Fibroids: The Big Women’s Health Dilemma
Uterine fibroids present one of the greatest health challenges to 24 million European women1.
Why? Because going to the doctor and getting fibroids diagnosed and treated can involve sacrifices in femininity, sexuality and even fertility.
But the alternative is to put up with the fibroids and the symptoms they cause, including heavy bleeding, abdominal bloating and pain, fertility and pregnancy complications, painful sex and bladder and bowel problems.
This is the tough dilemma faced every day by women – especially those of reproductive age – who suffer with symptomatic fibroids.
The ‘Do I visit my doctor? Dilemma
Fibroids occur in about 20-40% of women of reproductive age and of those 25-50% experience symptoms that have a negative impact on their day to day life, work performance, relationships and sex life2.
Women describe terrible abdominal pain, having to change their tampon every 40-60 minutes, sleeping on a pile of towels in case they leak, problems conceiving, severe fatigue and painful sex.
All these things have a massive impact on women’s ability to work and maintain relationships, not to mention shattered self-confidence.
Yet, unbelievably, women often wait as long as five years before seeing a doctor about their fibroids3.
Why? Many are embarrassed by their symptoms, especially if their personal life or career is affected, others decide to self-medicate and many decide to simply suffer in silence because they believe having fibroids is a part of normal life.
The Diagnosis Dilemma
Waiting to see a doctor can mean that valuable time is lost and investigations into the real cause of symptoms are delayed.
But getting a diagnosis as soon as possible is important, especially for women who want to start or expand their family.
Fibroids can prevent women in their reproductive years from conceiving4 and the growing tendency to have children at a later age, as well as the fact that fibroids tend to be more common as women get older, makes early diagnosis vital to maintain the fertility of women in their thirties and forties.
With such severe physical and psycho-social symptoms, visiting the doctor to get things sorted seems like the obvious choice. So what’s stopping women seeking treatment for their fibroids? The main problem is that there is no clear and effective treatment path for them to follow. Women must choose between putting up with distressing symptoms or pursuing surgical treatments such as hysterectomy or drug treatments. And if they DO choose these potentially life-changing treatments, there’s no guarantee they’ll work.
One recent study reported concerns among patients about the treatments available for fibroids. Eighty per cent of women polled wanted treatments that didn’t involve surgery, while 43% of women below 40 expressed a preference for treatments that wouldn’t prevent them having children.
Some of the biggest challenges women with uterine fibroids face are the ones that impact their daily lives. In a recent study, 42.0% of those diagnosed with uterine fibroids said their symptoms had a negative impact on their day to day life, work performance, their family, relationships and sex life.5 Embarrassment about uncontrollable bleeding, upset about pain and worry that fibroids might lead to uterine cancer6 were also reported.
One woman describes how she has to set her alarm every few hours to remind her to change her sanitary protection and how she plans holidays and visits to friends around her periods as she couldn’t stand the embarrassment of blood stained towels at a hotel or friend’s house.
Another study showed that almost two thirds of women with fibroids feared that their symptoms could lead to them missing days at work, while 25% who are in work but suffer from fibroids believe their condition will stop them reaching their career potential.
A 45-year-old sufferer describes her fatigue as “unbearable” to the point where she cannot concentrate at work. “I have the opportunity to take on a job with more responsibility, but my self-esteem is shaky during my periods and I often have to call in sick. But I feel ashamed of telling my boss about my situation.”
Stop Coping, Start Living
It’s clear that fibroids present a substantial health challenge to the women who suffer them. But it is possible to stop simply coping and start living, despite your fibroids – and it’s important that women seek treatment to get their lives back on track. There is substantial evidence to show that women who pursue treatments for their fibroids experience a positive outcome. In one 2009 study, 72% of women who had experienced painful sex and heavy bleeding and who felt their daily lives had been drastically impacted by fibroids, were content with their treatment and 76% would recommend treatment to others7.
In another 2011 study, women who received one of three treatments for uterine fibroids at a Boston hospital said their symptoms diminished and their quality of life significantly increased8.
Becky Bevers, who is married with a daughter, urges women who are suffering with fibroids to take action and seek treatment. Becky, who lives in Somerset, UK, experienced uncontrollable bleeding for months before she finally went to the doctor. “Without a shadow of a doubt, go and see your doctor straight way if you’re having problems with your periods,” says Becky. “If they don’t find anything, persevere and get a second opinion. “There are now treatments available that can help control the symptoms of fibroids ….make sure you know about all the options and discuss them with your consultant.”
1 Parker WH. ‘Etiology, symptomatology, and diagnosis of uterine myomas’. Fertility &
Sterility. Vol. 87, No. 4, April 2007.
2 Tropeano G, Amoroso S, Scambia G. Hum. Reprod. Update (2008) 14 (3): 259-274.
3 Bijan J, Borah, et al. T J Obstet Gynaecol. 2013; 209 (4): 31
4 Pritts EA, et al. Fertil Steril 2009;91:1215−1223
5 Zimmerman A et al: Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women. BMC Women’s Health 2012, 12:6 http://www.biomedcentral.com/1472-6874/12/6
6 Luiz Gustavo Oliveira Brito et al.: Uterine leiomyoma: understanding the impact of symptoms on womens’ lives. Reproductive Health 2014, 11:10.