While uterine fibroids are extremely common, fibroids awareness is very low. Because of that, many of us are working to raise fibroids awareness. That includes Kamala Harris, who sponsored a bill to build understanding and offer better fibroid care in this country. It’s also true of groups like The White Dress Project, who want women to live life free from fibroid symptoms. And now, it’s also true of Real Housewives of Atlanta star Cynthia Bailey-Hill. Which is why she’s our #WomanCrushWednesday this week!
It’s really hard to find equitable health care for black women with fibroids. In fact, 73 percent of Black women say their doctors never mention UFE, a minimally invasive fibroid treatment option. Even worse? One in five Black women believes her only fibroid treatment option is a hysterectomy. That’s a big problem, since this major surgery causes many adverse health effects, and is often not necessary to relieve fibroid symptoms.
These statistics reveal the treatment knowledge disparity that hurts women of color who have fibroids. And that’s something Kimberly Wilson, our Woman Crush Wednesday nominee, learned the hard way. But, after her healthcare struggle, she’s making it easier to find equal care for black women. And, together with efforts from other groups, Wilson is leveling the playing healthcare playing field. Which is why we’re sharing her story today, and naming her our #WCW, woman crush of the week.
Getting a Fibroid Diagnosis
In 2017, Wilson was diagnosed with fibroids. But, even though she had many fibroid symptoms, getting that diagnosis was really hard. She told Essence magazine, “Over a period of six months, I visited four different providers—all of whom were White men. Two completely dismissed my pain and trauma, while the other two stated that a hysterectomy was my only option. It wasn’t until finding a Black physician—over 100 miles away, that I received the culturally competent care that I needed and deserved.”
After her experience, Wilson wanted to make it easier for women of color to access quality healthcare. And part of that, she realized, meant these women needed help finding culturally sensitive healthcare providers.
That’s when she created HUED, a website that connects patients with medical professionals that specifically understand their cultural, physical and mental-health needs. Her goal? To help people of color access healthcare providers they could trust. Physicians who would listen to their needs. And never dismiss their reports of painful symptoms.
Today, that platform is helping black women access equal fibroid care. And care for many other health conditions. So we applaud Wilson’s efforts. Plus, we’re happy to report, she’s not alone in this fight.
Say Goodbye Fibroids
The White Dress Project, one of our favorite organizations, is also joining the fight. They’ve partnered with Acessa Health Inc. on the Goodbye Fibroids initiative. It’s goal? To unite women, doctors and political leaders in raising awareness of and improving care for women living with fibroids.
They’ve made presentations at the Congressional Black Caucus’ Annual Legislative Conference. And they’ve spent time discussing how women of different races don’t receiving the same quality of fibroid care.
As Acessa Health CEO Kim Rodriguez noted, “Unfortunately, there is a well-established racial barrier to women receiving less invasive alternatives to hysterectomy.”
In other words, black women have a much higher risk of developing fibroids. But they are much less likely to receive information about the full range of fibroid treatment options. Especially about minimally invasive procedures like Uterine Fibroid Embolization.
The facts are clear (and upsetting.) Among women who treated their fibroids with hysterectomies, African American women were less likely to receive a minimally invasive surgery compared to white women. They were also 40% more likely to develop complications. And nearly three times as likely to have an extended hospital stay. Plus, three times as likely to die after their procedures.
While these are statistics for hysterectomies, they don’t even begin to explore other fibroid treatment options. Which likely means that women aren’t even being informed about hysterectomy alternatives. In other words, equal fibroid care for black women is still a distant dream.
Working to Create Equitable Health Care for Black Women with Fibroids
Tanika Gray Valbrun, founder of The White Dress Project, also spoke to the Black Caucus. She said, “As a community we need to begin to address and change the clear, systematic and structural defect within the US healthcare system. [It] disproportionately pushes women of color toward the most invasive option, which is hysterectomy.”
Of course, for Valbrun, this cause is very personal. As she recently shared on her platform at CNN.com, “I’ve heard tales of women with light periods—you know, the ones where you can play tennis or have brunch, like in a tampon commercial. But since I was 14, my menstrual cycles have been something to survive, not celebrate. And it was years until I found out the reason why: Just like my mother, I have uterine fibroids.”
Diagnosed later in life, the blows kept coming for Valbrun. When she and her new husband tried getting pregnant, her doctor said she had 27 fibroids, and “They advised me to look for a surrogate.” Now, fibroids can interfere with conception. But Valbrun wasn’t willing to give up. Instead, she says, “I cried for days. Then I decided to get a second opinion.”
Luckily for Valbrun, at her next medical appointment, she learned, “there was still a chance” for her to conceive. First, she removed those 27 fibroids via myomectomy. Five years later, she needed laparoscopic surgery to remove new growths. Recently, she chose to shave down an existing fibroid. And today she says, ” I’m still on my path to motherhood, and have experienced two failed embryo transfers. Now, with my uterus as clean as possible, we will try again.”
Coochie Conversations: Joining the call for Equitable Health Care with Fibroids
In 2012, Tanya Leake, a certified health coach, started experiencing disruptive symptoms when a small fibroid grew larger. She tried managing her symptoms with lifestyle changes, but she was still suffering. So she started researching her treatment options. And that’s when the trouble began.
Leake met with four different physicians. Three told her she would only find relief with a hysterectomy. And the fourth? That provider never followed up with her after receiving her scan results.
Luckily, Leake spoke with a friend about her desire to avoid a hysterectomy. That friend, she told NPR, helped her find a less invasive treatment option. And, in the wake of her experience, Leake launched Coochie Conversations, a series of small virtual gatherings dedicated to highlighting treatment options for various women’s health issues. She hopes this series will help women find ‘that friend’ who steers them toward equitable health care, And toward less invasive fibroid treatment options!
Help for Fibroids in Houston
As interventional radiologists in Houston, we stand with Leake, Wilson and Valbrun. We want all women to know their fibroid treatment options, and to keep their fertility options open. And we want black women to get equal care and attention from fibroid specialists.
To help that cause, we promote #FibroidFix. This is a campaign to make all women aware of all the available treatment options for fibroids. Particularly the ones that preserve their fertility and minimize the risk of surgical complications. Will you join us in spreading the word?
We invite you to reach out to us for more information about UFE. And we ask you to share this information with all your female friends. You’ll help us make better healthcare accessible to every woman in this country.
Are you worried about fibroids during pregnancy? Those non-cancerous tumors made up of cells and muscle 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. And, if you do become pregnant, how your baby will develop with fibroids. And that was certainly the case for Love & Hip Hop Miami star Shay Johnson, our Woman Crush of the Week!
When it comes to your health, it’s important to know your risk factors for fibroids–plus what it means for your health if you get this diagnosis. Many women have heard about fibroids (benign tumors that develop in or on a woman’s uterus) but don’t know much more than the name. Here is our quick cheat sheet for really understanding these tumors:
What are Your Risk Factors for Fibroids?
Before we get started, we have to be clear: we still don’t the exact reason why women get fibroids. But, thanks to recent studies, we do have a clearer picture of what raises women’s fibroid risk.
First, we know that race plays a major role in your fibroid risk. While any woman can develop fibroids, the ones at highest risk: have a family history, are Black or Hispanic, and/or have a higher Body Mass Index (BMI). In fact, according to a recent study in the BJOG Journal, black women have a two-threefold higher fibroid risk. That’s why about 70% of black women develop fibroids, according to the study. And it may be why European women have a lower fibroid risk than women in the U.S.: the racial mix in populations is very different.
Still, as more Caucasian women present with elevated BMIs, their fibroid risk has also increased. And we know, thanks to this study, 11 other factors that increase your fibroid risk. These include your age (risk decreases as you get older), premenopausal state, hypertension, family history and the time since your last birth. (Having more full-term pregnancies seems to decreases your fibroid risk. Breastfeeding could also impact your fibroid risk. That’s because your ovarian hormones decrease when you nurse. ) Smoking or consuming certain food additives or soybean milk may also increase your chances of getting fibroids.
In some cases, the use of oral contraceptives or the injectable contraceptive depot medroxyprogesterone acetate increased your fibroid risk. That’s not necessarily surprising, since we know that two things make fibroids grow: hormones, especially estrogen, and blood supply.
But, while some forms of birth control increase your fibroid risk, we can also often control fibroid growth with birth control pills. And, we can shrink the tumors by cutting off their blood supply using a procedure called UFE (uterine fibroid embolization.)
Genetic Fibroid Risks
We are constantly discovering other fibroid risk factors, and recently, scientists from the University of Helsinki uncovered a genetic link. After monitoring 728 women with 2263 tumors, researchers grouped their fibroids by genetic variants.
For most women, these fibroids fell neatly into one of three. But a number of the fibroids didn’t fit into previously identified categories. Instead, they showed variations that cells’ histone activity. (Histones help shape and control genes.activity.)
After seeing this variation, the researchers discovered an inherited fibroid risk. Women with certain genetic mutations have a higher risk of developing tumors. As a result, with more research, women with these mutations could receive counseling and regular fibroid screening. In that way, it could be easier to detect and diagnose any developing growths in their earliest stages.
New Genetic Test for Fibroids: If My Mother Had Fibroids Will I Get Them?
A new study in Human Genetics identified certain gene combinations that point towards your risk factors for fibroids. Having highlighted this grouping, doctors could screen patients for these genes. Then, they could avoid delaying a fibroid diagnosis. So that women wouldn’t have to suffer for years without relief.
After studying the test results of almost 500 women with fibroids, researchers compared their genetic markers to women without these growths. Here’s what they found. There are 30 specific genetic chromosomal locations that can be linked to an increased fibroid development risk. Now that we know their connection, if your mother or grandmother had fibroids, you can ask doctors to screen you for these markers. Then, if you have any, you may reach a fibroid diagnosis faster if you start displaying any symptoms.
How Can I Confirm my Fibroid Diagnosis?
If you are experiencing fibroid symptoms like heavy periods, pelvic pain, incontinence or constipation, your doctor may check you for fibroids. Usually, you’ll be diagnosed with a pelvic exam and a pelvic sonogram. You may need a transvaginal sonogram to determine if the fibroid has affected your uterine lining.
As soon as you’ve been diagnosed, you’ll need to consider your treatment options. And remember that you do have options: not all fibroid diagnoses will end in surgery. In fact, there are minimally invasive fibroid treatments that can help you find relief. But the option you choose will largely depend on the type of symptoms you’re currently experiencing.
How will Fibroids Impact my Life?
Once you know you have fibroids, you have lots of options. If you aren’t bothered by symptoms, you may just monitor the tumor(s). With fibroids that are small, birth control, diet and exercise may keep them from causing you pain. But if pregnancy is important to you, the location of your fibroids will also be important. Fibroids that grow in the uterine cavity or block the fallopian tubes may affect your fertility.
If symptoms or infertility send you in search of relief, it’s important to research all your treatment options. While some doctors may recommend surgery (myomectomy or hysterectomy), we like to explore less invasive options. To learn more about non-surgical fibroid treatments schedule a consult today with our Houston area fibroid experts.
We’re here to help women avoid hysterectomy complications and surgeries they don’t need. And that’s a big deal. Because, according to the American Journal of Obstetrics and Gynecology, 400,000 women each year get hysterectomies. Sadly, up to 70% of those surgeries were likely avoidable. (Which means other treatments could have been offered.)
That was the case for Washington D.C on-air broadcaster Delia Goncalves. Recently, she took a two-month TV hiatus. Then, she spoke to her home station, WUSA9, explaining why. She said, “I had a hysterectomy to remove an aggressive 15-centimeter fibroid. I started feeling discomfort during the height of the pandemic, but like so many women – I just pushed through.”
Sadly, that’s the case for so many women living with fibroids. What’s worse? Many women with fibroids learn this the hard way. In fact, they’re often told hysterectomies are the only way to relieve fibroid symptoms. But help could come with less invasive treatment options. Now, like Delia, we want to help make sure women know about those alternatives! Because, as Delia said, “My message to you: listen to your bodies and don’t delay your care. I’m eternally grateful to my gynecologist who knew there was a problem before I did. I am lucky.”
And we want you to get early intervention, too. Because, that way, we hope you can avoid hysterectomy, whenever possible.
Hysterectomies Aren’t the Only Option for Fibroid Treatments
While some women may need a hysterectomy to treat their fibroids, others can be helped with medication, myomectomies, or minimally invasive procedures like Uterine Fibroid Embolization. Also known as UFE, this last is a procedure performed by specialists like Houston’s Dr. Fox and Dr. Hardee. Doctors inject embolizing materials into the blood vessels that feed a woman’s tumors. Soon, they ‘starve’ and shrink, all without a surgical procedure, hospital stay or down time.
Spreading the Word about Fibroid Treatment Options
So, if there are other effective fibroid treatments, why are so many women still giving up on their uterus and fertility? Quite simply, they don’t know they have a choice! According to Sir Marcus Setchell, a former British gynecologist, “There is clearly a failure of communication about the use of these less-invasive treatments.” And, says Dr. Anne Deans, another British gynecologist who consulted on this project, “Women should be given a choice, but many are not being told about the alternatives to hysterectomies. This is major surgery involving six weeks off work.”
Now, fibroid specialists like our Houston doctors are working to publicize alternatives with the hashtag #FibroidFix. And now, we aren’t alone! Recently, the Fibroid Fighters Foundation launched a new campaign, “Talk about U.” Now, can you guess what the ‘U’ stands for? It’s all about the uterus. And they’re encouraging women to do just that, in order to help get out the word about fibroids.
Women Helping Women Avoid Hysterectomy Complications
Fibroid Fighters Foundation Founder Dr. Yan Katsnelson says the campaign is critical. Because women don’t talk about fibroids. So they’re “one of the least discussed chronic health challenges that women face.” To change that, her non-profit is helping women record virtual interviews for sharing on social media.
Women can go to their site and answer a series of questions by audio, video or in writing. The topics cover your journey to diagnosis; how fibroids impact your life; and if or how you’ve navigated fibroid treatment options. The goal? To arm women with information, so you can avoid hysterectomy if possible.
Why does that matter so much? Each week, we hear more stories about hysterectomy complications. And it’s devastating to think they happened for no reason.
Hysterectomy Complications in the News
Late in 2021, 41-year-old Michelle Nugent had a hysterectomy because of uterine scarring. But days after her procedure, she developed excruciating pain. Plus, she lost bladder control, and started vomiting. At first, doctors thought she had a UTI. But later, they realized she’d developed a fistula between her bladder and vagina. (That means the two organs developed an abnormal connection.)
Unfortunately for Michelle, the symptoms of her hysterectomy complications didn’t improve. Even after a reparative surgery. To this day, sex hurts too much for her to be intimate with her husband. And, while a jury awarded her $10 million in damages, it can’t undo the daily pain she experiences.
Avoid Hysterectomy Complications with Other Fibroid Treatments
While Michelle’s hysterectomy wasn’t fibroid-related, her story could easily be. To this day, too many women with fibroids see this surgery as their only treatment option. And that’s because of the stigma surrounding this condition.
After all, as Dearra Williams recently said after sharing her interview, “I didn’t know that other women had experienced fibroids until I started speaking up about my own condition. Experiencing fibroids is tough, and women need to know that they are not alone. We need to support each other because there are thousands of women going through this.”
We love Dearra’s message, and we want to help change the current state of fibroid treatment. Because, now, there too many women who think fibroid diagnoses must lead to hysterectomies. And we know that’s not true. So, will you help us spread the word about alternative treatments? We urge you to visit the Fibroid Fighting Foundation and “Talk About U.” Or just share this article with the hashtag #FibroidFix. Together, we can help women avoid invasive, life-altering surgeries! And remember: if you’re one of the women still searching for a fibroid solution, come to our office for a consultation. We can help you explore ALL your treatment options!
Black women and fibroids just seem to go together. About 80% of all black women develop fibroids by the time they hit their 50s. In comparison, only 70% of white women will get these tumors in their lifetime. And it happens sooner too: almost 25% of black women aged 18-30 30 have fibroids. That’s another awful contrast, since just 6% of white women that age have them. Black women are also two to three times more likely to have recurring fibroids or suffer from complications. This means that the rate of fibroid development is much higher among black women, but that’s not the only concern.
Black women are far more likely to end up in the hospital because of fibroid complications. Even worse? Because they have more fibroids, traditional screening methods often miss endometrial cancers in Black women, resulting in their 90% higher mortality rate for this cancer type, according to a new study in JAMA Oncology.
Those are scary statistics. And that’s why many women impacted by these benign tumors are taking steps to raise fibroid awareness. Another motivating reason? They want to help other black women gain the information needed to receive high-quality fibroid care, that doesn’t always involve a hysterectomy. Because black women are also at least twice as likely as white women to get a hysterectomy due to fibroids, even when they’re still of childbearing age. But they need some encouragement to start speaking about their experiences. Something our uterine fibroid embolization specialist Dr. Eric Hardee recently tried doing, thanks to this interview with NBC news.
Now, those missions line up perfectly with our own. So, today, we salute two of the women crusading for black women with fibroids as our Women Crushes of the Week.
Black Women’s Health and Fibroids: the Silent Pandemic
When LaToya. Dwight was diagnosed with fibroids, her doctors offered a hysterectomy. But, as she explained in a recent interview, “I did not know what fibroids were, and was not given any resources… That did not sit well with me and made me do my research.”
Thankfully, that research led her to lifestyle changes, and a less invasive treatment option. Following her decision, she said, “I realized that a lot of women do not know where to turn because they are typically given the recommendation of having a hysterectomy. And while there is nothing wrong with having one, statistically, 60% of hysterectomies are not needed.” To help fill that information gap, she started the Fibroid Pandemic platform.
Among other resources, Dwight shares information that will help Black women address fibroid symptoms holistically. Specifically, she helps target factors that may be responsible for Black women’s increased fibroid risks. One key lifestyle change she advocates? Changing cosmetics brands. Especially hair care products, since many products marketed for black hair care contain strong chemicals that have been linked to increased fibroid risk. This is very important information, as are the tips our next #WCW shares through her platforms.
Meet The Black Woman “Fibroid Queen”
Registered nurse and fitness trainer Phyllis Frempong expressed concern about Black women’s healthcare equality: “Black women are last when learning the information needed to maximize our options. In the medical system, it has been this way for a long time. It has been set up for us to be at a disadvantage; therefore, we are required to educate and empower ourselves to stay abreast of what is going on.”
She uses her Instagram platform to advocate fibroid fighting fitness routines. As we know, maintaining a healthy weight can help minimize fibroid symptoms and growth, likely because carrying extra pounds can mess with your hormones.
Still, Ms. Frempong knows that talking fibroids isn’t easy. She says, “I grew up in an African household, so talking about medical issues was not encouraged. I remember my mom coming home really drained and tired, and asking her what happened. After initially dismissing me, she later said that her doctor informed her that she would need to get her uterus taken out. I asked why and she said that was fibroids. I did not quite know what fibroids were, I just remembered the name. So, years later, while in nursing school, I asked the doctor for an ultrasound and was questioned. When in a situation like this, always go with your instincts. Something told me to request it, and after finding a quarter-sized fibroid on my uterus, I was told to just monitor it.”
The Growth Cycle Continues
She did just that, but she developed more fibroids, like so many black women with fibroids. And they grew large. Frempong says she felt like a failure, because she’d waited around for things to get worse. All without knowing steps that could help stop her fibroids’ progression.
Today, she’s protecting other women from the same experience. She says, “I used what I learned as a nurse and fitness coach and created a lifestyle regiment to not only reduce my symptoms but shrink my fibroids. I realized that if I could do that, then I could help others. So now, my mission is to help millions of women end their suffering with holistic resources and a community of like-minded women to live their lives beyond fibroids.”
Black Women’s Health: Uterine Fibroid Embolization
In our Houston area fibroid practice, we also work hard to share information about treatment options. We want women to know that hysterectomy isn’t always the answer. That’s part of why we share women’s fibroid stories. And it’s why we always offer patient education regarding Uterine Fibroid Embolization, or UFE, a non-surgical fibroid treatment.
We also know that UFE isn’t for everyone. And that’s ok. Our only goal is to make sure all women know that they have choices. So, if you want to explore minimally invasive fibroid treatments, we are here to help. Check out our guidelines to see if you’re a UFE candidate. And feel free to schedule an in-office or Telemedicine consultation with our team of specialists.
When choosing how to treat your fibroids, you need to know the uterus removal side effects. As many as 70% of women will develop uterine fibroids in their lifetime. And they’ll likely experience symptoms such as heavy bleeding and pelvic pain or pressure. When fibroid symptoms are painful and disruptive, you want relief. Just be sure to choose a treatment that won’t cause you more problems down the road.
Why is Hysterectomy a Challenging Fibroid Treatment?
Many women with fibroids consider hysterectomy. In fact, about 600,000 American women get hysterectomies each year. But, many times, a less drastic procedure could have worked instead. Check out these reasons why you shouldn’t have a hysterectomy.
Discontinuing Progesterone and Fibroids: Another Bad Choice
Some doctors suggest managing fibroid symptoms by taking progestogens, or progesterone-based birth control pills. Unfortunately, new evidence shows that this option is at best ineffective. And, at worst, progesterone can even contribute to fibroid growth.
Even worse? Suddenly stopping progesterone can lead to problems that rival uterus removal side effects. Now, scientists haven’t done a ton of research on this topic. But one study just revealed that women who stop taking progesterone could become extremely aggressive. And that’s why you’ll want to find an alternative to hysterectomy and to hormone therapy if you’re living with fibroid symptoms.
Other Uterus Removal Side Effects: Who Shouldn’t Get a Hysterectomy?
Even if your doctor says a hysterectomy if your best treatment choice, there are good reasons to explore other options. You should not choose hysterectomy if:
You want a baby in the future.
A hysterectomy is not an option for women if they would like to have a baby. If you are young and have fibroids, consider alternatives. Even if you don’t want kids now, really think about your options. After all, a hysterectomy is forever.
You can’t afford to take time off.
Traditional hysterectomies take approximately six weeks to recover, while minimally invasive procedures can take about two weeks. For women who are busy with school, work, or raising a family, this time off may severely impact their lives. Even after recovery, it may be even longer before the patient can return to a completely active lifestyle.
You have not yet reached menopause.
When you lose your ovaries as part of a hysterectomy, your hormonal balance gets disrupted. This makes your estrogen and progesterone production decline. These two hormones play an important part in heart, bone, breast, and brain health. Even when an ovary-sparing hysterectomy is performed, the patient is more likely to develop premature ovarian function failure.
You wish to avoid the risks of surgery.
Infections affect approximately 9 to 13 percent of those who undergo a hysterectomy. There is also a risk of damaging surrounding organs, nerve damage, hemorrhage, and anesthetic complications.
You want to preserve your sex drive.
Because of the sudden drop in estrogen, your sexual desire is likely to drop after a hysterectomy. Vaginal dryness can also be a problem after removing your uterus. Which means that, even if you’re in the mood, sex may be painful for you without lubrication. Plus, there are other, long-term effects of hysterectomy that can impact your mental and physical wellbeing.
Consider Uterine Fibroid Embolization
Uterine fibroid embolization is completed through local anesthesia and is significantly less invasive than a surgery and patients can return to their daily lives much faster than those who have undergone a hysterectomy. In addition, studies show that approximately 90 percent of women who underwent UFE had significant or complete relief from the symptoms of uterine fibroids.
Sources: National Women’s Health Network
Hysterectomy causes major side effects, and they aren’t just menopause and infertility. Now, many women with fibroids think they need a hysterectomy—a surgical removal of the uterus. And some are told it’s the only way to relieve fibroid symptoms. But there are less invasive treatments available, like uterine fibroid embolization (UFE). This is a problem because, no matter what the reason, women who undergo hysterectomies face major surgery complications. And now, studies show that hysterectomy side effects may include mental and physical health struggles. We’ve already explored how hysterectomy side effects damage your heart health. So, today, we’ll explore this surgery impacts your memory and your anxiety levels.
How a Hysterectomy can Hurt Your Mental Health
Women’s risk for anxiety and depression increase after hysterectomy, according to a study in the journal Menopause.
To reach this conclusion, researchers reviewed the medical records of 2,094 hysterectomy patients. For this study, none of those women had cancer. Next, they compared the records to those of same-aged women who hadn’t had a hysterectomy. And then they followed both groups for 22 years.
As it turns out, woman’s risk for depression relatively increased by 26 percent with hysterectomy. And the risk for anxiety increased by 22 percent after hysterectomy. Researchers discovered that age matters, too. In young women, who had a hysterectomy before 35, there was a 47 percent increased risk for depression. Also, the anxiety risk increased by 45 percent. Outside of cancer, the reason for the hysterectomy didn’t seem to impact the increased risk of mental health issues.
According to lead study author, Dr. Shannon K. Laughlin-Tommaso, an associate professor of obstetrics and gynecology at the Mayo Clinic, “Hysterectomy is right for some women. But there is this 4 to 6 percent of women who will be affected by depression or anxiety. We’re hoping women will talk with their doctors and see if there’s any alternative they could use instead.”
Uterine Surgery May Interfere with Memory
Depression isn’t the only way hysterectomy may affect your brain function. According to a pre-human trial from Arizona State University, a hysterectomy could impact your memory. Now, if that sounds strange, it is. But here’s what we know: your ovaries and brain are connected. So your estrogen and progesterone levels impact your memory. But we now know that your uterus is tied to your autonomic nervous system. Which means that losing your uterus could affect your cognitive ability.
In order to illustrate this fact, Dr. Heather Bimonte-Nelson studied rats before and after a hysterectomy. Allowing for 6 weeks of recovery time, the study tested their post-hysterectomy working memory. And here’s the bad news: after hysterectomy, rats couldn’t navigate a maze they used to complete. In comparison, rats who kept their uterus had no problem finishing the maze. In other words, losing their uterus directly impacted rat memory. Clearly, this study has troubling implications for human females.
Urinary Incontinence Added to List of Hysterectomy Side Effects
A new study reveals that urinary incontinence becomes a problem for many women after uterine removal surgery. In fact, 38% of women reported this problem after surgery. But they had no incontinence concerns before their hysterectomies.
Researchers for this study thought that the type of hysterectomy might make a difference on women’s bladder control after surgery. But that was not the case. Because, though participants were divided into groups by surgery type (laparoscopic hysterectomy (SLH), total abdominal hysterectomy (TAH), supervical abdominal hysterectomy (SH), or vaginal hysterectomy (VH)) they experienced incontinence at similar rates.
Myofascial Pain After Hysterectomy
And wait, there’s more! Research now links myofascial pelvic pain and hysterectomy! In fact, if you have pelvic pain prior to your hysterectomy, you’re more likely to need prescription opioid medications following surgery. And, as we know, these medications are highly addictive, and part of the growing opioid crisis in this country.
Now, this discovery is troubling. After all, many women choose hysterectomy because their fibroids trigger chronic pelvic pain. So, if the surgery actually makes pelvic pain worse, that could be a reason to seek other treatment options.
UFE: The non-surgical fibroid treatment option
Thankfully, many women with fibroids can find a non-surgical alternative to hysterectomy in our Houston-area practice. Using imagine, catheters and an injection, we are able to cut off blood flow to your fibroids, which makes them shrink and, eventually, disappear. It’s a minimally invasive procedure, usually not involving a hospital stay.
If you have fibroids and are concerned about having a hysterectomy, reach out to our doctors. We can help you determine if UFE is the right treatment option for you.
Recently, we learned that WWE star Naomi had a myomectomy, and we wish she could have found other alternatives to a hysterectomy. The fierce wrestler announced on her Instagram: “In the midst of hurricane Sally and COVID I also underwent an unexpected 6 hour surgery to finally remove a massive fibroid that’s caused me severe anemia fatigue horrible abdominal pains and more problems I don’t even want to mention over the past year and a half. I’m recovering well. I’m relieved and already feeling so much better. So family and fans don’t worry, I’m ok. Lol, miss ya.”
First, let’s be clear: we’re happy Naomi found relief. And we applaud her as our Woman Crush of the week for bravely sharing her story. But we also wish she’d learned about other options before her fibroid got so large. Because we believe that there need to be more alternatives to fibroid surgery in this country. Too many women with fibroids—non-cancerous tumors of the uterus—get hysterectomies (complete uterus removal). 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. In our office, we offer Uterine Fibroid Embolization, a non-surgical treatment that shrinks your fibroids.
Oral and Minimally Invasive Alternatives to a Hysterectomy
Recently, the FDA approved a new oral medication for women with fibroids, that’s expected to be available later this month. Called Oriahnn, the pill combines estrogen, progestin, and elagolix (a gonadotropin-releasing hormone). It’s important to note that this pill doesn’t shrink your fibroids. Instead, it decreases fibroid symptoms like heavy bleeding.
How effective is this pill? A recent study highlights the effects of elagolix, just one piece of the new drug’s puzzle. Over the course of two and a half years, they followed 433 women who had fibroids and heavy menstrual bleeding. 67% of participating women were African American, since black women are disproportionately affected by fibroids.
Women who took elagolix did get relief from heavy periods, but they also suffered hot flashes, night sweats, and bone loss. In contrast, 90% of the women who took a mix of elagolix, estradiol and norethindrone acetate (“add-back therapy”) experienced reduced blood loss, but with fewer side effects. The “Add-back” therapy combatted effects of stopping estrogen and progestin, as Oriahnn does. Some of these women saw their uterus size decrease. But their fibroids did not shrink.
Also, this pill won’t prevent pregnancy, even though it’s hormonal. And, studies note that taking the medication can cause long-term bone loss. Which means that you can’t take the pill for more than two years. That leads us to the question: what next? Unfortunately, once you stop taking this pill, your fibroid symptoms would return, sending you back to the start of your treatment journey. And, since they don’t want that journey to end in a hysterectomy, researchers at Michigan State University are trying to figure out why fibroids form in the first place. Because, in doing so, they hope to keep every woman from being pushed towards hysterectomy because of fibroid tumors.
Alternatives to a Hysterectomy: Stopping Menstruation with Medication
Another approach to managing heavy periods? Stopping your period with the help of an outside medication called goserelin. In some ways, this method is effective. By taking the drug, you can stop your period. So you can also stop blood loss, anemia and other fibroid-symptoms linked to heavy menstrual cycles.
But here’s the problem. A new study revealed that this approach hurts women more than it helps. Because, after just six months using this medication, most of the women developed osteoporosis. And the damage was irreversible.
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.”
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.
Are you wondering about progesterone and fibroids? If you’ve been diagnosed with uterine tumors, you may want to slow fibroid growth. After all, many women with fibroids struggle to understand, Why did I get this kind of tumor? How fast will it grow? What can I do to slow down or stop the growth in my fibroids?
While we don’t know what causes women to develop fibroids, we have some clues about what increases your fibroid risk. In the past, people thought that vaginal infections could increase your risk for fibroids. But recent studies suggest that bacterial vaginosis or other infections don’t increase your odds of developing fibroids.
With one theory disproved, others remain. It’s clear that Black women develop fibroids more often than women of other races. And, while research is ongoing, we think that could be due to chemicals in hair products targeting Black women, as well as other environmental factors.
We also have an understanding of what these tumors are and what factors may increase your risk of developing fibroids. We also know certain factors that affect fibroid growth. To help you gain a better understanding, let’s start at the beginning, with a basic explanation of fibroids.
What are Fibroids?
Uterine fibroids are non-cancerous tumors that develop in the wall of your uterus. Fibroids can grow alone or in clusters; they vary in size, from microscopically small to rare cases where they grow to the size of fully-developed fetus.
Fibroid symptoms can include:
- Heavy menstrual bleeding
- Painful periods
- Bloating in the pelvic region
- Lower back pain
- Painful sex
- Frequent need to pee
Fibroids and Progesterone What Can Speed Up Growth?
While your genes will play a role in how quickly fibroids grow, hormones like estrogen and progesterone also affect the growth of these tumors. Without these two hormones, fibroids are unable to grow which is why, in the past, causing a woman to experience menopause was considered the only cure for fibroids.
At the same time, some doctors think that progesterone and fibroids could help manage some fibroid symptoms. That’s especially true for the most common symptom: heavy menstrual periods. While trying to decide on more permanent treatment options, some women will take oral or injectable contraceptives to manage heavy periods. But many forms of birth control are progestins, which can increase progesterone levels. And, since fibroids and progesterone can be a dangerous combination, we now tell patients not to use progestins to manage fibroid symptoms.
So, we want to avoid major surgery. And we know that taking progestins could speed up fibroid growth. So, how can you slow fibroid growth, or get rid of them altogether? Thankfully, we can offer women less dramatic, more effective, treatment options.
How Big Will My Fibroids Become?
It’s difficult to know how big a fibroid tumor will become–growth varies from person to person, predict how big a fibroid will grow or what causes a fibroid to grow rapidly. In some cases, fibroids even disappear without treatment. This however, is not common: most fibroids will grow larger unless you opt for medical intervention.
So, just how big will your fibroids become? Honestly, the size limit is based only on your body’s ability to expand. Fibroids can stretch and enlarge your uterus to accommodate their own growth. In fact, some fibroids get so big that you appear to be in the second trimester of pregnancy!
In extreme cases, fibroids will grow so large that doctors can only treat them with surgery. For this reason, it’s important to begin researching fibroid treatment options as soon as you receive a diagnosis.
Can I Slow Fibroid Growth?
Certain steps, like adopting a fibroid-friendly diet, may slow the growth of these tumors. Research suggests that dairy products like milk, cheese and ice cream may inhibit fibroid development. Green tea has also been shown to slow fibroid growth and, in some cases, even kill off existing fibroid cells.
For some women, the hormones in certain forms of birth control can help slow fibroid development.
When it comes to interventions that simply slow down fibroid development, there are no guarantees…that’s the bad news. The good news, however, is that we have better treatment options available. Instead of slowing fibroid growth, interventional radiologists like Dr. Fox and Dr. Hardee are able to use a method known as Uterine Fibroid Embolization to cut off the fibroid’s supply of blood and oxygen. This minimally invasive treatment causes fibroids to shrink and, eventually, die. Want to know if you’re a good candidate for UFE? Just reach out to our Houston area team and we’ll be happy to set you up with a comprehensive consultation.