The Truth About Uterine Fibroids

Uterine fibroids are non-cancerous tumors that can cause bleeding, cramping, swelling and miscarriage. Farai Chideya talks to gynecologist Hilda Hutcherson about diagnosing and treating uterine fibroids.

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FARAI CHIDEYA, host:

I'm Farai Chideya, and this is NEWS AND NOTES.

In today's health segment - uterine fibroids. They're non cancerous tumors that can cause bleeding, cramping, swelling, and miscarriage.

Roughly half of black women of childbearing age will have fibroids, as compared to 25 percent for white women. Gynecologist and NEWS AND NOTES regular health contributor, Dr. Hilda Hutcherson, has more.

Welcome Dr. HUTCHERSON.

Dr. HILDA HUTCHERSON (Gynecologist): Hello, Farai.

CHIDEYA: First, describe what fibroids are and what might be symptoms that would bring a woman to her doctor.

Dr. HUTCHERSON: Fibroids are benign tumors of the uterus. It's the most common tumor in the reproductive organs in women. And it is made up of the same tissue that composes the uterus. It is extremely common in women. Fifty percent of African-American women over the age of 35 have fibroid tumors, but when you look at African-American women over the age of 50, 80 percent of us will be found to have some fibroid disease.

CHIDEYA: What does this condition do to people?

Dr. HUTCHERSON: Most people who have fibroids don't even know that they have it because it doesn't cause any symptoms at all. Of those women who do have symptoms from their fibroid disease, most commonly they'll have bleeding, they'll have pain, go to the bathroom to urinate more frequently, have constipation, infertility, miscarriage, and pain with sex.

CHIDEYA: I'm sure a lot of these symptoms could be ascribed to other causes. If a woman is having symptoms like bleeding a bit too much at the time of the month, should you immediately go off to a doctor? What should you do?

Dr. HUTCHERSON: Absolutely. When you have abnormal bleeding or you have significant pain, you should certainly see your doctor. And a gynecologist -when he or she does the pelvic exam - may note that the uterus is larger than normal. And if you can rule out pregnancy, then the next step would be to have a pelvic sonogram. And with that pelvic sonogram, the physician will be able to see these tumors in the uterus that suggest that you have fibroid disease.

CHIDEYA: A lot of people don't like going to the doctor, period. And then add on to that women going to the gynecologist really hate that. A lot of women are like, oh no. So, you know, how can you encourage people as a gynecologist yourself to say, you know what, it's not going to be that bad, just go get checked out if you've got any questions?

Dr. HUTCHERSON: Oh, just like every woman, I hate going to the gynecologist, and I have to psyche myself up in order to go there and put my feet in those stirrups. You know, it's just not the most comfortable exam. But what you have to realize is that most of the things that your gynecologist will find are benign and are treatable. And on the other hand, if you ignore these exams, some things that are treatable early become untreatable later.

CHIDEYA: If you have severe fibroids, what are the treatment options? In the past, a complete hysterectomy was considered one of the treatments. Now are there other options?

Dr. HUTCHERSON: Absolutely. And the good news is we have many options for therapy of fibroids. Hysterectomy remains the most common form of treatment for fibroids. In my own opinion, hysterectomy should be the treatment of last resort because we have so many other options. Myomectomy for instance is a surgical procedure in which you can remove just the fibroids, and you leave the uterus intact so that one can go on to have children if they would like to have that as an option. And the myomectomy can be performed now through tiny, little incisions in your abdomen called laparoscopic myomectomy, so you don't have to have your abdomen opened up completely. We also have other noninvasive or minimally invasive procedures such as hysteroscopic surgery, where you place a camera and a small instrument into the vagina and through the cervix and into the uterus. And the fibroids can be removed that way.

We can do laparoscopic surgery in which we don't actually remove the fibroid, but we can freeze the fibroid or burn it. And after that procedure, the fibroids will decrease in size. One of the newest treatments for fibroid disease is a procedure called uterine artery embolization. And this is a procedure that's done on an outpatient basis. And it is a procedure in which the radiologist will thread a catheter in through your veins and then inject small plastic particles into the arteries that supply the fibroids. And this blocks those uterine arteries completely so the fibroids are robbed of blood supply. And when this occurs, the fibroid undergoes some cell death and that causes a shrinkage in the size of the fibroids. They certainly don't grow anymore. And this will take care of problems that women might be having with pain and also with heavy bleeding.

CHIDEYA: What about menopause? If someone has been having issues with fibroids and she's about to enter menopause, is there anything that she should know about treatment?

Dr. HUTCHERSON: The good news is that once you go through menopause, you will be cured of your fibroid disease. The fibroid tumors depend on estrogen in order to live and grow. And when the estrogen is removed as it is when one goes through menopause, then the fibroids will shrink.

CHIDEYA: Well, thank you Dr. Hutcherson.

Dr. HUTCHERSON: Thank you, Farai.

CHIDEYA: Dr. Hilda Hutcherson is a gynecologist and regular health contributor to News and Notes.

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