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Category: Treatment Options

Warning: Hysterectomy May Cause These 2 Mental Health Issues

Many women with fibroids think they need a hysterectomy—a surgical removal of the uterus. Some are told it’s the only way to relieve fibroid symptoms, even though there are less invasive treatments available, like uterine fibroid embolization (UFE). No matter what the reason, women who undergo hysterectomies must deal with the recovery of a major surgery. And now, according to a new study, we know they may also end up facing mental health struggles after their hysterectomy.

How a Hysterectomy can Hurt Your Mental Health

In a new study published in the journal Menopause, women’s risk for anxiety and depression increased after  hysterectomy.

To reach this conclusion, researchers reviewed the medical records of 2,094 women who’d had ovary-sparing hysterectomies. For this study, none of those women had cancer. Next, they compared the records to the same amount of same-aged women who hadn’t had a hysterectomy. 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. Apparently, women who had a hysterectomy before  35 were at a 47 percent increased risk for depression and a 45 percent increased anxiety risk. 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.”

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

This is What Black Women Must Know About Fibroid Surgery

Fibroids—non-cancerous tumors of the uterus—are a pretty common problem. Especially among black women, who develop these tumors at a higher rate than other women. In fact, by the time they reach 50, 80% of black women will develop fibroids.

Fortunately, fibroids are fairly easy to treat. Unfortunately, many women opt for what they think is minimally invasive fibroid surgery. And then, they end up dying. Why? Because the surgeries they thought would cure them actually spread undiagnosed uterine cancer to other parts of their bodies. Of course, this could happen to any woman with fibroids. But as it turns out, it’s impacting black women at a higher rate of danger. uterine fibroid embolization procedure

Fibroid Surgery Can Spread Cancer

So many doctors recommend laparoscopic surgery to remove a woman’s fibroids. They claim it is a minimally invasive procedure. But, because it involves the use of a surgical instrument called a power morcellator, it is actually an extremely dangerous procedure.

Why? Morcellators divide and remove large masses of tissue, like fibroids. during laparoscopic surgery. In fibroid surgeries, the tumors are chopped up (or morcellated) into smaller pieces so they can easily be removed through the small incision.

This is all well and good if a woman is completely healthy. If, however, she has undiagnosed uterine cancer, some of the cancer cells may be spread while the non-cancerous fibroids are being morcellated. And, if the cancer is leiomyosarcoma, or LMS, (an aggressive form of uterine cancer) doctors are unlikely to notice the cancer cells until they are in the middle of surgery, or, even worse, after the procedure is done and the tissue is being examined in the lab. At either of those stages, damage may already have been done. Cancer could be spread outside the woman’s uterus.

Cancer Could be Hiding Next to Fibroids

While fibroids are non-cancerous tumors, some may also be attached to cancerous cells. And if those cancerous cells are LMS, they will likely give no warning signs or symptoms until it’s too late.

Now, when LMS stays in your uterus, there’s only a 50% survival rate after five years. And chopping up and spreading those cells outside your uterus decreases that already low survival rate.

And here’s even more bad news. Not only are black women at a higher risk of developing fibroids, they are also  two to three times more likely to have LMS than white women. When you combine those two factors, it adds up to this fact: black women who get laparoscopic fibroid surgery or laparoscopic hysterectomies have an extremely high risk of spreading cancer throughout their bodies. In fact, according to the FDA, the odds  are about 1 in 115.

Morcellators are Still In Use

Each year in this country, 50,000 to 100,000 still have laparoscopic surgeries with morcellators. And many of the women receiving these operations don’t even know their risks! Currently, the FDA is reviewing the safety of the power morcellator. But, when women who were hurt by this procedure testified, not one black woman was included in the group. That means we need help spreading the word. Tell your friends with fibroids that laparoscopic fibroid surgery could be fatal. Then, send them our way. We can discuss safer treatment options, including Uterine Fibroid Embolization, a minimally invasive treatment option that doesn’t come with a risk of spreading uterine cancer.

Why Choose Fibroid Surgery? UFE Gives Equal (or Better!) Results

we We’ve got some exciting news: UFE is just as effective at treating fibroids as myomectomy surgery!

Uterine fibroids are muscular tumors that develop in the wall of the uterus. They’re typically non-cancerous, and may go unnoticed by some women. Symptoms of fibroids include heavy menstrual bleeding, frequent urination and pain during sex. Women with fibroids may also have a hard time becoming or remaining pregnant. 

Many women are told that a hysterectomy (surgical removal of the uterus) is the answer to troubling fibroid symptoms. But women who don’t want to have a hysterectomy have to choose between other treatment options, including Uterine Fibroid Embolization and Myomectomy. UFE involves threading a thin tube into the blood vessel that supplies a fibroid tumor. Then, we permanently block the blood vessel with an injection of small plastic or gel particles. That blockage causes fibroids to shrink over time. Myomectomy, in contrast, involves surgical removal of a fibroid tumor. It’s  a more invasive treatment, but may be a better option for women who still want to become pregnant. 

New Study Compares Fibroid Treatment Options

In this study, researchers looked at data from 950 women, half of whom had UFE and half who had a myomectomy to treat fibroids. Both groups of women gave health updates for the following seven years. 

After reviewing the data, the findings were pretty clear: the procedures were similarly effective fibroid treatments. Seven years after the procedures, women in both groups had higher hemoglobin levels. Hemoglobin rose because heavy bleeding improved.

When it came to follow up procedures, the UFE group fared better. While 9.9% of the myomectomy group needed secondary procedures, in the UFE group, that number was only 8.6%. 

And, among the women who had a myomectomy, there were higher rates of post-surgical complications, including the need for a blood transfusion (2.9% versus 1.1% for those who had UFE). 

Study author Dr. Jemianne Bautista-Jia said, “The two treatments were comparably effective [and] UFE resulted in more favorable outcomes.” Additionally, the radiology resident at Kaiser Permanente Los Angeles Medical Center noted, women who had UFE had less pain and shorter recovery times. Those women also reported greater relief from heavy bleeding.

These benefits are so clear, but “Patients are often not fully informed of their treatment options…UFE and myomectomy are procedures with similar efficacy and durability for treating fibroids, but the UFE has fewer complications and shorter hospital stays.” She hopes these study findings will help raise UFE awareness. She encourages all women with fibroids to discuss UFE with their doctors before deciding on a course of treatment. 

Check Out 4 Facts about Birth Control & Fibroids

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, most doctors agree that their 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 how  birth control will impact your fibroids. Here are four things you should know about birth control and fibroids. 

How Will Birth Control Effect my Fibroid 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!

Choosing the right birth control when you have fibroids can be complicated, so it’s crucial to review all your options with your fibroid specialist. Feel free to reach out to Dr. Fox or Dr. Hardee to schedule a consultation on all your fibroid treatment options.


#WCW: Philly Woman Fights Avoidable Hysterectomies

In our Houston fibroid practice, we want women to know they have options when it comes to treating fibroids. So we also like to celebrate women (and men) who share our passion for sharing fibroid health education.

This week, we honor Lisa Ismail, a Philadelphia area woman who is sharing her personal fibroid story. She hopes to help other women in similar situations.

A Fibroid Diagnosis During Pregnancy

Lisa was first diagnosed with fibroids while she was pregnant. Her ultrasound technician found the non-cancerous tumor during a routine pre-natal scan.  Uterine Fibroids

Happily, she went on to have a healthy baby, and didn’t think much about her fibroid. Until, that is, symptoms started impacting her daily life.

Lisa told KYW News Radio, “Eight years later, my period started to be really irregular and I went to the doctor and you know she kind of just was like, ‘oh, well your age.’”

Shockingly, despite her earlier diagnosis, Lisa says that nobody suggested treating her fibroid. Because of that, it grew larger, causing her to experience life-altering symptoms.

“I bled all month,” she said. “I didn’t stop, I became anemic and they did a vaginal ultrasound and I find out that I have this seven centimeter fibroid inside my uterus.”

Large Fibroids Mean Major Symptoms

For Lisa, the heavy periods endangered her health. She was losing enough blood to require a transfusion. So, to stop the bleeding, she had a hysterectomy (surgical removal of her uterus.)

Unfortunately, Lisa learned first-hand how devastating this treatment option can be. “It’s not an easy surgery,” she explained. “These are major surgeries and it’s an emotional surgery.”

And here’s what we, as fibroid doctors, find equally devastating: according to the National Institutes of Health, more than 200,000 hysterectomies are performed each year for uterine fibroids. And many of those women could have at least tried alternative, less invasive, treatment options.

Lisa shares our outrage, “It’s upsetting,” she said. “Like, why wasn’t I told about this so I could’ve followed it so I could’ve known? I wouldn’t have probably have had a hysterectomy, they probably if it was small enough could’ve taken it out vaginally without going through an invasive major surgery,” she said.

Or, as we know, she could have shrunk the tumors using Uterine Fibroid Embolization, which cuts off their blood supply using a minimally-invasive catheter injection.

Because of the avoidable outcome in her case, Lisa wanted to share her story with other women. She hopes that women will seek early treatment, and explore their non-surgical treatment options, so no one else has to lose her uterus unnecessarily.


70% of Hysterectomies Are Avoidable!

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 (other treatments could have been offered.) Many women with fibroids have learned this the hard way. All too often, they’re told hysterectomies are the only way to relieve fibroid symptoms. But help could come with less invasive treatment options. Now, we want to help make sure women know about the alternatives! 

Hysterectomies Aren’t the Only Option for Fibroid Treatments Hysterectomy alternatives

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 gynaecologist, “There is clearly a failure of communication about the use of these less-invasive treatments.” And, says Dr. Anne Deans, another British gynaecologist 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.”

In short, there too many women who think fibroid diagnoses necessitate hysterectomies. Will you help us spread the word about alternative treatments? Just share this article  with the hashtag #FibroidFix. Together, we can help women avoid invasive, life-altering surgeries!

Sources: American Journal of Obstetrics and Gynecology, U.S. News & World Report 

#WCW: Kim’s Life-Changing Decision

Our Woman Crush Wednesday series is all about celebrating fibroid warriors. What are fibroid warriors? Women who share their stories to help make the path to relief a bit easier for other fibroid sufferers. This week, we feature Victoria, a 45-year-old woman who recently shared her story with the Society of Interventional Radiology. 

Tough to Diagnose Fibroids

Kim was diagnosed with fibroids five years ago, at the age of 40. Unfortunately, she says, it took a long time to get that diagnosis–and to figure out her best treatment option. 

“I went to about four different gynecologists and all of them said, ‘the only real option … was a hysterectomy, or to just live with it,” she says. “They talked about myomectomy (surgically removing individual tumors), but they said I probably wasn’t a candidate because I had multiple fibroids.”

Removing her entire uterus seemed drastic. But Kim knew some form of treatment was necessary. Her symptoms were just causing too may problems in her personal life. 

Struggling with Fibroid Symptoms

One of her biggest concerns? Kim’s fibroids were causing pain during intercourse, and taking a major toll on her love life. And the heavy bleeding was also a major cause for concern. 

“I got to the point where I couldn’t go anywhere because if I didn’t know exactly where the bathroom was, it would be a disaster,” Kim says.

Desperate for relief, Kim searched for better treatment options. And once she learned about uterine fibroid embolization, a treatment that shrinks fibroids by cutting off the blood supply that let’s them grow. She recognized its viability as an alternative to the major surgical risk of a hysterectomy, and knew she’d found her solution.

UFE and it’s Recovery

Kim opted to have UFE. She rested for a few days after the treatment, and then things started looking up. First, Kim felt well enough to have dinner out with her family. Pretty quickly after that, she was ready to return to work. For the next few weeks, Kim did experience mild cramping, as her fibroids shrank due to the cutting off of their blood supply.  One month after treatment, her fibroid cramps were gone. All that remained? Normal menstrual cramps which, Kim describes as “much less [painful] than it ever used to be.”

And while that relief is fantastic, for Kim this is the best part of her journey. “At one month I was totally back to normal … like I never even had fibroids,” she says proudly. 

Sources: Society of Interventional Radiology

Reality Check: When is Hysterectomy Necessary?

As we’ve shared previously on the blog, many women in this country have hysterectomies they don’t need. Since a hysterectomy–the complete removal of a woman’s uterus–is a really big deal, that’s scary news. But are there cases when hysterectomies are a must? Let’s take a closer look! 

What’s a Hysterectomy?  Even with multiple fibroids, hysterectomy can be avoided

As we said, a hysterectomy is an operation to remove a woman’s uterus. Oophorectomy is a process where the ovaries are removed. When only the fallopian tubes are removed, the process is called salpingectomy. The uterus, fallopian tubes and ovaries are removed in a hysterectomy with a bilateral salpingo-oophorectomy.

There are partial, total or radical hysterectomies. Partial hysterectomies leave your cervix remains in place. Total hysterectomies remove the whole uterus and cervix. Radical hysterectomies remove the whole uterus, including its tissue and its sides, the cervix and the top part of your vagina. 

When Do You NEED a Hysterectomy?

Hysterectomies are appropriate responses to life-threatening conditions. Radical hysterectomies are often given to women with cancers of the uterus, fallopian tubes, cervix or vagina. It may be necessary if a woman’s uterus ruptures during childbirth, or if her post-delivery bleeding is life threatening. In some cases, women with severe PID (pelvic inflammatory disease) will need this surgery. 

So, that’s when you really need a hysterectomy. But there are other times when hysterectomies are also considered. Many women with fibroids and endometriosis are told they need to remove their uterus to get relief. And, while this may sometimes be true, other women can avoid this major surgery with less invasive treatment options. In our opinions, as Houston fibroid specialists, if there are treatments that could help women avoid hysterectomies, that should be the first line of defense. Except in cases of emergency, hysterectomies should be the last option your physician recommends. 

#WCW: Tanika Gray Valburn

It’s #WomanCrushWednesday! Today, we honor Tamika Gray Valburn, founder of The White Dress Project. For years, Tanika suffered from fibroids .  She saw her mom lose two sets of twins due to her own fibroids, but didn’t make the connection to her own diagnosis right away! 

In fact, Valburn didn’t officially get a fibroid diagnosis until her late teens, even though she experienced painful symptoms. “You just think it will skip a generation,” she recently revealed in an interview. “When you’re young, you’re not thinking it will be your story as well.” But, like so many women, Valburn discovered that fibroids do tend to run in families. 

And, because her fibroids caused such heavy periods, Valburn said, ““I’ve had to learn how to pad myself [to keep from leaking through clothes.] I know the whole formula—what kind of underwear to wear, what kind of tights, what kind of Spanx. I’ve tried and tested everything. It’s become a way of life.”

Eventually, Tanika surgically removed 27 fibroids from her uterus. After her recovery, she wanted to help other women. In 2014, Tanika convinced a Georgia state representative to officially declare July as Fibroid Awareness Month, helping women get the crucial health information they need.

But she didn’t stop there. Tanika realized that she’d never bought white clothing. She said, “It’s a simple thing. Like, who cares, why not just wear black? But I love clothes, and the fact that I had to sacrifice wearing white for these benign tumors—I wasn’t feeling it.”

The White Dress Project

That same year, Tanika founded the White Dress Project, a nonprofit organization dedicated to promoting fibroids awareness, supporting research, and bringing together a community of women who work to empower one another.  The white dress became their symbol, as it signified a milestone in Tanika’s recovery – the moment she could rock a white dress without any fear. Now, the white dress has become a symbol of strength and power to other women dealing with fibroids, becoming one step in the fight to take control of their menstrual health issues.

As doctors involved in the daily battle against fibroids, we salute Tanika, our forever #WCW. We invite all women who are dealing with fibroids to slip on their white dresses and take control of their health by learning more about UFE, a minimally invasive treatment for fibroids!