Health Decisions supports the recognition of July as Fibroid Awareness Month. Health Decisions’ Chief Medical Officer Andrea S. Lukes, MD, MHSc, FACOG, is a practicing OB/GYN and an active Principal Investigator with experience in uterine fibroid clinical trials. Dr. Lukes offers this blog post in support of fibroid awareness and clinical development of new fibroid therapeutics and diagnostics.
Fibroids are benign tumors of muscle within the uterus. The cumulative incidence by the age of 50 is 80% in black women and 70% in white women. The symptoms can be divided into two categories: bulk symptoms and bleeding symptoms. Often these symptoms are mild and do not impact a woman; however, in some cases the symptoms can have a profound negative impact on a woman’s quality of life.
The bulk symptoms of fibroids include pelvic pain and pressure, back pain, bloating, constipation and bladder symptoms. The bleeding symptoms may range from heavy regular bleeding each month to abnormal bleeding that is prolonged and irregular. The management of the symptoms depends on many factors including a woman’s age, desire for children or contraceptive needs, and medical conditions, as well as preference for a medical or surgical approach. Further management depends on the type and severity of symptoms and the size and location of the fibroid(s).
The presence of fibroids can be initially suspected by history and physical examination. However, a pelvic ultrasound should be performed to diagnose fibroids. The ultrasound can determine the type of fibroid based on location from the cavity of the uterus or endometrium. For instance, if the fibroid is predominantly within the cavity then a hysteroscopic approach (through the vagina / cervix) can be done versus if the fibroid is subserosal (protruding from the surface of the uterus), in which case a laparoscopic or abdominal approach may be necessary.
There are exciting on-going research studies through both pharmaceutical and diagnostic companies that will bring women more options in the future. I am the Principal Investigator in many of these studies and have had the opportunity to help design some of the studies. I encourage my patients and other women who are interested to participate in clinical trials. Clinical trials of fibroid treatments can offer effective treatments. Further, enrollment in a clinical trial usually involves pelvic ultrasounds and further opportunities for a woman to learn more about fibroids and how they impact her health.
One of my current patients who had uterine fibroids participated in a past clinical trial for the treatment of heavy menstrual bleeding (HMB), joined me in a recent webinar and reported that she was glad she had participated in a clinical trial.
Awareness of fibroids is important because these benign tumors are common and can have an impact on a woman’s quality of life. Organizations like the Fibroid Foundation are a great way to support and raise funding for continued research in fibroids detection, management and treatment. Research is needed to improve the range of treatment options for women experiencing different fibroid symptoms. The White Dress Project is another organization offering support and empowerment to the high percentage of women living with uterine fibroids and their bothersome symptoms.