Treatments for Fibroid Tumors in Today’s Era

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The UC of San Francisco provides valuable information on treating fibroid tumors using today’s new treatment options.  This pretty much confirms my previous email on how fibroids are treated, but in their article they list specific medications that are given to treat the fibroids without the need of surgical procedures.

The problem I find — and have heard from other women — is that the use of hormonal medication is not as affective as a surgical procedures that can remove the fibroids permanently.  There is news for women who seek continue having children with the myomectomy which is the best procedure to opt for if child bearing remains an option.

I encourage women who have been diagnosed with fibroid tumors to read the Fibroid Treatment article.  This is current information and will shed some light on the different treatment options that are available.  One thing this article does not provide information on and that is how the procedures are performed.  When seeking treatment advice from your physician and/or OB/GYN you will want to be sure you ask these questions and arm yourself with as much information as possible.

Email Update

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Hi, Everyone,

If you tried to send me an email and experienced any difficulties in doing so, please know that the issue has been resolved.  The email is fibroidawareness@yahoo.com if you would like to email me and tell me your experience with fibroid tumors, or if you just need someone to talk to.  If you want your story/experience share here on the blog, please feel free to let me know that as well.

Fibroid Awareness Group: The Open Forum for the Support of Women with Fibroid Tumors

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In 2008 when I was diagnosed with fibroid tumors, it seemed like the world was coming to an end for me at first.  And I really felt, to be honest, that the health care system had failed me because I was never warned of the risk for long-term use of birth control pills.  The truth is, it was also my responsibility to arm myself with as much information I could to have avoided having gone through that experience.

Arming myself with as much information I could about fibroid tumors and the many procedures that are available to treat them was enough to educate me on what to expect for the long haul.  The importance of getting a second opinion made things a little more easier to deal with — having gotten through the crying phase of it — and alerting my family of what was to be expected made things easy for them, too.

Since my surgery of a total hysterectomy in January 2009, the same day as President Obama’s inauguration — as my daughter continues to remind me because that was a tough day for her, too — I can honestly say I have not had any side effects from the surgery or any of the medication I was on post surgery.  I refused to go on any medication for menopause or hormone replacement — didn’t need it, and I lost weight throughout the process.  I healed faster than they expected, and was back to work on time in three weeks.  But I must that admit, which it took me a long time to tell others, that I was angry that I did not have my second child, and that no one supported me or shared in my decision to want a second child.  Talk about feeling alone.  So you can imagine the horror I felt when I was diagnosed with the tumors and that I needed surgery to remove them — I refused to have them remove via a laser procedure because I read they could come back, and I refused to have my life complicated with getting regular birth control shots and ultrasounds.  Hell no, was I going through that nonsense.

I visited many forums, talked to many women on online chat forums, and saw daytime talk shows on Dr. Oz about women who had gone through horrific experiences — had a hysterectomy and didn’t need them and have been scarred for the rest of their lives because their birthing days have taken away from them.  But I looked at it as they didn’t arm themselves with the right information, didn’t ask the right questions, didn’t seek second, third and fourth opinions, they basically went with what they were told and pretty much rolled with it and now their lives have been damaged by the mistakes they made in not seeking additional answers from various resources.

My heart went out to those women who appeared to have spent many days crying.  Apart of me wants to reach out and hug each and every one of those women when I think back about it.  And every time now when I hear a woman prepping for a hysterectomy or was diagnosed with fibroid tumors and don’t know what to do or what to expect, I want to just sit with them, talk with them, and help ease their mind.  Because I know what I went through, and what two of my closest friends went through.  It’s a life altering experience and if you’re not ready for it, it can take you down mentally and emotionally.

I am putting The Fibroid Awareness Group back on the grid because I am hearing some alarming things taking place in our medical field.  Using machines to perform a delicate procedure just sounds horrendous to me and leaves too much room for putting patients at critical risks.  It’s one thing for women to be diagnosed with having fibroid tumors, it’s another thing to have to hear, “oh, this mega machine of a monster is going to be performing the procedure.”  While opting for the use of the machine may seem like an option, but is it practical?  Why not just go with the traditional way of doing things?  It’s all about money that is continuing to drive our health care through the roof.  Somebody’s got to pay for it so where do you think they are sticking the cost? 

The Fibroid Awareness Group will serve as an open forum and support outreach for women who need to ease their mind.  You are not alone.  If you have concerns about going in to have a hysterectomy, or you need someone to talk to pre and/or post surgery, you can email me at fibroidawareness@yahoo.com.  This is a struggle that no woman should have to bear alone.

Increased Hysterectomies Performed

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It’s reported that the number of hysterectomies are being performed at an alarming rate.  And what’s worse is that many of them being performed could have been avoided and/or other alternatives could have been sought. 

The thing that grabs me is that the one thing we are forgetting is “research” which plays a major role in determining if whether or not a hysterectomy is the only solution to treating fibroids. 

With me, and let me be clear, I chose the total hysterectomy, even with all of my research, the alternatives available to be me, the risk factor involved, and possible side effects that I could have experienced.  In 2009 I had my total hysterectomy and did not undergo any side effects, did not have to take any hormone replacement medication, and my recovery period was only three weeks.

Of course, no one woman is the same, this is a point I need to re-emphasize.  But at the same time, w he have to understand, too, that if a doctor blatantly tells you that this is your only alternative, you have the right to get as many opinions as possible in order to make the best possible decision.

Hysterectomies should be performed if it is a serious health issues which points back to there being no other alternative.  Although there are many procedures available as modern medical technology continues to advance, it has to be perceived as being the only possible solution, otherwise consult others who are experts in the field and can give you the best possible advice.

Why are hysterectomies on the rise?  One possible conclusion is that women feel they are at the end of their child-bearing years and feel that they are ready to part with their uterus, ready to give up their childbearing rights and they have not thought it through enough to understand what all is involved. 

Another conclusion is that they were not completely consulted with to understand what they are getting themselves into.  Thus hit depression later on feeling that they’ve made a terrible mistake and feel there could have been other alternatives.

Another conclusion, and this is one is alarming, is that it’s a money thing among the doctors performing the surgery/procedure, which the women have not received valid consultation, were not given alternatives, did not do enough research to understand the evasiveness and non-evasiveness of the surgery/procedure, what the risks are, the side effects, and the recovery period.

There is wide discussions as to what can be or is being done to lower the number of hysterectomies being performed in a single year and is it associated with women understanding the various methods available for treating fibroid tumors and understanding that any method of a hysterectomy may not be necessary, and if it is then it may be so non-evasive that they can return to their normal life in just a matter of days.  And you have a lot less women crying about it later, worried that they’ve ruined the rest of their lives.

Research the Pill Before Going on the Pill

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Are you new to taking birth control pills?  Chances are you’ve seen all the commercials about the ability to shorten your monthly period significantly.  And chances are you are thrilled at the idea of having just three periods a year.  But do you know the risks that are greatly involved?  Do you know the side effects you can experience?  What these commercials do not tell you is that there is the possibility of having a bleeding uterine fibroid that can cause you to almost bleed to death.  These commercials don’t tell you that the side effects are far more greater than they are leading to believe, and that the makers of these birth controls have the burden of proof and are obligated to share this information with consumers (i.e., women who opt to take these pills).

Study is not given enough to the severity of these side effects that are not widely reported.  Women who are experiencing problems with taking Seasonique or Beyaz or Yaz (now Beyaz) should come forward and tell their story, what they went through, how significant the problem was, and what they had to undergo in order to solve/treat the problem.

What should make any woman have second thoughts about Beyaz (formerly Yaz, because you don’t see Yaz commercials anymore) is the statement that says, “Beyaz increases the risk of serious conditions including blood clots, stroke, and heart attack. The risk of blood clots is highest during the first year of use.

In addition, Beyaz contains drospirenone, a different kind of hormone that for some may increase potassium too much. Consult your healthcare provider if you are on daily long-term treatment for a chronic condition with medications that may also increase potassium, as you should have a blood test to check your potassium level during the first month of taking Beyaz.” 

The site also stated that in clinical trials, the most common side effects were headache/migraine, menstrual irregularities, nausea/vomiting, breast pain/tenderness, fatigue, irritability, decreased libido, weight gain and mood changes. 

Seasonique’s side effects are associated with similar to those of other birth control pills, including bleeding or spotting between periods, nausea, breast tenderness and headache.   They say that additional side effects that were reported by “>5% of women taking Seasonique in clinical trials were heavy bleeding, weight gain and acne.  Like other birth control pills, prescription Seasonique has serious risks including blood clots, stroke and heart attack. Smoking increases these risks, especially if you’re over 35.”

Ovcon 35 (28) has much less risk factor and major side effects than from both Seasonique and Beyaz, then again, it’s been years since I started taking birth control pills and it’s been since 2008 since I’ve been on birth control completely, and they have changed tremendously over the year, although when I was on Ovcon 35 (28) I did not experience any problems except a couple of missed periods, and there was a little nausea, which was calmed by taking the pill with crackers or juice rather than straight water.

The point is, ladies, if you are new to the idea of taking a birth control pill, understand that there are many pills on the market and that you should thoroughly talk it over with your OB/GYN about the many types that are available, their risk, the side effects and what to expect.  No one woman is the same and the pills has different effects on many. 

Getting a second opinion about a birth control is not such a bad idea, but keep in mind that long-term use can cause the growth of fibroid tumors.  At least for me it did. 

Know what you’re getting into before you make a firm decision to go on the pill.  Get as much information as you can about birth controls before you subject your body to the risks that are involved.  The body was not to have its monthly period shortened significantly.

Fibroid Tumors Link to Birth Control Pills

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What women new to taking birth control pills need to know is that there is a link between fibroid tumors and estrogen.  Although the true cause of fibroids is not known, it is known that fibroid tumors grow during taking birth control pills and during pregnancy when more hormones are released.  After menopause the tumors do shrink because the estrogen is no longer produced.  In some cases they may even disappear.

What women need to know is the many types of fibroids tumors there are.  Read my post, What Are Fibroid Tumors, to understand what they are and where they grow.  There are various types of treatments, evasive and non-evasive procedures that can help treat and remove fibroid tumors.

If you have been diagnosed with having fibroid tumors, you should be aware of the many current procedures that are available to you and what your choices are in terms of treating them.  Treatments are evasive and non-evasive and it is important to know what you are a candidate for.  Depending on your individual case your OB/GYN will be able to tell you through examination what is available and what is best for you.

Be sure to obtain as many opinions as necessary for making a final decision, if your health is at risk, the best decision may be the only decision.  Because once you go down that road, in many casing there is no reversing the procedure.  That’s why it is important to understand what you are dealing with.  If you don’t receive during an examination when you are diagnosed, request an ultrasound.

In my case I had a total hysterectomy due to where the fibroid tumors were growing which caused the removal of my uterus altogether.  I had several tumors, which put together, formed the size of a small melon.  I no longer have a period nor do I feel the discomfort I felt before they were removed.  I’d conducted all of the research I needed to know what was available in order to make an informed decision based on my condition and my research.  My fibroid tumors were from long-term use of birth control pills.

Today’s birth control pills cause me to worry about the decreasing number of periods per year, versus the regular 12-month cycle.  I can’t help but wonder if this is not putting women at greater risk for fibroid tumors and/or other health risk.

I have been researching this because a dear friend of mind was recently hospitalized for heavy and uncontrollable bleeding to where she lost so much blood she was near death.  And this was from her recently starting to take Seasonique.

Some of the comments I read on the side effect of using Seasonique is worrisome.  I found these comments on Seasonique’s web site that talks about the side effects experience recently posted:

“The first month and a half of me taking seasonique has been good, after that it has been down hill and hell. I get these un-bearable cramps and pains in my stomach all day, I have even been taking medicine to keep my cramps away periodically through out my whole day,they only seem to get worse. I have migrains through out the whole day,I get pissed off easily and worst of all I have been heavily bleeding for 3 weeks. I recommend this birth control to no one, it will make you miserable and that’s a guarentee.!!!”

“I decided my senior year that after suffering irregular and severly painful and stressful menstral cycles and being in a three year relationship I should start considering birth control. Immediately after starting, I got my period. It was not common to start bleeding until you came to the last pills of the three months but the even more uncommon side effect was having my period for 8 weeks until finally consulting my doctor and having to discontinue taking the pills for 3 days for it to finally stop. I now have frequent spotting that make my mood swings strenuous on my life and relationships and makes my stomach hurt and acne flare. I am greatful I am not pregnant, but I would have also appreciated all the other health benefits I thought I would get and not have had to deal with all the other unexpected side effects.”

My suggestion is before using any of these new fang-dangled birth control pills that women check with their physician to see if whether or not it is actually healthy to reduce the 12-month cycle down to four and whether or not the side effects are worth what I’ve read so far.

Uterine Fibroid Embolization (UFE) Procedure

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In 2008 it was recommended that consideration be given to the Uterine Fibroid Embolization (UFE) procedure, thus giving women another alternative to current treatments already available to them.  Uterine fibroid embolization (UFE) is a minimally invasive treatment for fibroid tumors.  The procedure is also sometimes referred to as Uterine Artery Embolization (UAE), but this term is less specific and, as will be discussed below, UAE is used for conditions other than fibroids.  Fibroid tumors, also known as myomas, are benign tumors that arise from the muscular wall of the uterus.  It is extremely rare for them to turn cancerous. More commonly, they cause heavy menstrual bleeding, pain in the pelvic region, and pressure on the bladder or bowel.

In a UFE procedure, physicians use an x-ray camera called a fluoroscope to guide the delivery of small particles to the uterus and fibroids. The small particles are injected through a thin, flexible tube called a catheter.  These block the arteries that provide blood flow, causing the fibroids to shrink. Nearly 90 percent of women with fibroids experience relief of their symptoms.

Because the effect of uterine fibroid embolization on fertility is not fully understood, UFE is typically offered to women who no longer wish to become pregnant or who want or need to avoid having a hysterectomy, which will remove the uterus.  As in my case.

How is this procedure performed?

The procedure involves inserting a catheter through the groin, maneuvering it through the uterine artery, and injecting the embolic agent into the arteries that supply blood to the uterus and fibroids. As the fibroids die and begin to shrink, the uterus fully recovers.

What are the benefits vs. risks?

Benefits

  • Uterine fibroid embolization, done under local anesthesia, is much less invasive than open surgery done to remove uterine fibroids or the whole uterus (hysterectomy).
  • No surgical incision is needed—only a small nick in the skin that does not have to be stitched closed.
  • Patients ordinarily can resume their usual activities weeks earlier than if they had a hysterectomy.
  • Blood loss during uterine fibroid embolization is minimal, the recovery time is much shorter than for hysterectomy, and general anesthesia is not required.
  • Follow-up studies have shown that nearly 90 percent of women who have their fibroids treated by uterine fibroid embolization experience either significant or complete resolution of their fibroid-related symptoms. This is true for women with heavy bleeding and for those with bulk-related symptoms such as pelvic pain or pressure. On average, fibroids will shrink to half their original volume, which amounts to about a 20% reduction in their diameter.
  • Follow-up studies over several years have shown that it is rare for treated fibroids to regrow or for new fibroids to develop after uterine fibroid embolization. This is because all fibroids present in the uterus, even early-stage masses that may be too small to see on imaging studies, are treated during the procedure. Uterine fibroid embolization is a more permanent solution than another option, hormone therapy, because when hormonal treatment is stopped the fibroid tumors usually grow back. Regrowth also has been a problem with laser treatment of uterine fibroids.

Risks

  • Any procedure that involves placement of a catheter inside a blood vessel carries certain risks. These risks include damage to the blood vessel, bruising or bleeding at the puncture site, and infection.
  • When performed by an experienced interventional radiologist, the chance of any of these events occurring during uterine fibroid embolization is less than one percent.
  • Any procedure where the skin is penetrated carries a risk of infection. The chance of infection requiring antibiotic treatment appears to be less than one in 1,000.
  • There is always a chance that an embolic agent can lodge in the wrong place and deprive normal tissue of its oxygen supply.
  • An occasional patient may have an allergic reaction to the x-ray contrast material used during uterine fibroid embolization. These episodes range from mild itching to severe reactions that can affect a woman’s breathing or blood pressure. Women undergoing UFE are carefully monitored by a physician and a nurse during the procedure, so that any allergic reaction can be detected immediately and addressed.
  • Approximately two to three percent of women will pass small pieces of fibroid tissue after uterine fibroid embolization. This occurs when fibroid tissue located near the lining of the uterus dies and partially detaches. Women with this problem may require a procedure called D & C (dilatation and curettage) to be certain that all the material is removed so that bleeding and infection will not develop.
  • In the majority of women undergoing uterine fibroid embolization, normal menstrual cycles resume after the procedure. However, in approximately one percent to five percent of women, menopause occurs after uterine fibroid embolization. This appears to occur more commonly in women who are older than 45 years.
  • Although the goal of uterine fibroid embolization is to cure fibroid-related symptoms without surgery, some women may eventually need to have a hysterectomy because of infection or persistent symptoms. The likelihood of requiring hysterectomy after uterine fibroid embolization is low—less than one percent.
  • Women are exposed to x-rays during uterine fibroid embolization, but exposure levels usually are well below those where adverse effects on the patient or future childbearing would be a concern.
  • The question of whether uterine fibroid embolization impacts fertility has not yet been answered, although a number of healthy pregnancies have been documented in women who have had the procedure. Because of this uncertainty, physicians may recommend that a woman who wishes to have more children consider surgical removal of the individual tumors rather than uterine fibroid embolization. If this is not possible, then UFE may still be the best option.
  • It is not possible to predict whether the uterine wall is in any way weakened by UFE, which might pose a problem during delivery. Therefore, the current recommendation is to use contraception for six months after the procedure and to undergo a Cesarean section during delivery rather than to risk rupturing the wall of the uterus during the contractions of labor.

What are the limitations of Uterine Fibroid Embolization (UFE)?

Uterine fibroid embolization should not be performed in women who have no symptoms from their fibroid tumors, when cancer is a possibility, or when there is inflammation or infection in the pelvis. Uterine fibroid embolization also should be avoided in women who are pregnant or in women whose kidneys are not working properly—a condition known as renal insufficiency.  A woman who is very allergic to contrast material (which contains iodine) should be offered a different treatment option.

What are Fibroid Tumors

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Fibroid tumors are grow in the uterus usually during women’s fertile years.  They are the most common, non-cancerous pelvic masses.  They are rarely cancerous and can grow to be quite large and uncomfortable. Fibroid tumors can range in size from quite small (measured in millimeters) to large (many centimeters.) Large fibroid tumors can distort the urterus, making it appear lumpy when visualized during a pelvic exam.

Causes of Fibroid Tumors

Some theories about the causes of uterine fibroid tumors are conclusive, while others are only speculative. There is conclusive evidence that fibroids can be caused by:

  • The hormone estrogen: uterine fibroids grow in the presence of estrogen. This is why they tend to develop and grow during the fertile years of a woman’s life (when she has the highest levels of estrogen in her body), and they stop growing and new fibroids usually don’t develop after menopause.
  • Heredity: apparently scientists have found gene mutations in fibroid tissue cells. A patient’s risk of developing fibroids increases if a close family member (mother and/or sister) has the tumors.
  • Race: for reasons unknown, African-American women are more likely to develop fibroids than any other race. They are more likely to have larger and/or multiple fibroids as well.

Possible factors that decrease the risk for developing fibroids (speculative):

  • Oral contraceptives
  • Pregnancy (although some theorize that they actually grow during this time, due to increased estrogen levels)
  • Being athletic (whereas being overweight has been thought to increase the odds of developing fibroids)

Symptoms of Uterine Fibroid Tumors

  • Abdominal or pelvic pressure, fullness, or chronic pain
  • Bladder problems such as difficulty emptying or an increase in urgency
  • Difficulty moving bowels
  • Very heavy and/or painful periods
  • Bleeding between periods

If you experience some or all of these symptoms, or if you have a family history of fibroids, you might want to consider scheduling an appointment to see your gynecologist as soon as possible.

Knowing that they can distort the overall appearance of the uterus, uterine fibroids are actually quite smooth, rounded, and said to be well-defined.  They are overgrowths of the muscular, middle layer of the uterus, the myometrium.  When the tumors they project into the endometrium, the submucosal, they can cause heavy menstrual bleeding which can go beyond the days of a normal cycle.  Fibroid tumors can project outward,  the subserosal, and can press on the bladder or rectum.  This can cause additional problems.  One other type of fibroid actually grows outside of the uterus and is attached by a very narrow band of blood vessels, known as the “pedunculated.”

What you should also know about fibroids is that they can cause a heavy, full feeling in the abdomen and can be singular or multiple in number.  For some women, they feel hard when they touch the lower area of their abdomen.

Types of Fibroid Tumors

There are types of tumors you should be familiar with, starting with the utering fibroids which are classified according to their location within the uterus.  There are three primary types of fibroid tumors:

Subserosal fibroids develop in the outer portion of the uterus and continue to grow outward. These fibroids typically do not affect a woman’s menstrual flow, or cause excessive menstrual bleeding, but can cause pain due to their size and the added pressure on other organs.

Intramural fibroid tumors are the most common and develop in the uterine wall and expand. These fibroids can cause the uterus to appear larger in size which can be mistaken for weight gain or pregnancy. Associated symptoms include heavy menstrual bleeding, pelvic and back pain, frequent urination and pressure.

The other type of fibroid tumor is submucosal, the least common of the three. These fibroids develop within the uterine cavity and can cause excessive menstrual bleeding along with prolonged menstrual cycles.

A woman may have one or all of these types of fibroids. It is common for a woman to have multiple fibroid tumors and it may be difficult to understand which fibroid is causing your symptoms. Because fibroid tumors are a diffuse disease of the uterus, there are usually more fibroids present than can be detected because of their small size. Even a woman who has only one visible fibroid needs to assume that there are multiple uterine fibroids present when discussing therapy. Uterine fibroids may also be referred to as myoma, leiomyoma, leiomyomata, and fibromyoma.

If you think you may have uterine fibroids, or are experiencing any of the related signs and symptoms of uterine fibroids, please contact your primary care provider or OB/Gyn as soon as possible in order to rule out any other complications that could be causing your symptoms. Knowing the types of fibroids and understanding their symptoms can help you choose the right fibroid treatment.

Welcome to The Fibroid Awareness Group

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It’s important that women diagnosed with fibroid tumors be aware of the many options available to them today.  New treatements are being introduced in the hopes of providing women with better and additional options with shortened recovery periods.  But it is amazing as to the number of women who are not aware and are not given the opportunity to make choices suitable to their own health needs.

This blog is created to provide information and resources for women who are considering treatments for their fibroid tumors, women who are post surgery, and women who are unsure of what to do after being diagnosed.  It bothered me that a number of women who have had a hysterectomy are feeling like their are living in a nightmare, regretting having gone through that process.  This leads me to believe that they did not have the opportunity to view their options, discuss what’s available with their physician or even research the number of treatments available.  Ladies, this site is for you!  I hope I bring some comfort to many by bringing women together.