the United States. It’s also the seventh most common cause of cancer-related death in this country. And, according to the CDC, it’s becoming even more common: in fact, women who carry extra weight are up to four times more likely to develop uterine cancer, and we all know that obesity has become a national concern.  Why does weight increase your risk of uterine cancer? Obesity effects your hormone levels, because fat cells have high levels of estrogen, and estrogen increases your risk of this kind of cancer.  

You Can Avoid Hysterectomy 

Removing your uterus is not always the answer. Even if you’re dealing with non-cancerous conditions like fibroids or adenomyosis, you might be referred for a hysterectomy. But removing your uterus can affect more than just your reproductive health. So, before undergoing this major surgery, you must explore less invasive treatment options like Uterine Fibroid Embolization.

Sources: yahoo.com, cdc.gov 

Here’s What you Need to Know about Period Blood Clots

 

When you think about blood clots, you likely think about the ones that can form inside your veins and cause major health problems. But when you notice a blood clot during your period, it’s in a whole different category.

Menstrual clots aren’t composed entirely of blood—they are partially coagulated blood, but also contain some tissue from your uterine lining and dead skin cells. In many cases, these clots are part of a normal menstrual cycle, though they usually form when your flow is very heavy. And, as you may already know, a heavy flow can be a sign of other medical problems. So how can you tell if these clots are normal or something to worry about? Read on for answers! 

When Should I Worry about Menstrual Blood Clots?

As it turns out, the key here is size. If a clot is small—between the size of a nickel and a dime, even on your heaviest day—you’re probably in the clear. Especially if you’re not experiencing unusual pain, cramping or other symptoms. And don’t worry too much about the color, either. Clots come in many shades, from light red to dark, all of which are normal.

So when should you worry about those clots? Once again, size is a factor, so anything larger than a quarter is worth discussing with your doctor. And, if your clots represent a change in your cycle, that’s also worth bringing up at your next gyno appointment. But there’s more. If you’re seeing clots and:

 

·         Experiencing longer periods, lasting more than seven to 10 days

·         Your flow is so heavy you have to change your pad or tampon hourly

·         You are experiencing regular spotting

·         You have lots of pain and cramping

It’s time to talk to your doctor ASAP.

Why am I clotting during my period?

As we discussed, some clots are just part of a normal flow. But other conditions could be causing those worrisome clots, including:

Uterine fibroids: These are tumors that develop in your uterus, but they are almost never cancerous. Still, they can cause symptoms like long, heavy periods, and extreme pelvic pain.

Endometriosis: This condition occurs when the endometrial tissue (it lines the inner portion of your uterus) grows outside.

Adenomyosis: Like endometriosis, this is a condition where endometrial tissue escapes the uterus. But with adenomyosis, the tissue grows into the muscular walls of your uterus.

Uterine polyps: These growths are attached to the inner wall of your uterus, and reach into the uterine cavity. They are not usually cancerous, but can change and become problematic.

Other conditions, including missed miscarriages and even cancer could be causing your large clots, so be sure and speak to your doctor if this is a concern. The good news is that many of these conditions, including fibroids and adenomyosis, can be controlled with minimally invasive treatment options. So get into the office today and start feeling better.

 

This Study Proves UFE is as Effective as Hysterectomy for Fibroid Symptoms

As interventional radiologists, we always want patients to consider every fibroid treatment option. And, we want women to find the least-invasive treatment that will provide them with symptom relief. That’s why we are so excited about the results of a new, 10 year EMMY study. Its findings reveal that Uterine Fibroid Embolization provides similar symptom relief to hysterectomy!

Women with Fibroid Symptoms Find Relief

The study followed women who treated fibroids that caused heavy menstrual bleeding. Researchers compared two groups: those who’d had UFE and those who’d had hysterectomy. Women in both groups reported on their clinical results and on improvements in their overall quality of life.

Here’s the great news: after 10 years, two thirds of UFE patients didn’t need hysterectomies. That’s because their symptoms had resolved.  Around 35% of the  women did go on to have a hysterectomy, but the rest found relief without radical surgery. And, even within the hysterectomy group, 17% of women required follow-up surgical procedures.

Jim Reekers, lead researcher, says: “After 10-years of follow-up, about two thirds of patients with symptomatic uterine fibroids, who undergo treatment with embolization can avoid a hysterectomy.”

He went on to state that after 10 years, women in both the UFE and hysterectomy groups had similar quality of life results. In conclusion, he said, “Uterine artery embolization is a well-documented and good alternative to hysterectomy for symptomatic uterine fibroids, on which all eligible patients should be counselled.”

History of Uterine Artery Embolization

Uterine artery embolization, or uterine fibroid embolization, has been a viable fibroid treatment option since 1995. So why aren’t more women opting for this less invasive procedure? The sad answer is: many women don’t even know it’s an option.

As Reekers told Interventional News: “Not informing patients about uterine fibroid embolization, when these 10-year data are available, is unethical. Uterine fibroid embolization is an interventional radiology procedure that has level one evidence to back its use. In this trial, we treated the worst end-stage scenario without any reintervention, so real world outcomes for embolization will be even better.”

UFE vs. Hysterectomy: Equal Results, Traumatic Differences

In conclusion, study authors found that UFE is a very effective fibroid treatment option. In fact, it was just as effective as hysterectomy. As the study authors reported, ““After 10 years, generic health-related quality of life remained stable, without differences between both groups. The urogenital distress inventory and the defecation distress inventory showed a decrease in both groups, without significant differences between study arms, but with a trend towards better outcome for uterine artery embolization.”

But, there is one big difference between the two treatment options. UFE’s recovery time is, typically, a few days. The aftermath of a hysterectomy can be felt for months, and even years, following the procedure. Given that fact, doctors owe it to their patients to share UFE information. And if your doctor isn’t telling you about this treatment option, come into our Houston area offices to learn more.

 

Sources: American Journal of Obstetrics and Gynaecology, interventionalnews.com

How Long Should My Period Last?

Abnormally long or heavy periods can be a sign that you have uterine fibroids, but many women ask: how long should a normal period last? 

Of course, every woman’s menstrual cycle is different. Generally speaking, howeve,  your cycle begins on the first day of one period and ends on the first day of the next. The cycle usually lasts between 21 to 35 days.

For the first few years after you get your period, you may have long cycles; these will likely shorten and become more regular as you get older. Your estrogen levels also begin to decline as you age, so it’s not uncommon to experience shorter, lighter and less regular periods even before menopause begins. Barring the natural aging process, here are some changes you should recognize as signs to talk to your doctor.

What the Length of Your Period Means

doctor appointment
If your period lasts too long, make an appointment with your doctor: it could mean you have fibroids!

A normal period can last from two to seven days, but most women have periods that last three to five days. If your period is very short, it could be a sign that your estrogen levels are low. If you don’t produce enough estrogen, the lining of your womb won’t be very thick so, when it’s time for it to shed, the process won’t take very long.

Your birth control, weight loss, intense exercise schedule and/or stress could also impact and shorten the length of your period.

If your period lasts longer, hormonal imbalances could also be to blame. Conditions that can cause hormone imbalances include: polycystic ovary syndrome (PCOS), diabetes and thyroid conditions. Extreme weight gain can also throw off your hormones.

Uterine fibroids (non-cancerous, muscular tumors), can also make your periods longer and heavier, as can polyps, (Small, benign growths on the lining of the uterus).

If your heavy, late period is a one time thing, it may actually be due to a miscarriage. Uterine and cervical cancers can also make you have heavier than normal periods.

Finally, some medications can make your periods longer and heavier. Potential culprits include: anti-inflammatories, estrogen and progestin supplements, and anticoagulants.

 

As always, it’s important to remember that your normal period won’t be identical to your friends’, mom’s or sister’s. If, however, your personal normal period has changed and your concerned, talk to your doctor right away.

 

Sources: RSVPlive.com 

5 Fibroid Myths to Forget Right Now

If you’ve been diagnosed with uterine fibroids, people will likely inundate you with information and opinions. Unfortunately, not everything you hear will actually be true. To help you sift through the info overload, here are 10 common thoughts about fibroid tumors that are totally and completely untrue: 

MYTH #1: Fibroids are cancers.

Because they are tumors, many patients worry that their fibroids are a sign of cancer. Fortunately, that’s completely untrue! Fibroids are benign growths; they aren’t linked to uterine cancer. They can be painful and cause disruptive symptoms like pelvic pain and heavy bleeding, but they are not typically a life-threatening condition.  

MYTH #2: Women with fibroids need a hysterectomy

For years, women with fibroids were told that hysterectomy was their only treatment option. Today, however, that is no longer the case. Myomectomies can be performed to surgically remove individual tumors, or women may seek Uterine fibroid embolization (UFE), a minimally invasive option. This nonsurgical procedure is performed on an outpatient basis; it treats fibroids while preserving a woman’s uterus.

MYTH #3: Women with fibroids can’t get or stay pregnant.

While some fibroids may affect your ability to conceive, or may complicate your pregnancy and delivery process, others will not have any impact on your fertility. If you have fibroids and are having a hard time conceiving, however, seeking fibroid treatment may improve your odds of starting a family.

MYTH #4: Removed fibroids don’t come back

While we’d like to believe that women will only require one round of fibroid treatments, this is not always the case. For some women, fibroids will recur after an initial treatment. For this reason, surgery may not be an ideal treatment option. While many women solve their fibroid issues after one round of UFE, those who require additional treatment will at least not be dealing with multiple invasive surgeries.

MYTH #5: All women with fibroids have heavy periods and pelvic pain.

With fibroids, as with life, every woman is different. Some women with fibroids will present with these common symptoms. Others will experience no symptoms whatsoever, and may in fact be surprised by their diagnoses. Still others will face constipation, frequent urination or other issues. What’s key is to see your OBGYN for regular exams, and to bring up any side effect or symptom that is unusual for your individual body.

Warning: Excess Weight Could Delay a Fibroid Diagnosis

Women with uterine fibroids typically experience symptoms like heavy or prolonged periods, weight gain, protruding bellies, constipation and pelvic pain. But what if you already experienced many of those symptoms because you were carrying extra weight? It would certainly make it harder to recognize an abnormal (but non-cancerous) growth in your uterus! UAE treatment for Adenomyosis

Missed Fibroid Symptoms

 

For one woman from Wales, that was exactly what happened. Tina Mathias, at her heaviest, weighed almost 340 pounds. She suffered from chronic back pain and constipation, but when she shared these symptoms with her doctor, they were considered a byproduct of her poor diet and excess weight. 

At the time, Tina assumed her doctors were correct. “My periods were normal which is why I didn’t think it was a problem with my reproductive system,”  she says. 

In the hopes of improving her health and alleviating her worst symptoms, Tina set out on a weight loss journey. She was extremely successful, dropping 182 pounds, but her problems didn’t resolve. 

“I’d lost so much weight and I thought I’d be healthier, but the pain in my lower back, sides and abdomen carried on,” she says. “Then it got so bad that I couldn’t get out of bed and I would wince if my husband touched me.” 

Still, Tina didn’t think her problems could be caused by fibroids. She simply continued eating healthfully, trying to lose more weight and hoping to feel better. 

 

Finding Answers

Finally, when Tina was extremely thin, she had a moment that put everything into perspective. 

“When I really slimmed down, my belly was still so large. I looked six months pregnant,” she says. “Someone in work asked me when the baby was due and that’s when I knew something really wasn’t right.”

Still, doctors didn’t immediately figure out what was ailing Tina. They attributed her constipation to a low calorie diet, and didn’t think to examine her for fibroids until sex with her husband became extremely painful. Finally, she was sent for a scan, and doctors discovered a nine-pound fibroid, made of muscle and fibrous tissue, that had likely been growing in her uterus for a decade or more!

It was now dangerously close to perforating her bowel, and doctors told her she needed a life-saving hysterectomy. Just 36 at the time, Tina was devastated but, since the tumor was so large and in such a dangerous location, she had no choice. Now 43, Tina has had to give up on her dreams of having a family, but she is living a happy, healthy and pain-free life. 

 

Recognizing Fibroid Symptoms

The saddest part of this story is that, had someone diagnosed Tina’s fibroid earlier on, she could have preserved her fertility. That’s why its important for women to know all of the symptoms of fibroids. Its crucial to recognize that, even if your periods are normal, you may still have a problem. You also need to be your own advocate: if your pain persists and your doctor insists its because of your weight, it’s not time to give up hope: it’s time to get a second opinion. The earlier you treat fibroids, the more options that will be available for your treatment.  

 

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!