WHAT DO I NEED TO KNOW?
Fibroids and Hysterectomies used to go together like Rogers and Hammerstein. Not anymore. If your physician recommends removing your uterus as the most effective treatment for severe fibroids without first considering less invasive therapies, start singing another tune and get a second opinion!
Just ten years ago, chances are you would find yourself in the hospital undergoing major surgery to treat pelvic pain or abnormal uterine bleeding caused by your fibroids. And while a hysterectomy is associated with a low death rate, this procedure is no joke. In addition to the lengthy hospital stay and recovery period at home, there’s at least a 30% complication rate and serious issues regarding a woman’s sexuality and quality of life once the uterus is removed.
The trend is moving away from treating fibroids with hysterectomies, but fibroids remain the number one reason for performing hysterectomies in the U.S. According to the National Center for Health Statistics, approximately 600,000 hysterectomies are performed each year and 60% are due to uterine fibroids. The bottom line: most women with uterine fibroids do not need a hysterectomy.
Even among physicians, the indications for hysterectomies are vague at best. And studies published in top medical journals estimate that 20 to 40% of hysterectomies cannot be justified on any established criteria.
Unfortunately, because there have been so many advances in a short period of time, not every doctor is knowledgeable about or qualified to perform the latest, less invasive alternatives to the hysterectomy. You really have to do your homework and learn what your options are. Remember, fibroids are not cancerous and you don’t have to rush into anything.
How should you manage your fibroids then? Depending on the severity of your symptoms and where you are in life (do you want to have children?) there are different approaches you and your doctor can consider.
It may be that you don’t have any symptoms. Fewer than half of the women who have fibroids ever experience any symptoms at all. Most women don’t even know they have fibroids until their physician feels them during a routine pelvic exam. If you fall into this category, all you probably have to do is watch to see that they don’t grow in size Doctors call this "expectant management".
If you are approaching menopause (most women stop having their period around age 51), you may not have to do much either. These estrogen-loving growths tend to shrink as the supply of estrogen in our bodies dwindles with middle age.
On the other hand, your uterine fibroid(s) may be causing you a great deal of discomfort, pain and embarrassment. Abdominal and lower back pain (one third of patients), alarmingly heavy menstrual bleeding (one third of patients), and frequent urination or constipation are not easy to live with. Now, managing your fibroids becomes an important quality of life issue.
The following article will give you background information about uterine fibroids; why you probably don’t need a hysterectomy and what you can do to manage them if they are creating problems for you. Learn more about hormone therapy, myomectomy, endometrial ablation, myolysis, uterine artery embolization, and minimally invasive surgery if a hysterectomy is absolutely necessary.
Take the Fibroid Quiz and test your knowledge base. Check out the Expert Interview with Fancis L. Hutchins, M.D., a nationally recognized fibroid expert. There’s also a Questions For My Doctor Checklist that you may find useful.
This article courtesy of EmpowerMed, an Internet-based service that empowers individuals and their families to become more active participants in the decisions that affect their health and well-being. This free service will be available in April, 1998 at www.empowermed.com. Copyright 1998 EmpowerMed, all rights reserved.
