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So many menstrual symptoms can leave you stuck wondering about adenomyosis vs endometriosis diagnosis. That's because, if you experience painful periods, heavy bleeding, and chronic pelvic pain, your symptoms could mean a few different things. First, you could have fibroids. But there are two other diagnoses that might apply: endometriosis, a condition in which endometrial tissue leaves your uterus and implants in other parts of the body. When you start your period, this rogue endometrial tissue sheds as well, causing you to bleed in your pelvis and beyond. This bleeding can leave you with cysts, scar tissue, and adhesions.

Adenomyosis also causes these kinds of symptoms, but it is a separate condition. With adenomyosis, endometrial tissue lodges itself deep in the muscle of the uterus. It does not leave the uterus. Now, you could have both conditions at the same time. Yet, even if that is the case, there are several ways in which these conditions affect you differently. Even if your initial symptoms seem the same.

What is Adenomyosis?

Adenomyosis is a condition that affects your uterus. With this condition, your uterus enlarges as its internal lining (endometrium) starts growing in your muscular uterine wall. Soon, you may experience painful periods. That happens because blood goes through both the walls of your uterus and through your vaginal canal.

What is Endometriosis?

Approximately 11% of women in the US suffer from this condition, according to the Office on Women's Health. When you have endometriosis, you also experience changes in your uterine lining. Here, endometrial tissue grows outside your uterus, possibly involving your ovaries, fallopian tubes, and pelvis. When it's time for your body to shed its uterine lining--during your period--you'll experience extreme pain. This is because, without access to your vaginal canal, tissue that's formed on your other pelvic organs gets stuck.

Adenomyosis vs Endometriosis: Distinguishing Symptoms

As we mentioned, both endometriosis and adenomyosis leave women with pelvic pain and heavy bleeding. What’s different is the timing of that discomfort: women with adenomyosis usually experience that pain around their periods. Women with endometriosis have period pain, for a few days before, during and after their periods. But they also often experience pain with bowel movements and at other times in their cycle. Also, with endometriosis, symptoms such as heavy menstrual bleeding and menstrual cramps become progressively worse over time. In contrast, adenomyosis can cause uterine enlargement, a symptom more commonly associated with fibroids.

Causes of Adenomyosis vs. Endometriosis

We don't really know what causes either of these conditions. But what we do know is that the possible links to each are slightly different. Let's take a closer look.

What Causes Adenomyosis?

Like uterine fibroids, we don't know the exact causes of adenomyosis. Still, we can identify certain factors that may increase your risk. These include:

What causes Endometriosis?

Here, again, we don't know exactly why women develop endometriosis. Rumors suggest that only women over 35 are affected by endometriosis, yet it can affect any woman who menstruates. Within that large group of women,  we do know that certain groups of people who have a uterus are more likely to end up with endometriosis. Some contributing factors include:

Adenomyosis vs Endometriosis: Clues to the Cause of Your Symptoms I shrink my fibroids naturally

Clearly, both conditions are characterized by uterine tissue that grows outside your uterine. And we don't know exactly what that starts happening. But there are key differences between these conditions that will affect your diagnosis and treatment process. You see, with adenomyosis, uterine tissue penetrates the muscular wall of your uterus, developing inside the tissue. For many women, this triggers symptoms that are far more invasive than those associated with endometriosis.

In fact, with adenomyosis, your period could feel like it's gushing out. This could lead to iron deficiency, anemia and dizziness. And that's on top of the chronic pelvic pain and uncomfortable sex we already discussed. Of course, many of these symptoms might also mean that you have fibroids or endometriosis. And that is why your healthcare provider may go through several diagnostic tests to get you the proper diagnosis.

Adenomyosis vs Endometriosis: Differing Diagnosis Methods

Endometriosis can be tough to diagnose, which is why many women can only confirm they have this condition after laparoscopic surgery (a doctors insert a thin tube with a light and camera into a small incision in your stomach. This tube lets them see the lesions, cysts, and adhesions that confirm this condition. It also helps them identify the location of endometrial tissue, and the size of the deposits that are outside the uterus.

In contrast, women with adenomyosis can usually receive their diagnosis with an MRI or transvaginal ultrasound. These minimally invasive tools can also confirm the scope of your condition: if you have just a few cysts in your uterus, your adenomyosis is considered focal. If the tissue is widespread within your uterus, you will be diagnosed as having diffuse adenomyosis.

Treating Adenomyosis: UAE Can Help

For both endometriosis and adenomyosis, there are a wide variety of treatment options. And many of these options overlap. Your treatment plan could be as simple as taking birth control pills or inserting an IUD.  But some doctors will recommend more invasive treatments, ranging from minor surgery to as serious an intervention as a hysterectomy.

Now, it's true that getting a hysterectomy is the only way to cure these conditions. But there are other options that can help control your symptoms. For women with adenomyosis, there is a newer treatment available: UAE, or Uterine Artery Embolization. (This treatment may also be called UFE, uterine fibroid embolization, but the process is the same.)

With UAE, particles are injected into the uterine artery to block the blood flow to the specific problem area in your uterus. The goal is to deprive the tissue of both blood and oxygen, so your condition will abate. The procedure involves an overnight stay in the hospital.

Our doctors use three types of particles: smaller, normal and larger particles. This new protocol has increased UAE’s effectiveness rate to 80%. For this reason, UAE seems to be an excellent short term treatment option for many women.

If you have adenomyosis and are seeking relief, we're here to help. Go online and schedule a consultation at our Houston area adenomyosis center. Or, to speak with one of our doctors, please give us a call anytime at 713-575-3686.

Sources: ABC Everday, Health.com

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. However, we do know that, by the age of 50, 70% of women will develop these tumors. And, of those women, between 20-25% will experience disruptive fibroid symptoms. Plus now, thanks to recent studies, we also 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. (The Society for Interventional Radiology estimates 80% of black women will develop fibroids by the time they turn 50.) 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.)

Environmental Risk Factors for Fibroids' Growth

Recently, we've learned something about fibroid risk and your environment from this study in Fertility and Sterility. When pregnant women expecting daughters were exposed to endocrine-disrupting chemicals, the babies seemed to have a higher rate of developing fibroids. While researchers aren't sure why, it seems that these hormones change the developing uterus in ways that make fibroid growth more likely.

What are endocrine-disrupting chemicals (EDCs)? Well, they can be man-made or natural. Either way, these are chemicals that interfere with your endocrine system. As a result, they can harm your developmental reproductive, neurological and immune health. BPA and phthalates are some of the best-known EDCs.

In fact, reviews in 2017 and 2019 found that exposure to phthalates at any point in your life increases your risk for fibroids. In the first study, researchers in China discovered that having more of the phthalate DEHP in your urine (it's often added to plastic to make it flexible) translated to a higher risk for fibroids. And in the second study, Black women with higher phthalate levels in their urine had both larger fibroids and enlarged uteruses.

Now, these are just the risks associated with one kind of EDC. But many others exist. And now we can say that any exposure ups your fibroid risk, as does having diabetes; being obese; suffering from cardiovascular disease or reproductive tract disorders; being over the age of 40; having no children; or having neurodevelopmental disorders.

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. After identifying these genes, they can assign screened women a uterine fibroid polygenic risk score (PRS). The idea? The higher your PRS, the more likely you are to develop fibroids. Now, doctors can screen patients for these genes and determine each woman's PRS score. After receiving an elevated PRS score, women could place their symptoms in context if they appear. 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? heavy periods change your life

If you are experiencing fibroid symptoms like heavy periods, pelvic pain, incontinence or constipation, your doctor may check you for fibroids. Unfortunately, many women will face physicians who dismiss their pain, so you may have to self-advocate or see several doctors to be taken seriously. We hope that's not the case, but you should be prepared...and persistent.

Once you find a doctor who listens, you'll usually receive a pelvic exam and a pelvic sonogram; together, they should deliver a fibroids diagnosis. Still, 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. However, fibroids can lead to hypertension when you have fibroids in your 40s, and that can take a greater toll on your overall health. Plus, 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.

Sources: International Journal of Fertility and SterilityBJOG: An International Journal of Obstetrics and Gynecology 

If you're looking for relief from pelvic pain, you may need to know what causes adenomyosis. After all, this is a hard-to-diagnose condition, but it could be the cause of your pain. Here's the story.

Adenomyosis is a condition that causes many symptoms—like pelvic pain, bloating, an enlarged uterus, 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. And all of these factors trigger symptoms that are also similar to endometriosis. (But adenomyosis and endometriosis are two very different conditions.)

What Causes Adenomyosis?

Unfortunately, we still don’t understand the exact cause of this condition, although different thepain from uterine fibroidsories 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.

In some cases, you may develop adenomyosis if the barrier between your uterus and your endometrial lining sustains damage. You could also develop adenomyosis after sustaining damage to your uterine muscle. (That could happen during a Caesarean section. Or it could be the result of myomectomy surgery to remove fibroids. For that reason, choosing non-surgical fibroid treatments such as UFE may be a safer choice. Especially if you've had a c-section before.)

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. And, regardless of the causes, we know that about 1 in 10 women will be affected by this condition. 

How is Adenomyosis Diagnosed?

In the past, adenomyosis was diagnosed after a hysterectomy, when doctors were able to examine the tissue of the removed uterus. Today, the diagnostic process has improved, allowing for detection without this surgery. However, the diagnostic process still isn't perfect.

First, many women wait years to receive an adenomyosis diagnosis symptoms mimic those of other conditions. And because, too often, menstrual symptoms are 'normalized,' that makes it harder for women to self-advocate, meaning they don't get the diagnosis they need. However, when you speak up and begin to seek a diagnosis, you can sometimes detect adenomyosis with a pelvic ultrasound scan. Still, it can be difficult to spot lodged cells on an ultrasound, 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:

How do we Treat Adenomyosis?

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. We use this technique commonly used to treat uterine fibroids, but it can help adenomyosis, too. Here, we inject particles into the uterine artery, blocking blood flow to the problem area. We do this to deprive your tissue of blood and oxygen, helping stop adenomyosis' progression. But, unlike UFE for fibroid treatments, when you have UAE for adenomyosis, you have to spend the night 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.

Are you living with adenomyosis and need pain relief? Click here to request an appointment with our Houston area specialists today. We are here to help you get back to a pain-free life!

Sources: Journal of Clinical and Experimental Reproductive Medicine

It's important to know that you can treat fibroids without a hysterectomy. Why is that such crucial information? Hysterectomy causes major side effects, and they aren't just menopause and infertility. Now, many women with fibroids think they need a hysterectomy—surgical removal of the uterus. That's the case for Real Housewives of Potomac star Gizelle Bryant, who recently revealed on the show that “My uterus fibroids are so huge that they can’t just remove the fibroids. They’ve got to also remove my uterus, which is just like a full-blown hysterectomy.” Furthermore, she revealed, she "often broke out in a sweat" just thinking about the complications associated with this surgery.

Unfortunately, like Gizelle, some women are told that getting this drastic surgery is 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.

Female with Fibroids

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.”

From Science to Real Life

And these findings aren't just scientific observations. Real women are speaking up about the same issue. In fact, New Yorker author (and fibroid sufferer) Anna Parini just penned an extended essay about the grief she experienced due to a hysterectomy. She poignantly noted, "I imagine that, a few weeks or months after surgery, I’ll feel a sense of relief. No more heavy bleeding. No more anemia. No more Always Overnights, Size 5. But I know that I’ll be grieving, too, for a part of me that feels, even now, as I approach menopause, central to who I am and who I’ve been." Clearly, the struggle is real. But, for many women, it's also avoidable.

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.

Sources: Menopause, The New York Times, Journal of Endocrinology

We need to talk about your fibroid treatment options. Right now, uterine fibroids are one of the main reasons why women get a hysterectomy. And that's a shame since most women prefer an option that lets them keep their uterus--and their fertility.   (more…)

Many women diagnosed with uterine tumors are worried about covering the cost of fibroid treatments. In our Houston fibroids practice, we offer a non-invasive, alternative  treatment option known as Uterine Fibroid Embolization. Its benefits include: minimal downtime, no hospital stays and the ability to avoid surgery and hysterectomy!

Understanding Costs

Fortunately for patients seeking fibroid pain relief, UFE is established as an accepted treatment option. As such, all major insurers (and most plans in general) cover the cost of treatment (check out the helpful video below for more information from one of our fibroid experts, Dr. Hardee.)

In fact, because we perform all UFE procedures in our Houston fibroids office, on an outpatient basis, many patients face much lower out-of-pocket expenses compared to other treatments. While myomectomies and hysterectomies require costly hospital stays, anesthesia and other  expenses, many women who proceed with UFE receive a bill totalling as little as an office visit co-pay. Additionally, if you choose treatment after meeting your insurance plan deductibles, you may further lower the expected cost of treating fibroids.

Of course, as an office, we want patients to focus on getting better, not on worrying about paying for their treatment. For that reason, our experienced team is on hand and available to help handle any insurance issues that arise. Even before your treatments begin, someone from our office will contact your insurance company directly to address any coverage issues.

Cost of Fibroid Treatment: Insurance and our Houston Fibroid Practice

Uterine-Fibroid-Treatment-for-African-American-Women in HoustonThankfully, our practice also works with a wide variety of insurers: from Medicare to HMO plans, we have one of the most comprehensive insurance offerings in the greater Houston area. This means that you will more-than-likely be covered when it comes to paying for UFE.

We know that fibroids take a toll on your life. That's why our doctors offer a less invasive treatment option. And a variety of ways to pay for the treatment itself. Don't let concerns about cost prevent you from treating your fibroid pain. Contact our office at (713) 575-3686 or click here to begin your insurance-covered journey to better health!

 

 

 

 

 

 

Uterine fibroids are growths that form within or on your uterus. Made of muscular tissue, they aren't usually cancerous. For many women, they can cause unwanted symptoms, leaving them seeking fibroid treatment options. Others, however, aren't bothered by fibroid symptoms or don't even know they have these growths. So, what happens if fibroids go untreated? Keep reading to find out!

Different Types of Fibroids Question mark symbol

Fibroids can grow to different sizes, and develop in different locations. In fact, we classify fibroids five different ways, based on their location.

Subserosal fibroids grow outside the uterus, while intramurals develop within the muscular uterine wall. A
pedunculated fibroid grows apart from the uterus, attached via stalk-like growth to the outer or inner surface of the uterus. Submucosal fibroids, the least common, develop beneath your uterine cavity lining. And calcified fibroids are hardened growths that have accumulated calcium deposits, making them harder to remove.

The size and location of your fibroids will often determine your symptom severity, along with your treatment decisions.

Fibroid Treatment Options

After your fibroids are detected, you'll have time to explore treatment options. Some women prefer to watch and wait, seeing if they become more bothersome. Others prefer to manage their symptoms with medications, while leaving the growths in place. In some cases, women will surgically remove tumors via myomectomy, while others elect to remove their uterus via hysterectomy.

It's important to remember, though, that you can treat fibroids without surgery. That's why, at our Houston fibroids clinic, we offer Uterine Fibroid Embolization. It's a minimally invasive procedure that shrinks fibroids without surgery or overnight hospital stays. So, now you now you have options when it comes to fibroids treatment. But what happens if you don't make a choice? Here's what you need to know!

What Happens if Fibroids Go Untreated?

If you choose to delay or avoid treatment options, you may be fine for a while. But, your fibroids could also grow larger. Or new ones could develop. And that could lead to new or worsening symptoms, including heavy periods, pelvic pain, infertility and weight gain, just to name a few.

Want to avoid fibroid complications and surgery, while finding symptom relief? Click here to request an appointment with our fibroid specialists in Houston. Together, we can help you avoid worsening symptoms with a minimally invasive approach.

 

When patients are black women, major fibroid treatment gaps often mean delayed diagnosis, worse symptoms and too many hysterectomies. Now, that’s a big problem. Because black women have a higher fibroid risk. In fact, by the time they’re in their 40s, almost 80% of black women will develop these non-cancerous tumors.  And, as a result, they often experience pain, heavy bleeding, anemia and other debilitating symptoms.

New Evidence on Fibroid's Racial Disparities

fibroid treatment gaps

Recently, a National Institutes of Health study uncovered a genetic finding that could explain why Black women are disproportionately affected by fibroids. And it all has to do with factors that turn genes 'on' or 'off' in the muscular uterine tissue, also described as gene expression

Basically, when genes get turned on in a cell, they proceed to make RNA and proteins. And, in this study, researchers observed higher expressions of the VWF gene in uterine muscle tissue for Black women than for women of other races. Why does that matter? Well, the VWF (von Willebrand factor) gene gives instructions to a protein that regulates blood vessel formation. If black women form more uterine blood vessels than white women, that means they also develop more vascular smooth muscle cells. And, since researchers suspect that these smooth cells give rise to fibroid formations, it could explain why women of color have higher fibroid occurrence rates.

More and Later Diagnoses

Having an increased fibroid risk is bad enough. But all too often, black women face delayed fibroid diagnoses. In fact, research from Johns Hopkins Medicine reveals that up to 50% of fibroids cases go undiagnosed, often because doctors don't bother taking women's complete menstrual histories.

Even worse? If women of color do receive an accurate diagnosis, they often receive less comprehensive medical information. That means they’re less likely to learn about non-invasive fibroid treatment options. And more likely to undergo avoidable hysterectomies.

Already, efforts like the fibroid bill are trying to close these fibroid treatment gaps. And now, the state of New Jersey is joining the cause. That’s why, today, we’re highlighting the Garden state’s efforts to improve black women’s health outcomes, especially when it comes to fibroid treatments.

Unmuting Fibroids: A Black Women’s Health Imperative Campaign

Linda Goler Blount, president and CEO of the Black Women’s Health Imperative, recently explained to Spotlight News that closing fibroid treatment gaps means first addressing years of inequity. She said, “Women don’t want to talk about it. Men obviously don’t want to talk about it. This makes it a challenge. And as Black women, we are socialized to suffer in silence.”

To address that challenge, women need to speak up about their fibroid experiences, she said. “Women—Black women in particular—need to pay attention to our bodies. We need to know this isn’t normal. You shouldn’t be suffering month in and month out. Suffering is not normal, and it is not necessary.”

We couldn’t agree more. That’s why we highlight fibroid warriors in our Woman Crush Wednesday series. And it’s why we celebrate legislative efforts that help women understand their treatment options.

Closing Fibroid Treatment Gaps: Government Support

NJ Senator Cory Booker sponsored the Stephanie Tubbs Jones Uterine Fibroid Research and Education Act.  It allocates $30 million a year, for the next four years, to fund fibroid research, increase federal efforts to collect treatment outcome data, and to publicly share treatment options.

The bill is much-needed in New Jersey especially, where black women face many health disparities. In that state, Black women are seven times more likely than white women to die during or shortly after childbirth. In trying to improve maternal health outcomes, doctors and legislators are also trying to close fibroid treatment gaps. And that’s an effort we applaud as Houston area fibroid specialists.

Fibroid Treatment Options

There are several different ways to treat fibroids, and they range from natural to minimally invasive, followed by surgical options. Not every treatment makes sense for every woman. But each fibroid sufferer—regardless of race—deserves to learn about every option. That way, she can make an informed decision. And hopefully, she’ll realize that most women with fibroids don’t need a hysterectomy to find relief.

Sadly, fibroid treatment gaps widen because of racial disparities in healthcare. Dr. Ndeye-Aicha Gueye, member of the New Jersey Black Women’s Physicians Association, explains the problem. “Sometimes [women are] just so desperate to have their symptoms lessened,” they sign up for surgery without exploring other possibilities. Even worse, she says? “Black women are also less likely to be offered other options.”

Plus, we know less about how fibroids affect Black women, because of limited research on their specific symptoms and outcomes. So, to counteract this inequity, we need more research focused on women of color. And we all need to speak up about minimally invasive fibroid treatment options like UFE (uterine fibroid embolization.)

Want to learn more about this alternative to hysterectomy? We invite you to schedule a consultation with our team of fibroid specialists. Don’t live in the area? No problem. We also offer virtual consultations, to help you understand all your treatment options. And to join efforts to close fibroid treatment gaps, all across the country.

 

You can use birth control with fibroids, but you may have to discuss options with your doctors. You see, uterine fibroids are non-cancerous tumors. Many women will be affected by fibroids in their life.  Fibroids can develop in several different places in or on the uterus. Depending on where they develop, they will be classified as subserosal, intramural, or submucosal.

While no one knows exactly why these tumors develop, there are a few different theories. Things that impact growth in your body, such as insulin-like growth factor, may trigger fibroid growth. Extracellular matrix (ECM), a material that makes cells stick together, could also be involved. When you have fibroids, ECM increases and makes these tumors fibrous. But ECM also stores growth factors, and may trigger  biologic changes in your cells, increasing risk of more fibroids.

Now, these are elements we don't totally understand. But most doctors do agree that fibroid growth can be affected by the presence of estrogen. This may be why many women’s fibroids grow and develop during pregnancy. Because of the connection between estrogen and fibroid development, you may be wondering about birth control with fibroids, and how it will affect their growth? Here's what you need to know about using birth control with fibroids.

How Will Oral Birth Control with Fibroids Affect Symptoms?

  1. Your Periods Will Probably get Lighter

A common side effect of fibroids is long, heavy periods; using birth control pills may help manage this symptom. Birth control typically gives women lighter, shorter periods because the estrogen in the medications can help improve blood clotting and reduce your menstrual flow.

2. You May Have Fewer Cramps

Pelvic pain and cramps are another typical fibroid side effect—and these cramps can be quite severe for women dealing with these tumors. Many women on birth control pills experience cramping relief because the medications can decrease a woman’s prostaglandin count (prostaglandins make the uterus contract, leading to cramps.)

3. Your Fibroids Could Get Bigger

While taking birth control may help you manage certain side effects of fibroids, there’s a caveat: fibroids are very responsive to estrogen, which means that taking birth control can actually make your tumors grow larger. For this reason, you’ll need to discuss your options with your doctors carefully. A larger fibroid tumor may cause you to experience a worsening of symptoms, canceling out the temporary relief delivered by the estrogen in your birth control pills.

4. Birth Control Can Help Prevent Fibroids

If you already have uterine fibroids, taking birth control could make your tumors increase in size. But if you haven’t yet been diagnosed, certain birth controls (especially those with lower doses of estrogen) may reduce your fibroid risk!

5. Hormonal Birth Control Can Raise Your Risk for Certain Cancers. 

Previous studies have confirmed that taking birth control that combines estrogen and progesterone slightly increases your risk for breast cancer. Because of those findings, many women have migrated to progesterone-only contraceptives. Now, a study out of the United Kingdom confirms that progesterone-only birth control also slightly increases your risk for breast cancer. As a result, this option may not work for many women.

Can I Implant an IUD with Fibroids?

If oral contraceptives aren't your best choice, you may be interested in an IUD (intrauterine device) birth control with fibroids. This is a small device which gets implanted into your uterus to prevent pregnancy. IUDs come in two forms: hormonal and non-hormonal, and the type you choose will make a difference in your fibroid experience. Let's explore the differences between the two types of IUDs.

Hormonal vs. Non-Hormonal IUD

Hormonal IUDs prevent pregnancy by releasing synthetic hormones to thin your uterine lining and thicken your cervical mucus. They also partially prevent you from ovulating. In contrast, non-hormonal IUDs release copper into your uterus. And that coppers creates an inflammatory reaction within your uterus, which results in an environment in which sperm can't survive.

Now that you understand how IUDs work, let's explore if they work for women with fibroids. And here's the story: sometimes they do. But sometimes, if your fibroids have changed the shape of your uterus, you won't be able to use and IUD. In those cases, then, you'll want to explore alternative methods of birth control. If, however, you're a good candidate for an IUD, you'll need to choose between a hormonal or non-hormonal device.

Should I get a Hormonal IUD with Fibroids?

For many women with fibroids, using a hormonal IUD will relieve your symptoms. That's especially true for heavy periods, since this kind of IUD gives you a thinner uterine lining. Also, since you'll lose less blood each month with a hormonal IUD, you're anemia risk will be lower. If you were already anemic, your symptoms should improve.

Hormonal IUDs may also reduce painful cramping, since your uterine lining cells release the chemicals which cause this symptom. Basically, a thinner lining means less blood loss and less materials to cause cramps. Which means if you're suffering from these fibroid symptoms, you may benefit from a hormonal IUD. Except, of course, in one instance. Keep reading to find out when you shouldn't use a hormonal IUD.

 

Could Hormonal IUDs Make my Fibroids Worse?

Let's be clear: we don't know what causes fibroids to develop or grow larger. But we do suspect that there's a link between hormones and fibroid growth. In other words, there's a chance that implanting a hormonal IUD could cause your fibroids to grow larger.

If that possibility makes you nervous, we completely understand. Just know that you can still use an IUD for birth control. In this case, you'd just opt for a non-hormonal IUD. But, keep in mind, while this IUD effectively prevents pregnancy, it won't do anything to improve your fibroid symptoms. In fact, some women using non-hormonal IUDs report heavier bleeding and cramps. Obviously, you'll need to think carefully about your options before selecting a non-hormonal IUD.

And, before choosing either type of IUD, keep in mind that your fibroids will increase your risk for IUD expulsion, which occurs when your device falls fully or partially out of your uterus. If you partially expel your IUD, you'll need to consult your doctor about safe removal, and likely move on to another form of birth control once your situation is resolved.

A Final Warning on IUDs

Recently, we've learned more concerning information about hormonal IUDs. Recently, a young woman named Chelsea revealed that, in just 5 weeks, her Mirena IUD left her with debilitating anxiety, brain fog and ocular migraines that stole her sight for up to 45 minutes at a time. Her symptoms eventually sent her to the Emergency Room. At that point, though her doctor said her symptoms would likely resolve after she'd adapted to her IUD, Chelase decided not to wait and see. Instead, she had her IUD removed, and shared her story with IUD Alert to help other women make informed decisions. So, if you're prone to migraines or anxiety, you may want to mention that fact to your doctor when you discuss birth control options.

Plus, there is now a class-action lawsuit against Mirena launched by women who claim it increased their breast cancer risk. And, while there are questions of science that the judge ruled would have to be answered later in the suit, there was enough evidence of a link that the case was allowed to proceed in court.

Clearly, shoosing the right birth control can be challenging. And, when you have fibroids, it can be even more complicated, so it’s crucial to review all your options with your fibroid specialist. But please remember, while birth control may alleviate fibroid symptoms, it can't "cure" or eliminate your actual fibroids. That will only be possible with fibroid treatment. So, feel free to reach out to  Dr. Fox or Dr. Hardee to schedule a consultation on all your fibroid treatment options. And, if getting to one of our five Houston-area offices is a challenge, you can also choose to schedule a remote, Telemedicine fibroid consultation.

Sources: Mayo Clinic, fibroids.com, USA Fibroid Centers

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?

Hysterectomy alternativesMany 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. Many women experience depression and anxiety after removing their uterus. Part of this is due to the sexual and social stigma associated with the loss of a childbearing organ. Plus, the change in hormones can actually trigger chemical depression. But aside from these concerns, there are other reasons to look for an alternative to hysterectomy. 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. Additionally, according to a new study in Stroke, women who have a pre-menopausal hysterectomy have an increased risk for cardiovascular disease, even if they keep their ovaries.

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.

If you would like to see if UFE is right for you, contact Houston Fibroids.

Sources: National Women's Health Network

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