By: Maryam Henein
July is National Fibroid Awareness Month. Were you aware that fibroids are a super common condition that marks a silent crisis, plaguing women around the world?
Four months ago, I started bleeding twice a month, and feeling fullness around my pelvis. And I was also waking up four or five times every night with the urge to pee. Following an ultrasound, I realized I had at least two fibroids, which had grown within the muscle wall of the uterus. Ouchy.
Fibroids, which are noncancerous growths of the smooth muscle, are the most common benign pelvic tumors in women. In fact, 70 percent of women in the United States will be affected by uterine fibroids before the age of 55, according to National Institutes of Health (NIH). And African-American women are two to three times as likely to develop fibroids.
Approximately 20 percent of women experience significant symptoms from their fibroids, including heavy menstrual bleeding, menstrual periods lasting more than a week, pelvic pressure or pain, frequent urination, difficulty emptying the bladder, constipation and backache/or leg pain.
“Not only can they vary in size and number, there are also multiple types of uterine fibroids, each characterized based on their location,” says Dr. Jessica Shepherd, OB/GYN and women’s health expert, based in Chicago. She is also a doctor on the advisory board of the White Dress Project, an organization dedicated to raising funds for research and awareness for uterine fibroids.
If fibroids grow mainly outward away from the cavity of the uterus, they are called subserosal. If they stay within the muscle wall they are called intramural fibroids. If they extend into the uterine cavity, they are called submucosal fibroids. My fibroids were subserosal and intramural.
With more than 10 million symptomatic women in the U.S. each year, it has been estimated that uterine fibroids cost the economy upward of $34 billion!
If you think you may be suffering from fibroids, or just have a uterus, here are 4 things you should know.
1. Natural Ways To Combat Fibroids
As a functional medicine coach, I advocate for people to be their own best health advocate. If something is off in regards to your female parts, the first thing is to get an ultrasound. Keep in mind that the accuracy and diagnostic capability of ultrasonography is highly dependent on the technician performing the scan. I can vouch. I was incorrectly told I had a cyst. I only discovered the truth, three months later, when I went to another imaging center and insisted they perform a transabdominal and transvaginal ultrasound. Accuracy is improved when both are combined.
If the fibroid(s) is small, less than 3 cm, your doctor will likely tell you to keep an eye and monitor your symptoms, aka “watchful waiting.” My biggest fibroid was 2.6 cm by 1.9 cm.
Factors associated with an increased risk of fibroid growth include first menstruation before 10 years of age, not having children, polycystic ovary syndrome, diabetes and being over 40 years of age, according to Life Extension.
Fibroids are also associated with metabolic syndrome, which is basically when your biochemistry goes wonky. Incidences of metabolic syndrome include increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels. Excessive carbohydrate consumption and abnormal glucose metabolism can also lead to fibroids.
Since none of those symptoms applied to me, and I follow a keto diet, virtually eating very little carbs and no sugar, I considered the emotional plane. Negative mental processes can also cause physical illness. According to the late Louise Hay, author of the guidebook, Heal Your Body, fibroids can manifest when you are nursing a hurt from a partner and have experienced a blow to the feminine ego. This resonated since I have been under extreme stress and there was still residual debris from my former relationship. The suggested mantra, “I release the pattern in me that attracted this experience. I create only good in my life.”
Meanwhile, I started doing many natural things to help mitigate pain and shrink the fibroids such as ozone vaginal insufflation, acupuncture and castor oil packs. I also incorporated recommended herbs and vitamins like green tea, vitamin D, curcumin and black cohosh extract.
All these combined with eating a clean diet definitely helped me with pain and discomfort.
2. Dismembering Women One Uterus At A Time
If you are symptomatic and want to treat your fibroids with Western medicine, you’ll likely be told that the primary “solution” is the complete removal of your uterus, aka a hysterectomy. Talk about throwing the baby out with the bathwater.
“Seven hundred hysterectomies will be performed today for fibroids,” says Dr. Bruce Lee who is a gynecologist with a practice in Beverly Hills.
Consider that out of the approximately 620,000 hysterectomies performed every year, 90 percent of them are performed for benign indications like fibroids, and that a woman’s lifetime risk of all gynecologic cancers is less than 3 percent. In other words, women’s wombs are being needlessly removed. Even the conservative American Congress of Obstetricians and Gynecologists (ACOG) acknowledges that at least 70 percent of the hysterectomies that women undergo every year are unnecessary at a cost of $17 billion a year.
How has modern medicine normalized this barbaric practice and institutionalized castration?
According to Dr. Lee, gynecologists are taught during residency that the uterus is only a worthwhile organ for having children. But nothing could be further from the truth. Many women experience lifelong irreversible health issues after a hysterectomy.
“The doctor who did it to me, against my directive, absolutely considered the uterus and ovaries useless unless you plan to have children,” says Eliza Moriarty, a master herbalist and the mother of five. She had the procedure five years ago for a condition other than a fibroid.
“I’m only finally recovering. It changed the way my brain works, the way I process information. It strongly impacted my cognition. I needed to learn to live with a new processing system. It’s tougher than getting a new body.”
Would we be removing men’s testicles if fibroids were a male thing? I don’t think so.
We shouldn’t accept that hysterectomy is the primary solutions to fibroids. I want to keep my body parts regardless of whether I still want children or not. So I looked to see if there were any effective, quick and noninvasive treatments in 2018.
3. Uterine-Preservation Treatments In The 21st Century
Myomectomy is the surgical removal of fibroids without removing the uterus. There are variations on the procedure but success is associated with the number and size of the fibroids. Lee says it’s common to find women with fibroids the size of a papaya!
Women who undergo myomectomy have a 10-30 percent chance of recurrent fibroids within five years. Cesarean section deliveries are often performed on women who have had a myomectomy due to the risk of complications during vaginal birth.
While some authors suggest that laparoscopic (small incision into the abdomen) myomectomy improves a woman’s chance of conceiving, it carries risks including blood loss, pain, adhesions, problems with childbirth and complications from tissue power morcellation, which is a procedure the FDA warns against.
Uterine Artery Embolization (UAE)
During UAE, a catheter is inserted through the large femoral arteries in the groin and guided into the arteries that supply blood to the fibroid tissue. Microscopic inert particles are then injected to disrupt the blood supply to the fibroid. The idea is that these embolic agents cut off the blood supply to the fibroids, causing cells to die and the fibroids to shrink in size.
Compared to hysterectomy or myomectomy, UAE, which became available in the mid-‘90s, involves a shorter procedure time, hospital stay and quicker return to normal activities. However, complications from UAE can include blood collection outside of vessels (hematoma), bleeding and infection; further surgeries are required after UAE in approximately 30 percent of cases. Post-embolization syndrome, which is characterized by pelvic pain, cramping, nausea, vomiting, fatigue and mild fever affects most UAE patients.
This procedure peaked my interest, but then I wondered what the particles were made from.
“They’re plastic,” explained Lee, “and they don’t tell you that they can travel everywhere. And sometimes the agents not only cut off flow to the fibroids but to the entire uterus, which then leads to an unwanted hysterectomy.” He has ‘fixed’ a lot of UAE procedures that go awry.
Magnetic resonance-guided focused ultrasound surgery
During magnetic resonance-guided focused ultrasound surgery (MRgFUS), a patient is placed into an MRI machine to visualize fibroids and surrounding organs, while high-energy ultrasound waves are directed at the fibroid, causing an increase in temperature and tissue damage. Clinical studies show that 70-80 percent of women have improvements in clinical symptoms after MRgFUS. However, these improvements may be temporary as one study found 71 percent of women experienced symptom reduction at six months, but the proportion declined to 51 percent at 12 months (Stewart 2006).
The Acessa procedure, which became available in 2012, is a minimally invasive, uterine-sparing fibroid treatment procedure that is conducted on an outpatient basis. Lee designed the Acessa System instrumentation after he witnessed women undergoing unnecessary hysterectomies and strife.
“I wanted to empower women by giving them a viable option so they could choose rather than be told they needed a hysterectomy,” says Lee. He has treated over 8,000 uterine fibroids with this novel technology (originally developed to treat cancer) and instructs physicians on how to perform it worldwide.
Acessa treats fibroids of all types and sizes and in all locations within the uterine wall. It uses radiofrequency ablation to destroy each fibroid by applying controlled energy through two ports that are inserted surgically through the abdomen and into the uterus to locate and target fibroids. Surrounding normal tissue is not affected. The destroyed tissue may eventually be reabsorbed by the body over time.
Acessa is FDA- approved, has minimal side effects and complications, is safer, cheaper and boasts a faster recovery. It even can detect and therefore treat even very small fibroids that if left untreated, could grow and become problematic in the future. I was sold. Yet despite all the plusses, insurance companies oftentimes don’t offer the procedure, making it unavailable to many women, including me.
“Unfortunately the availability of optimal, individualized healthcare for symptomatic fibroid treatment has been hampered in the United States because of the disparity in payer coverage and by poorly understood treatment options,” says Ryan Graver, Vice President, Market Access & Reimbursement. He works with patients and appealing their letters of denial.
4. Get Informed: So Close Yet So Far
Alternatives to hysterectomy are underused, according to the Journal of Obstetrics and Gynecology. Despite the prominence of this condition and the dysfunction that symptomatic patients endure, Western medicine has not been briefed on the safest alternatives, insurance companies put profits over patient’s interests, and women aren’t advised about all the treatment options, surgical and nonsurgical, nor fully informed of the risks and benefits of those options.
As a result, women who want to keep their uterus wait an average of 3.6 years before seeking treatment. Soraya Kraszczyk, 48, has already waited more than a year after she was told that the only solution for her was a hysterectomy since she is already a mother of four and past childbearing years.
“Like many women, I do not want to have my uterus removed if I have other options available to treat my fibroids,” she said.
Her insurance company Cigna denied the procedure. Kraszczyk’s appeals have also all been all been refused as she continues to suffer from symptoms, with a hysterectomy as the only procedure her insurance will cover.
To quote a paper in the U.S. National Library of Medicine: “Promoting safe surgery should be an important component of a strong, value-based healthcare system.”
Looking to help or find more resources? The first step is to raise awareness and address “potentially perverse incentives” for certain surgeries. You can also: