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Category: Treatment Options

Warning: Surgical Menopause Takes a Toll on Your Heart

When you’re living with fibroids, your main concern is treating your symptoms. You just want to feel like yourself again. As soon as possible. But sometimes, in your rush to find a cure, you don’t think about the consequences of the treatment option you select. Now, a new study is pointing out the toll that may take on your long term health.

Surgically Induced Menopauses and Heart Disease Risk

So many women with fibroids choose to treat their tumors by having a hysterectomy. With this choice, you remove your uterus, automatically putting yourself into menopause. And once you enter menopause, especially if you do it before you turn 40, you’re at greater risk of osteoporosis, coronary artery disease, heart failure, and stroke. Serious woman

Those conditions are all pretty scary, but they don’t even pain your complete risk picture. In fact, according to researchers at Harvard Medical School, your risk goes up even more if your early menopause is brought on by surgery.

To reach this conclusion, researchers spent six years studying 144,260 women between the ages of 40 and 69. At the beginning of the study, the women completed a questionnaire about the details of their reproductive health. And, throughout the study period, researchers noticed the rate of coronary artery disease, heart failure, stroke, deep vein thrombosis, and narrowing of the arteries for all the women. They also checked up on the women’s blood pressure, cholesterol levels, rates of diabetes, and any other health diagnoses.

What they found was startling. All women who entered menopause before turning 40 had higher rates of cardiovascular problems. But the women whose menopause was trigger by surgery were even more likely to develop heart health issues.

For some women, hysterectomies are medically necessary—especially if you are also dealing with a cancer diagnosis. But, for many women with fibroids, non-surgical treatments like Uterine Fibroid Embolization will be equally effective—and cause fewer additional health problems. So, before you choose hysterectomy, we urge you to explore all your fibroid treatment options. Especially the ones that won’t send you into menopause.

 

Sources: Journal of the American Medical Association

3 Things you Need to Know About Hysterectomies

If you have fibroids or adenomyosis, you may have heard you need a hysterectomy (the complete removal of the uterus.) But, in many cases, you have other treatment options, so it’s important to research all your choices. After all, 44% of Americans don’t know what’s really involved in this procedure. So, if you are seriously considering surgery, here are three important things you need to know about hysterectomies.

Your Guide to Understanding Hysterectomy

Here are some facts you need to know about this surgery’ 

UAE treatment for Adenomyosis

  1. There’s more than one type of hysterectomy. In fact, there are 3 kinds:
    Supraservial (removing just the upper portion of your uterus)
    Total (removing the entire uterus and cervix.)
    Radical (taking out your uterus, its side tissue, your cervix, and the upper portion of your vagina. This option is typically for cancer patients only.)
  2. A hysterectomy comes with a serious recovery period. Because hysterectomy is a surgical procedure, you will need to stay in the hospital, likely for at least 24 hours, afterwards. Many women will be unable to drive for at least two weeks following a hysterectomy. And most women will have to refrain from heavy lifting, bending over, sex and exercise for at least six weeks after surgery. For all of these reasons, you need to carefully consider your options before undergoing hysterectomy: there are less invasive options, like myomectomy or uterine fibroid embolization, that can help manage symptoms of certain conditions, like fibroids. 
  3. Hysterectomies come with long term health complications. Not only will a hysterectomy permanently end your chances of becoming pregnant, this surgery comes with other risks. Young women who have hysterectomies are at higher risk of obesity and cardiovascular disease, just to name a few health concerns. It is not a treatment decision to be made lightly, as you will feel the impact of this surgery for years to come. 

Now that you are armed with the facts about hysterectomies, it’s time to get educated about alternative treatments. To find out if you are a good candidate for our minimally invasive fibroid treatments, feel free to schedule a consult with our Houston-area specialists. 

Sources: hysterectomy.org, hancockregionalhospital.org

#WCW: Sharing Fibroid Fears

As fibroid specialists in Houston, we know that a fibroid diagnosis doesn’t have to change your entire life. But we also know how scary it can be to learn you have tumors in your uterus—even though they aren’t cancerous. So that’s why his week’s Woman Crush Wednesday is our choice of honoree—she’s getting very real (in a very public way) about her fears over a fibroid diagnosis. Here’s to you, Shay Johnson, for sharing your fibroid story on Love & Hip Hop.

Women Need to Talk About Their Fibroids

About a year ago, Shay took to her social media accounts, sharing images of her in a hospital bed. She’d been admitted for a blood transfusion. But, at the time, she didn’t explain why she needed that transfusion.

Recently, however, she changed all that. Shay explained to her fellow cast member, Michelle Pooch, “There’s a few things going on with me medically that I haven’t told you about. I’m not dying, [but] I do have a medical condition called fibroids.”

In fact, she continued, she has two fibroids—one of them that has grown so large, it’s now the size of the grapefruit. And this, it turns out, was the explanation for last year’s transfusion.

As Shay explained to Michelle, one of her fibroid symptoms is that she has, “heavy menstrual cycles for longer than 15 days, [and] on top of that, I’ve been fainting because I’m losing so much blood.”

Because of her severe symptoms, Shay’s doctor suggested she remove her fibroids surgically (myomectomy.) In telling Michelle about this suggestion, Shay admitted that she was scared—both about her upcoming surgery and about what her monthly periods would look like afterwards.

Providing Women with Other Fibroid Treatment Options

Like many African-American women (who are disproportionately affected by fibroids), Shay has opted to treat her fibroids surgically. And that may well be the treatment option that’s best for her. But, many women aren’t told they have non-surgical options, too. Procedures like Uterine Fibroid Embolization (UFE) can help women with severe fibroid symptoms. Typically, the relief they experience will be equal (or even superior to) that of women who’ve had fibroid surgery.

But, in order to experience relief and avoid surgery, women need to know their options. So, while we commend Shay in this post, we also ask for help spreading the word: there are non-surgical treatment options for fibroids. Now, will you help us help women #ask4UFE? If you do, you just might earn a spot in our #WCW hall of fame!

 

Reality Check: When Do You Need a Hysterectomy?

So many women in this country get unnecessary hysterectomies! That’s scary news, since a hysterectomy (the complete removal of your  uterus) is a really big deal. 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, with a hysterectomy you lose your uterus. In an oophorectomy, doctors remove your ovaries. And with salpingectomy, you only lose your fallopian tubes. Need a hysterectomy with bilateral salpingo-oophorectomy? That means your uterus, fallopian tubes and ovaries all have to go.  

You may need a partial, total or radical hysterectomies. Partial hysterectomies preserve your cervix. Total hysterectomies don’t. And radical hysterectomies take your whole uterus, cervix and the top part of your vagina. 

When Do You NEED a Hysterectomy?

Hysterectomies are appropriate when you’re facing a life-threatening condition. So, if you have cancers of the uterus, fallopian tubes, cervix or vagina, you may need one. 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. 

Your Step-by-Step Guide to Fibroid Treatments (by level of invasiveness)

At one point,  removing the entire uterus (hysterectomy) was women’s only fibroid treatment option.  But today,  that’s far from the case. While fibroids may leave you dealing with disruptive symptoms, they aren’t cancerous. And that means you don’t need to rush sorting through your treatment options.

Instead,  take your time and consider a range of options. These may depend on the size of your fibroids and the severity of your symptoms. And, may we suggest starting with the less invasive options and working your way up to more permanent solutions if needed.

Option One: Leave Your Fibroids Alone

Not experiencing fibroid symptoms? Relax and leave them alone (at least for now!)

If your fibroids are small, you may want to leave them be. Or if your fibroids aren’t causing problems, treatment may  be avoidable.  Or, if you’re not getting pregnant any time soon, delaying treatment be best. But, the important thing to remember is: even if you decide not to treat your fibroids, that’s a decision that should be made after a lengthy discussion with your doctor and your fibroid specialist.

Option Two: Live a Fibroid-Friendly Lifestyle

While you may not actively treat your fibroids, you can still take steps to help keep existing tumors from growing larger. And, while we can’t know for sure, some of these changes may also stop new fibroids from ever developing.

Th

Hysterectomy alternatives

e biggest lifestyle changes you make to fight fibroids involve your diet and exercise. While we don’t know exactly why fibroids form, we do know that estrogen can impact fibroid development. Which means that women with fibroids should balance out their estrogen levels, and one key way to do so is by maintaining a healthy body weight.

This means following a balanced, healthy diet, full of fruits and veggies, and void of fatty foods—especially red meats. Regular exercise can also help you lose a few pounds. Plus, some studies suggest that exercise can help minimize your fibroid symptoms, even if it doesn’t lead to weight loss, or even if you’re already at your ideal weight.

Option Three: Medications that Fight Fibroids

Some hormone-based drugs can help manage your fibroids symptoms. They may even shrink existing tumors.

Certain drugs work by blocking your body’s natural hormone production, causing your fibroids to shrink, and stopping many of the worst fibroid symptoms, like long, heavy periods, pain in your pelvis, and the frequent need to pee. Unfortunately, these meds may replace fibroid symptoms with side effects that mimic menopause, which can be equally unpleasant, and force you to start taking more drugs to manage the new symptoms. Yet these new drugs may make the hormone blockers less effective, allowing your fibroids to flourish…basically, hormone blocking puts you on a not-so-thrilling roller coaster ride. Which is why it’s typically a short-term treatment option for women birth control pillswho’ve opted for surgery, but first hope to shrink their fibroids a bit.

In contrast, medications with hormones may also be used to treat fibroid symptoms. Drugs with ‘male’ hormones (androgen) can shrink your fibroids and stop your periods. But they may result in unwanted side effects, like unwanted hair growth, weight gain and a lowering of your voice.

Hormonal birth control can also manage fibroid symptoms, by helping control the length of your periods. They may give you relief from heavy periods, but they won’t do anything to shrink your fibroids, and your symptoms will likely return if you stop taking the contraceptives.

And don’t forget over-the-counter options like Ibuprofen—they can help you cope with mild to moderate pain, without impacting your fibroid size or development in any way.

Option Four: Uterine artery embolization (UAE)

This procedure, also known as uterine fibroid embolization, is what we provide in our Houston fibroid clinic. With UFE, we shrink and kill your fibroids by cutting off their blood supply. We insert a catheter through your arm, and UFE graphicinject it with tiny particles that block any blood from reaching the fibroids in or on your uterus. The procedure comes with an easy recovery period, and is typically performed on an outpatient basis.

As interventional radiologists, we believe in UFE because it is less invasive and more cost effective than surgery. UFE also leaves women dealing with fewer complications, while providing equal or greater relief from fibroid symptoms. While safe for most women, if you still plan on becoming pregnant after UFE, you and your doctor should carefully discuss your eligibility for this treatment option.

Option Five: Fibroid Surgery

In some cases, women may elect to surgically remove their fibroids—myomectomy. And, in extreme cases, they may need a hysterectomy (complete removal of the uterus.) But, many women can avoid invasive surgeries—which come with hospital stays, extended recoveries and, especially with hysterectomy, long-term complications—by starting their treatment journey with one or more of other treatment options we’ve discussed. For more information and help truly understanding your fibroid treatment options, feel free to reach out to our specialists for help making this important decision.

Going Global: UFE Helps Women Around the World!                

Here in Houston, our team of interventional radiologists have been providing minimally-invasive fibroid treatments for quite some time. But in other parts of the world, that isn’t the case. Internationally, women have spent years dealing with fibroid symptoms or opting for invasive treatments like hysterectomies.

A hysterectomy is a serious surgery that immediately puts a woman into menopause. It can also leave her dealing with years of complications. That’s why we are happy to reveal that Uterine Fibroid Embolization, an effective outpatient fibroid procedure, is now available to the women of Nepal.

UFE Comes to Kathmandu 

Recently, the doctors at Nepal Mediciti Hospital performed a UFE procedure on a 37-yea

uterine fibroid embolization procedure

r-old Kathmandu resident.

With UFE, doctors insert a catheter into your arm in order to access the arteries that supply blood to your uterus—and your fibroids. They inject particles into the catheter (a small, flexible tube) blocking the surrounding blood vessels and cutting off the fibroid’s nourishment.  This blockage causes your fibroids to shrink and then die.

The procedure can often be performed on an out-patient basis. You do not typically need to stay in the hospital when you have UFE. And, usually, your recovery period is brief: many women return to work or regular activity levels within days of treatment.

Any time we see women gaining more healthcare options, our fibroid specialists start to celebrate. There is nothing we care about more than helping women avoid invasive surgeries that can impact their fertility—and the rest of their lives.

Sources: The Himalayan Times  

 

Check out 2 Surprising Health Issues Hysterectomy May Cause

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. 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 hysterectomies may also lead to mental health struggles.

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.”

 

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

#WCW: Standing Against Surgery

When Patricia Unger was 28 years old, she received a fibroid diagnosis. Right away, she was worried. About symptoms like heavy bleeding and abdominal pressure, but also about whether she would ever be able to have a family with her husband, Jeff.

In spite of her fears, Unger’s doctors told her to just try and get pregnant. Then, once she’d had children, they would “cure” her fibroid symptoms with a hysterectomy—the surgical removal of her uterus.

Luckily, Unger decided to question this advice. “Something inside me kept telling me that it just didn’t sound right,” Unger told the New York Daily News. “I kept thinking to myself, ‘I don’t think I should have to lose my uterus just to get rid of a fibroid.’” And because she questioned the need for surgery, and took time to share her story, we have nominated Ms. Unger as our Woman Crush Wednesday honoree.

Too Many Hysterectomies Performed in this Country Woman holding a pregnancy test

According to the National Uterine Fibroids Association, over 200,000 of the 600,000 hysterectomies performed in this country are on women with fibroids.

When a woman has a hysterectomy, her uterus (and, sometimes, her ovaries and fallopian tubes) are removed. As soon as the surgery is complete, women enter menopause and can never become pregnant or carry children.  

Of course, for some women, this type of drastic surgery is necessary. But, according to a survey published in the journal Obstetrics and Gynecology, as many as 76% of non-cancer patients didn’t need to have the hysterectomies they were given. And, the rate of hysterectomies is twice as high in African-American women like Unger, who are also two to three times more likely to receive a fibroid diagnosis as compared to a white woman.

Less Invasive Fibroid Treatment Options

Thankfully, Unger decided to explore other solutions for her painful fibroid symptoms. Ultimately, she received a myomectomy—doctors removed her fibroid surgically, but preserved her uterus so she could still have children. Which she did: two daughters, Solange and Isabelle, now 20 and 17 years old, respectively.

And since she found a less-invasive alternative to hysterectomy, she shared her story so other women could do the same. Of course, myomectomy is still a surgery, but there are also effective, non-surgical treatment options women need to explore.

One important option? Uterine Fibroid Embolization (or UFE): it only requires local anesthetic. Your interventional radiologist will insert a catheter through a vein in your arm, accessing the blood vessels that supply oxygen to your fibroid tumors.  Your doctor then injects sand-like material into the catheter, blocking the vessels. And, without incoming oxygen, your fibroids shrink and die.

If that sounds good, consider this: studies have proved that UFE and hysterectomy provide most women with identical fibroid symptom relief. And UFE comes with fewer long-term side effects as compared to hysterectomy. And, while you should talk to your doctor before considering any procedure that could impact your fertility, many women go on to have healthy pregnancies following UFE treatment.

Sources: Journal of Obstetrics and Gynecology, New York Daily News

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.