Recent statics reveal a dramatic increase in the number of women who went to emergency rooms due to fibroid-related symptoms. Today we are going to look closer at the studies, analyze the problem and discuss the solutions.
Uterine fibroids or leiomyomas are noncancerous tumors that grow within the uterus. It is the most common pelvic tumor seen in women. Most adult women will develop these benign tumors, usually between the ages of 30 and 55 years. These tumors are common in all women but particularly in women of color – about 80% of adult African-American women have fibroids.
About half of the women with fibroids have no symptoms. These women may not know they have fibroids, but for the other half, the symptoms can be debilitating and interfere significantly with their quality of life.
Fibroid symptoms can range from mild to severe and include pelvic pain & pressure, heavy and prolonged menstrual bleeding, and lesser-known symptoms like lower back pain, leg pain, hip pain, constipation, and painful intercourse.
Anemia is caused when women lose too much blood and become iron deficient. Anemia can cause severe fatigue, lightheadedness or dizziness, migraine-like headaches, shortness of breath, rapid heartbeat, and more. If the anemia is significant, it may cause the woman to chew/crave ice or even inedible substances like clay, chalk, or dirt!
Sometimes, the blood loss is sudden and excessive, and can be very frightening with the passage of clots palm-size or larger! The passage of large clots like this through the cervix and into the vagina is also very painful. It is understandable when this combination prompts a trip to the Emergency Room, as she may feel that she is literally bleeding to death!
Fibroids and the Emergency Room
In the United States, the most common noncancerous gynecological condition experienced by women is uterine fibroids, and fibroids are also the number one cause of hysterectomy surgery – the surgery that removes the uterus.
The medical therapies for fibroids are not very effective. This often results in the Gynecologist then recommending surgery without informing the patient of the nonsurgical Uterine Fibroid Embolization (UFE) option. Most women have no desire for hysterectomy and when given that as the only option, many will suffer from the debilitating symptoms in silence.
As many as one in five women will go to the Emergency Room (ER) within 12 months of their fibroid diagnosis for treatment due to associated symptoms. Women with fibroids utilize the emergency room significantly more than women without fibroids.
A study released in Obstetrics & Gynecology Green Journal in May 2021 reported a significant increase in emergency room visits – 28,732 vs 65,685 ER visits from 2006 to 2017.
130% more women went to the ER due to fibroid-related symptoms. However, the data indicated that 9 in 10 women could have avoided the ER visit if attending regular OB/GYN appointments and receiving ongoing care. Interestingly, the number of women who were admitted to the hospital as a result of their ER visits decreased by 50% in the same time frame.
Why Are Fibroid Symptoms Prompting a Rise in ER Visits?
Researchers analyzed over 487 million records resulting from emergency room visits by women between the ages of 18 and 55 specifically looking for correlations between ongoing care accessibility vs utilizing the emergency room.
One interesting statistic highlighted was that low-income women between the ages of 36 to 45 utilized the ER more than any other group. How come these women did not go to their OB/GYN looking for ongoing treatment? Why did these women wait until they were in so much pain or experiencing scary symptoms before going to the emergency room? Some possible reasons may be:
- Lack of established relationship with an OB/GYN;
- General mistrust of the medical system due to historical treatment of women of color;
- The patient may not understand what is causing their pain or symptoms, or who to reach out to for help;
- Women may think their symptoms are normal and delay treatment;
- Women are not aware of the surgical and non-surgical options to treat fibroids;
- Lack of insurance, insurance gaps, and barriers to access could also be a factor.
Treating Fibroid Symptoms in the Emergency Room Is Costly
Emergency room care is about 10 times more expensive than using an urgent care center or an outpatient center for the same issue. The median cost for an ER visit related to fibroids more than doubled during the time elapsed over the study period.
The total annual cost of treating fibroids in ERs, including hospital admissions, has been reported to range from $5.9-$34 billion, thus contributing substantially to the economic burden. One of the contributing factors to the high expense is imaging costs and other tests run to address bleeding in the hospital ER environment.
The study’s senior author Erica E. Marsh, M.D., Chief of the Division of Reproductive Endocrinology and Infertility at the Michigan Center for Reproductive Medicine stated:
“Many of these patients were likely appropriate candidates for outpatient imaging, which potentially could have saved significant costs and resources… We should be focused on interventions that improve access to outpatient care for this group of women in order to help mitigate unnecessary, costly ER utilization.”
The study indicated that gaining insight into the driving factors of these fibroid-related emergency room visits and hospitalizations could result in patients being redirected to alternative medical care settings and major cost savings.
Video: Patient Testimonial – I Suffered From Fibroid Symptoms For 10 Years
What Fibroid Symptoms Send Women to ERs?
The most common reasons why women experiencing fibroid symptoms went to the emergency room were related to abnormal or heavy menstrual bleeding and/or symptoms related to significant blood loss and/or anemia, approximately 41% of ER visits. The second most common reason was due to abdominal or pelvic pain, approximately 21% of ER visits.
Chemistry studies were ordered for approximately 62% of patients who went to the ER with fibroid symptoms, 58% had blood work studies, 57% received pelvic or abdominal ultrasound tests, 14% were treated with IV fluids to address dehydration, and 2% received a blood transfusion.
Women Need To Know
The statistics revealed in the study clearly indicate a need for more national-level campaigns to educate women about fibroids, their symptoms, and treatment options. Many women do not know that fibroids are the number one reason for heavy and prolonged menstrual bleeding. They also may not understand that even though their periods have been heavy for a long time, it is not normal to bleed like that. They may not know the correlation between chronic menstrual bleeding and the resulting anemia symptoms. Education can empower these women to know all of their treatment options and seek treatment and connect with a healthcare professional they trust and feel comfortable with.
According to Marsh, there will continue to be efforts to identify opportunities to improve care in outpatient settings for women who suffer from fibroids. She also shared the vision of her diverse team as they continue to research the data and look for opportunities to remove barriers and ensure patient-focused, equitable care for all women with chronic symptoms.
Video: Diagnosed with Fibroids? Understanding My Treatment Options
Emergency Fibroid Symptoms Need to Stop Before They Start
Despite the limitations of the study, it was conducted using data from over 33.5 M emergency room visits from 984 hospitals, which presented a diversified sampling of patients. This study provided a basis for understanding emergency room visits and hospitalizations of patients presenting with uterine fibroid-related symptoms as their primary diagnosis. It identified several opportunities for improvement and change, including patient education, insurance disparities, and the creation of accessible outpatient healthcare settings for early intervention. The bottom line is that we need to do better in addressing this ongoing health disparity.
In 2020, statistics show that in the United States women with fibroids make up 70-80% of the female population. So this means that about ¾ of the female population in the United States and 38% of the entire population are subject to this health concern. It is mind-boggling that there has not been more research, education, and interventions dedicated to the study of uterine fibroids and the women who experience them.
If you suffer from symptoms of uterine fibroids, schedule a consultation with the Atlanta Fibroid Center®. Dr. John Lipman is an Interventional Radiologist with over 25 years of experience helping women eliminate the symptoms caused by fibroids. He is one of the world’s leading experts in a procedure called uterine fibroid embolization (UFE) that has helped women suffering from fibroids their life back.
UFE is a non-surgical, outpatient procedure that addresses all uterine fibroids by cutting off the blood supply they need to grow. The fibroids gradually soften, shrink, and die, eliminating the symptoms associated with these fibroids. Most patients are back to their normal routine within a week’s time, and by the time they are seen in follow-up three months after their UFE procedure, they have regained their quality of life back. If you suffer from symptomatic fibroids, don’t wait and suffer in silence, contact the Atlanta Fibroid Center® today.