Too few women know about this effective uterine fibroid treatment
For decades, women with uterine fibroids, or benign growths inside the uterus, commonly have been offered two options to manage the symptoms—get a hysterectomy, or just deal with the pain.
Uterine fibroid embolization, a minimally invasive procedure, can relieve painful symptoms without removing a woman’s uterus. But a 2017 survey found that almost half of women diagnosed with uterine fibroids had never heard of uterine fibroid embolization, which has been available for a couple of decades. This statistic shocked my Fibroid Center colleagues and me. Women need to know about this life-changing procedure, which involves pinhole incisions only and has been shown to improve symptoms in 90 percent of the women who get it.
More than a third of all hysterectomies are performed due to uterine fibroids. Doctors must do a better job of getting the word out about this procedure because fibroids affect millions of women. Uterine fibroid embolization is highly effective, and women who undergo the procedure can get back to their daily routines in about half the time as women who have hysterectomies.
LISTEN: Dr. Sabri discusses uterine fibroid embolization in the Medical Intel podcast.
How common are uterine fibroids?
Data from the National Institutes of Health indicate that nearly a third of women ages 25 to 44 have uterine fibroid symptoms. As many as 90 percent of African-American women and 70 percent of Caucasian women will have fibroids by age 50. Some women can have more than a dozen fibroids at once.
After menopause, when a woman is in her 50s or 60s, fibroids tend to shrink, and symptoms typically improve for most women. However, 25 to 30 years is a long time to suffer with uterine fibroids that enlarge the uterus and cause symptoms such as:
- Heavy periods
- Frequent urination that can disrupt sleep
These symptoms can range from annoying to debilitating. Multiple or large uterine fibroids that block the fallopian tubes can make it difficult to get pregnant or can cause ectopic pregnancy, in which an egg implants in the fallopian tubes instead of the uterus. Ectopic pregnancy can be life-threatening. Fibroids that cause heavy bleeding can lead to anemia, and fibroid tissue that becomes infected can lead to serious illness.
Some women live their whole lives with fibroids and never have symptoms. But when symptoms affect your quality of life or keep you from your activities, it might be time to consider a procedure such as uterine fibroid embolization.
Related reading: Fighting fibroids
How does uterine fibroid embolization work?
Uterine fibroid embolization is a minimally invasive, image-guided procedure. We place a catheter, which is a thin plastic tube, in an artery in your thigh or wrist. Then, we use X-ray guidance to direct the catheter to the arteries that supply the fibroid with blood. We inject small synthetic beads—no larger than grains of sand—into these arteries, depriving the fibroids of the blood that lets them grow. The fibroids then shrink, and your symptoms should start to improve over the next few days.
Most women can have uterine fibroid embolization as an outpatient procedure, though some patients may need to stay overnight in the hospital for monitoring. We tell patients to take it easy the first week and avoid lifting anything heavier than 10 pounds. Most women can go back to their daily routines within 10 days, compared with two to three weeks for hysterectomy. Though hysterectomies today can be done with minimally invasive techniques, the incisions are smaller with uterine fibroid embolization, which reduces recovery time and the risk of infection.
We’ve had many patients who come see us a few months after their procedures and want to hug everybody on our team because their symptoms improved so much. I remember one woman whose doctor recommended that she have a hysterectomy because she had around 20 fibroids. But she didn’t want a hysterectomy, and she came to us for a second opinion. Her symptoms were so severe that she was forced her to spend less time with her children and miss a lot of work.
This patient chose to have uterine fibroid embolization, and it completely changed her life. Within a week, she was feeling well enough to interact more with her children and return to work. When I saw her three months later at a checkup, she said her symptoms were completely gone.
How to choose the right procedure
If you are diagnosed with uterine fibroids, we’ll sit down and discuss all of your treatment options with you. Some women prefer to manage fibroid pain with over-the-counter medications or simply deal with the symptoms. But for more permanent relief, we recommend either hysterectomy or embolization, depending on your needs.
Ultimately, the choice of procedures is yours. You can use these guidelines to decide, paired with in-depth conversations with your doctor about your unique condition and needs.
Consider hysterectomy if:
- You’ve had fibroids in the past that returned (which happens in about one in five women)
- Your symptoms are severe and you don’t want to risk them coming back
- You don’t want to become pregnant in the future
- You can spend two to three weeks in recovery
Consider uterine fibroid embolization if:
- You want to keep your uterus, but your symptoms affect your quality of life (the procedure is around 90 percent effective to manage symptoms)
- You might want to become pregnant in the future
- You’d prefer a quicker recovery time of seven to 10 days
There also are other minimally invasive options we can pursue. Our expert obstetricians and gynecologists meet regularly with our interventional radiologists to discuss treatment plans for every patient with fibroids. Then, we counsel our patients about their options and discuss the science behind our recommendations. If you’re suffering with uterine fibroids, you owe it to yourself to investigate your options. And remember, we’re here to help you.