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Women's Health
Got Uterine Fibroids? Know This: 1) You Are Not Alone, and 2) You Might Not Need a Hysterectomy
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Jun 18, 2015 - 7:42:42 PM

(HealthNewsDigest.com) - If you are a woman with uterine fibroids, you may be surprised to learn that fibroids are actually extremely common: 7 in 10 women - and up to 8 in 10 African-American women - will experience fibroids by the age of 50. And while many women are asymptomatic, at least 25% will have a broad range of symptoms ranging from mild to debilitating and will require treatment. The good news is that while hysterectomy was long considered "the" treatment for fibroids, there are now a wide variety of alternatives to consider that enable women to keep their uterus and often avoid invasive surgery altogether - especially if you are diagnosed near the onset of your symptoms.

Uterine fibroids are common, non-cancerous tumors of the uterine muscle consisting of smooth muscle cells and connective tissue. A woman may have one fibroid or groups of several fibroids, and they can range in size from less than one inch to more than eight inches across[K1] [JA2] [JA3] .  Fibroid symptoms can include heavy or prolonged menstrual bleeding, menstrual pain or cramping, passing blood clots, bloating, bowel or bladder dysfunction, and fatigue.

Treating fibroids is not a one-size-fits-all approach.  A recent 2015 article in the respected New England Journal of Medicine (NEJM) by Mayo Clinic Ob/Gyn Elizabeth Stewart, MD, emphasizes that despite the high prevalence of fibroids, there is actually little research to guide treatment decisions - and that one woman's course of treatment may be very different than another's based on many factors. The article explores various treatment options for women - from hormone treatments to traditional surgical approaches like hysterectomy to the latest non-invasive techniques like focused ultrasound.   The good news for those who want to retain their uterus and/or not undergo the potential complications and recovery time associated with surgery is that there are options for you.

So what can you do if you know or suspect you have fibroids and are seeking symptom relief? It may sound obvious but the first thing to do is get diagnosed. A 2013 survey by patient education group Fibroid Relief of nearly 1,000 women with symptomatic fibroids - led by experts from the Mayo Clinic, the Cleveland Clinic, and the University of North Carolina - found that women wait 3.6 years on average before seeking fibroid treatment or diagnosis from a health care provider. This of course can narrow the range of effective treatment options that are available, due to unnecessary fibroid growth and other factors. If this sounds like you, go tohttp://www.fibroidrelief.org/resources-2/take-five-patient-tool/ to download a free online five-step "conversation starter tool" designed to help empower women to start taking action by talking with their physician about their fibroids and options for relief.

Then what? Once you are diagnosed, the next step is to gather information, discuss your options with your doctor and family members, and then agree on a treatment plan. Unfortunately only 32% of women in the Fibroid Relief survey said they expressed personal preferences to their doctor about treatment options, and just 35% felt their doctor discussed all possible treatment options with them. Be your own best advocate and educate yourself about treatments in advance of your next appointment. Assess your long- and short-term goals of treatment and come prepared with questions. Not surprisingly, the vast majority of women surveyed (84% of women under age 40) said they prefer a treatment option that does not involve invasive surgery of any kind - are you one of those women? Do you want children? Or are you close to menopause and your fibroids may soon shrink on their own?

Some treatment options to ask your doctor about include hormone therapy (least invasive), focused ultrasound, uterine fibroid embolization (UFE), myomectomy, and hysterectomy (most invasive). Hormonal therapy involves the use of birth control pills or other hormones to shrink fibroids or control fibroid related bleeding. Focused ultrasound uses waves of ultrasound energy to heat and destroy fibroid tissue. UFE involves blocking the uterine artery with small particles to decrease blood supply to the fibroid. Myomectomy surgically removes fibroids from the uterine wall, and hysterectomy involves removing the uterus entirely, eliminating any possibility of fibroid recurrence. You can download a freedetailed treatment options chart at http://www.fibroidrelief.org/treatment/.

While fibroids can compromise quality of life, and cause fear for many women, the great news is that there are many options for relief - especially if you are proactive about your treatment. Getting diagnosed early - and being intentional about your choices - will help ensure the best treatment course and outcome for you, based on your own health, lifestyle and professional needs, and family situation. Today having fibroids does not have to mean you will need a hysterectomy, and they may not even mean you need invasive surgery at all. So go educate yourself about your options, involve yourself in the decision-making process, and work with your doctor to choose a treatment that is best for you!

The author, Justine Atkinson, is the Executive Director of Fibroid Relief, a nonprofit patient education organization dedicated to supporting women suffering from uterine fibroids who seek noninvasive treatment alternatives.

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