With National Women's Health Week (May
8-14) fast approaching, it is time to highlight a common, but rarely discussed
gynecological problem faced by millions of women, namely uterine
fibroids, despite the fact that they are reported to be the most common
benign tumors in women of childbearing age in the US. In fact, recent studies
involving randomly selected women across the country between ages 35- 49 years
found that the incidence of uterine fibroids by age 35 was 60% among
African-American women and 40% among Caucasian women. The incidence increased
by age 50 to greater than 80% and to almost 70% for African-American and
Caucasian women, respectively. In addition, it was revealed that the condition
is responsible for nearly 1/3 (roughly 200,000) of all hysterectomies in the US
each year. Moreover, in 2007, there were an estimated 355,137 uterine
fibroid-related hospitalizations in women aged 15–54 years.
Fibroids are made of muscle cells and other
tissues that grow in and around the wall of the uterus, or womb. Symptoms
of uterine fibroids can range from mild to severe and often include (but
are not limited to): abnormal uterine bleeding characterized by long, heavy,
and / or irregular menstrual cycles, passing clots; pelvic pain; pelvic
pressure, backache, and abdominal bloating, distortion; infertility and
recurrent miscarriages. They may also be the cause premature labor or
interference with the position of the fetus.
Yet the survey found that women often wait
an average of 3.6 years from onset of symptoms before seeking treatment and 42%
of women saw 2 or more healthcare providers before diagnosis. The cause of
fibroids is unknown. However, fibroids run in families and appear to be partly
determined by hormone levels. In fact, they are dependent on estrogen and
progesterone to grow and therefore relevant only during the reproductive years.
Risk factors include obesity and eating a lot of red meat. Diagnosis may occur
by pelvic examination or medical imaging.
Most fibroids do not require treatment
unless they are causing symptoms. Current fibroid
treatments, however, include medication to control symptoms including oral
contraceptives (to reduce uterine bleeding and cramping); medication aimed at
shrinking tumors (including aromatase inhibitors); ultrasound fibroid
destruction; myomectomy
or radio frequency ablation; hysterectomy; and uterine artery embolization. In
the meantime it should be noted that fibroids tend to shrink after menopause
and it is unusual for them to cause problems at that time.
and it is unusual for them to cause
problems at that time.
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