A Conversation About Uterine Fibroids
It’s an extremely common condition – one that nearly three out of four women will experience at some point in their lives – but uterine fibroids are not something that you hear much about. Partly, this is because many women don’t even know they have them – most fibroids do not cause any symptoms or require any treatment. When they do cause symptoms, they can be the kind of thing that no one likes to talk about, even with close girlfriends.
Uterine fibroids are noncancerous tumors that grow from the muscle wall of the uterus. They can range in size from as small as an apple seed to as big as a grapefruit.
For about 20 percent of women with fibroids, they cause uncomfortable, unpleasant or even painful symptoms like:
- Heavy menstrual bleeding,
- Long menstrual periods (lasting seven days or longer)
- Pain during sex
- Frequent urination
- Lower back pain
- Pelvic pain
- Enlargement of the lower abdomen
Fibroids are benign – they have no link to cancer and often don’t cause fertility issues (although in some cases they can) but many patients seek relief from symptoms that interrupt their quality of life.
Treatment options for fibroids are evolving and range from “watchful waiting” (doing nothing but following up periodically to monitor any changes) to surgery and many options in between.
“It’s really important for healthcare providers to have a conversation with their patients about what’s important to them and understand their story so the decision on the most appropriate treatment for each patient can be made,” said Roopina Sangha, M.D., MPH, a gynecologist who is leading the Henry Ford team in a nationwide study on quality of life issues in women with uterine fibroids. “This is the idea behind what is known as ‘patient-centered outcomes.’ Presenting the options to the patient and then working with them to decide the best course of action, not just medically, but also based on their lifestyle and what their expectations from treatment are.”
To some patients, Dr. Sangha explains, any type of surgery is a last resort and they would rather cope with symptoms to avoid it, for example. Others may want their doctor to do whatever it takes to eliminate the fibroids. It’s about respecting each patient’s decision and working with her to achieve the best outcome.
Dr. Sangha notes that this new research, which is led by Duke University and includes eight other institutions from around the country, is important because few studies on whether or not uterine fibroid treatments have been successful have taken into account patients’ perceptions and expectations.
Myths and Fears About Uterine Fibroids
One reason these patient-centered conversations are so important is that there are a number of myths surrounding uterine fibroids and treatments.
“Many women worry about cancer but these tumors have no relation with cancer. Another common misconception is that women believe that they will need a hysterectomy because of their family history or the fact that a close female family member had one at an early age, which may not be true for their own case at all,” says Dr. Sangha.
These days, a hysterectomy is certainly not the only option. There are medications, minimally invasive procedures that preserve fertility and more. Even hysterectomy itself has changed – laparoscopic hysterectomy is less invasive and helps patients recover more quickly.
“Since diet, stress and environmental factors may also play a role in fibroid development, a healthy lifestyle is also beneficial – eating more vegetables and fruits and less fat, increasing Vitamin D intake, reducing stress (exercise, yoga, meditation) and avoiding toxins,” Dr. Sangha advises. “A holistic approach to life may be helpful not only in keeping fibroid development and symptoms under control, but also positively impact all other aspects of your health.”
However, she recommends being skeptical of claims that fibroids can be eliminated or “cured” with dietary supplements, herbal remedies or even through dietary changes alone. (Please consult with your doctor before you start using dietary/herbal supplements, as they could have some potentially harmful side effects.)
Knowing the Risk Factors
While their cause is unknown, fibroids are linked to hormonal and genetics factors.
- Age. Fibroids become more common as women age, especially during the 30s and 40s through menopause. After menopause, fibroids usually shrink.
- Family history. Having a family member with fibroids increases your risk. If a woman’s mother had fibroids, her risk of having them is about three times higher than average.
- Ethnic origin. African-American women are more likely to develop fibroids than white women.
- Obesity. Women who are overweight are at higher risk for fibroids. For very heavy women, the risk is two to three times greater than average.
- Eating habits. Eating a lot of red meat (e.g., beef) and ham is linked with a higher risk of fibroids. Eating plenty of green vegetables seems to protect women from developing fibroids.
If you are experiencing symptoms or are concerned about uterine fibroids, talk with your gynecologist or primary care provider.
If you have uterine fibroids and are interested in participating in the study, learn more and find out if you are eligible by calling (313) 874-6436. (This is an observational study. Participants complete confidential surveys online or by phone and will not be asked to receive treatment.)
Dr. Roopina Sangha specializes in minimally invasive gynecology and robotic surgery and sees patients at Henry Ford Medical Center – New Center One in Detroit. She has a special interest in preventive medicine and holds a master’s degree in public health from Johns Hopkins University.
Need an OB/GYN? Find one at henryford.com/findadoc or call 1-800-HENRYFORD (436-7936).