Uterine Fibroids Take Heavy Toll on Women, Survey Finds
But many delay seeing doctor for years because of concerns about treatments
It's no surprise that women often see more than one doctor, said Dr. William Parker, a gynecologist at the University of California Los Angeles Medical Center, Santa Monica. "Patients get told they need a hysterectomy, and they see another doctor," he said. "And they see another doctor."
The national survey was funded by Fibroid Relief, a program of the Focused Ultrasound Foundation in Charlottesville, Va. The foundation, which promotes ultrasound treatment for fibroids, is funded by ultrasound device manufacturers such as InSightec and others, as well as private donations.
The results are published in October in the American Journal of Obstetrics and Gynecology and the Journal of Women's Health.
Stewart has been a clinical trial investigator for InSightec and a consultant for Abbott, which also contributes to the foundation, and to Gynesonics, which makes a fibroid treatment device.
The exact cause of fibroids is unknown, Stewart said. Multiple hormonal and genetic factors are believed to play a role.
Doctors disagree about the best treatments for fibroids.
"I believe treatment needs to be individualized," Stewart said. Women need to assess where they are in their reproductive lifespan. "Most women get some shrinkage [of their fibroids] at menopause," she said.
If waiting isn't an option, treatment choices include medications such as birth control pills, surgery to remove just the fibroids or hysterectomy.
Ablation, a technique that destroys the lining of the uterus, and embolization, which cuts off blood flow to the fibroid to make it shrink, are also options. Focused ultrasound, which uses ultrasound waves to destroy the fibroids, is yet another treatment.
According to Parker, "ultrasound is the least invasive approach, but it has the least amount of data." It was approved by the U.S. Food and Drug Administration in 2004.
Information on the long-term safety of focused ultrasound, including pregnancy after the ultrasound treatment, is still being collected, Stewart said.