Nearly two-thirds of women in the United States experience fibroids by the age of 50, and many of them do not know that there is an alternative to surgical treatment.
In medicine new, improved treatments are constantly appearing. One of them is uterine fibroid embolization, a nonsurgical, painless, and safe procedure that cures all fibroids without the risk of relapse and complications.
However, as research and new treatment approaches are implemented, many people ask one question: will surgery become less necessary for women who want to eliminate unpleasant fibroid symptoms? And this question is important because many surgeries on women are performed for uterine fibroids.
And despite the availability of nonsurgical treatment alternatives, too many patients are still at great risk for choosing surgery when it’s not necessary.
That’s the question Erica Marsh, M.D., Chief of the Division of Reproductive Endocrinology and Infertility at the Center for Reproductive Medicine at U-M’s Von Voigtlander Women’s Hospital, has addressed at the annual American College of Obstetricians and Gynecologists meeting.
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Statistically, fibroids do not cause symptoms in almost half of the patients who have them, while others may experience serious problems. Among most common symptoms of uterine fibroids are significant pain, heavy periods, anemia, increased tiredness, and fertility problems.
And usually, treatment options range from watchful waiting and taking medications to large-scale surgery to remove the uterus (hysterectomy).
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But is it necessary to agree to extreme measures when you can choose a safe middle ground? The watchful waiting is only good for small fibroids that do not cause symptoms and do not affect the quality of life.
As for hysterectomy, 90% of women who are assigned to remove the uterus due to uterine fibroids are candidates for UFE.
Marsh, who is U-M’s lead researcher for a national project among several US centers, answers some questions about uterine fibroid treatment.
Is surgery the only reliable cure?
Marsh: Definitely not. Unfortunately, many women, having read the forums and listened to the advice of their friends, believe that hysterectomy is the only method for the complete treatment of fibroids. Many even hear this from their attending physicians! Often this leads to the fact that allegedly having no alternatives, the woman decides to postpone the treatment for several years, and as a result, when the disease becomes neglected, hysterectomy is inevitable. Although initially, the woman had options on how to cure fibroids without radical removal of the entire organ.
How do you help patients make the right decision about choosing the treatment option?
Marsh: Each method has its pros and cons; there is no treatment option with absolutely no risk. But the magnitude of this risk is different, as are the advantages of a particular method.
The most important factor for choosing a treatment option is the desire of the woman to become pregnant in the future. It is important that patients understand the risks and benefits of all types of treatment so that they have the opportunity to make an informed decision.
What prevents women from getting treatment right away?
Marsh: Often women do not even know that they have symptoms. Some of them think that what they are experiencing is a normal part of aging, when in fact their symptoms are signs of fibroids. We should inform women about the symptoms of fibroids better, as well as what is normal and what is not.
Do you imagine a day when surgery is not needed for this condition?
Marsh: Today we are talking about discussing with the patient her priorities and telling her about all treatment options. We strive to give the patient the opportunity to make an informed decision about which choice is best for her.
I think the goal is for fibroids to become obsolete some day. We hope to understand these tumors better and conduct research to find out how they develop. Our goal number 1 is to see the prevention of fibroids.
Until this happens, we want to explore the most minimally invasive treatment options. We hope to see a time when this disease is no longer the main cause of hysterectomy in the United States.
Every day, thousands of women around the world agree to fibroid surgery without knowing that they have options. Our main task is to inform women whose life is marred by fibroids that surgery is not necessary!
Not only hysterectomy changes a woman forever depriving her of an important organ, the ability to give birth to a child and maintain full health.
It often happens that the patient agrees to a little surgery, myomectomy, and wakes up without a uterus because it had to be removed during the surgery due to unforeseen complications.