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Do’s And Don’ts For Talking To Your Doctor About Fibroids

 

Knowledge is power. When it comes to your health, your doctor has a lot of it – and a lot of empowering knowledge to share. At the same time, you know your body best. You know if things are “off”, and – in order for your doctor to effectively do his/her job – you need to share what you know about your state of health.

If you’ve been diagnosed with (or suspect) fibroids, you have a lot of options. Your visit with your gynecologist is an opportunity to learn about and discuss those options, as well as to gather information that will help you better understand your condition. To get maximum benefit from your appointment, observe these “do’s and don’ts”.

THE “DO” LIST

DO EXPLAIN YOUR SYMPTOMS – ALL YOUR SYMPTOMS

Being forthcoming about your symptoms will help both you and your doctor to better understand the nature of your condition. Among the estimated 25%-30% of women who have symptomatic fibroids, the nature and severity of symptoms can vary, depending on the size and location of fibroids. For example, urinary urgency often results when a large fibroid is growing next to – and pressing against – the bladder. In the initial phase of diagnosing your condition, gathering information about symptoms like this will give your gynecologist a clearer idea about the nature and location of your fibroids. In turn, he or she can help you understand how the symptoms you describe are impacted by your fibroids.

DO ASK YOUR BURNING QUESTIONS

If you’ve been newly diagnosed with fibroids, you probably have a number of pressing concerns and questions.  Bring them up! No matter how strange, gross, or personal you may consider a question to be, you’re probably not the first woman to ask it. In a 2012 survey of women aged 29–59 with symptomatic uterine fibroids that was conducted by Harris Interactive, concerns frequently cited by participants included:

  • Physical concerns, including: the potential for physical impairment, worsening of symptoms, future fibroid growth, health complications such as cancer, and impact on fertility
  • Employment-related concerns, including concerns about the ability to perform job-related duties and fear of missing work
  • Relationship concerns, including how fibroids will impact personal relationships, sex life, and home life

Your concerns are valid, and your doctor’s visit is the best time to get them addressed. Don’t be shy: whatever the question, chances are, you’re not the first fibroid patient to ask it!

 DO ARTICULATE YOUR PRIORITIES

Numerous treatment options are available to women with uterine fibroids, including pharmacological treatments, surgical and minimally-invasive options, and complementary and alternative therapies. In order for your doctor to recommend a course of treatment that fits your needs, he or she has to know what those needs are.

Perhaps the most important piece of information in this regard would be whether or not you want to get pregnant at some point in the future. Hysterectomy is notoriously overprescribed as a treatment for fibroids, yet it is obviously a poor option for women who desire to eventually get pregnant: a uterine-conserving procedure is usually a more suitable option in such cases.

DO EDUCATE YOURSELF

Too often, we hear women who have undergone hysterectomy saying they “wish they had known” about less invasive options for treating fibroids. While your gynecologist should – in theory – inform you about all of your treatment options, the best way to ensure the decision you make is an informed one is to inform yourself. Do some research in advance of your appointment, so you can use the visit as an opportunity to ask questions about the treatments you’ve investigated. There are numerous reputable websites that are loaded with information about uterine fibroids and new treatment options: a couple of good places to start are www.womenshealth.gov (published by the NIH) and www.reproductivefacts.org (published by the American Society for Reproductive Medicine. A hysterectomy is not for everyone, so get to know what other treatments are available to you; your subsequent discussion with your doctor will likely be more productive, as a result.

DO WRITE DOWN YOUR QUESTIONS IN ADVANCE

Most of us have, at some point, left a doctor’s office thinking “oh no, I forgot to ask about (insert pressing concern)”. It’s hard to remember everything you mean to ask when you’re in the midst of an exam or office discussion. Do yourself a favor and write those questions down. If you’re not sure what you want to ask, print out our handy list of “Questions To Ask Your Doctor” and bring it to your appointment.

 

THE “DON’T” LIST

DON’T SKIP THE GORY DETAILS

It’s not unusual to hear a woman with symptomatic fibroids share an anecdote about “sitting in the tub and just bleeding out” or describing how her bathroom regularly “looked like a warzone”. Sure, these are not dinner-table conversations, but the “colorful” details about symptoms like blood loss can actually be helpful to your doctor in diagnosing fibroids. Heavy menstrual bleeding is generally considered the definitive symptom of fibroids; but what constitutes “heavy” can be somewhat subjective for women experiencing the symptom. For this reason, describing gross realities like this can actually clarify the severity of your symptoms.

DON’T BE AFRAID TO SEEK A SECOND OPINION

If you don’t think that you have all the answers to your questions or you are not satisfied with the options that have been presented, you may want to get a second opinion.  It’s great to trust your physician; what’s more important, however, is that you feel comfortable with the decision you and he/she reach together. There’s no harm in seeking further information through a second opinion, even if you completely trust your doctor.

 

>> SEE ALSO:  Where Can I Learn More About Fibroid Treatment Options?

 

SOURCES:

Stewart, E. et al. “The Burden of Uterine Fibroids for African-American Women: Results of a National Survey”, Journal of Women’s Health. 2013; 22(10):807-16

 

 

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The 5 Biggest Myths Surrounding Uterine Fibroids

 

shutterstock_325530068Fibroids are the most common type of pelvic tumor among women of reproductive age. Despite their prevalence, however, fibroids are widely misunderstood. A number of popular misconceptions, in particular, create confusion for women with fibroids who are trying to understand their condition and treatment options. To clear up some of this confusion, we’re breaking down five of the most common myths surrounding fibroids.

 

MYTH: If you have fibroids, you will experience symptoms like heavy menstrual bleeding and pain.
As common as the condition is, researchers estimate that between 50-80% of women with fibroids will experience no fibroid symptoms at all. Many women with asymptomatic fibroids never even know that they have the condition. And, because fibroid tumors are almost always benign, women who aren’t experiencing symptoms may opt to forgo treating their fibroids.

MYTH: A routine ultrasound will detect any uterine fibroids that are present.
If fibroids are suspected, the first diagnostic tool gynecologists employ to confirm the suspicion is transvaginal ultrasound. However, this imaging method doesn’t always reveal all existing fibroids. The size and location of uterine fibroids varies greatly, and extremely small fibroids, submucosal fibroids, and small fibroids that are hidden behind larger tumors, aren’t always detectable through a routine pelvic ultrasound. For clearer visualization of the tumors, physicians frequently rely on laparoscopic ultrasound, which requires inserting a scope through the vagina and into the abdominal cavity provides. Research has shown that laparoscopic ultrasound can detect up to twice as many fibroids as transvaginal ultrasound.

MYTH: Fibroid tumors will become cancerous.
Uterine fibroids, also known as leiomyomas, are almost always benign: in women of reproductive age, less than 0.01% of (removed) fibroids become cancerous. While fibroids typically shrink after menopause, those that do appear in post-menopausal women may be the cancerous type, called leiosarcomas. It’s important to note, however, that – regardless of age – simply having fibroids does not increase a woman’s chances of developing cancer in her reproductive organs.

MYTH: Endometrial ablation is a method of treating fibroids
Endometrial ablation (EA) is a commonly used to treat abnormal uterine bleeding. The technique entails destroying the layer of tissue that lines the uterus known as the endometrium, preventing new tissue from growing and thereby reducing or eliminating menstrual bleeding. While you may have heard EA discussed in the context of fibroids, it is not, in fact a fibroid treatment. The destruction of fibroids that can occur with EA is incidental, and is not likely complete. In such cases, the ablated fibroids will often regrow, since subserosal fibroids – the type that grow inside the uterus and are therefore subject to destruction during EA – often originate below the endometrium layer.

MYTH: If left untreated, fibroids will continue to grow throughout a woman’s lifetime.
Fibroid growth is fueled by estrogen. Accordingly, fibroids will grow and shrink in response to the body’s hormone fluctuations. Pregnant women often experience rapid growth in existing fibroids and may develop new fibroids during pregnancy, due to the heightened levels of estrogen that their bodies are producing. Conversely, fibroids typically shrink after menopause, because the ovaries have stopped producing estrogen. (Post-menopausal women undergoing hormone replacement therapy can expect the opposite to occur, however, since they are artificially replacing the missing estrogen.) Although fibroids do tend to disappear naturally after menopause, pre-menopausal women who are suffering with symptoms of uterine fibroids may not want to wait.

When fibroids are interfering with the quality of life, it’s advisable to discuss treatment options with a gynecologist. With a plethora of treatments available to women with fibroids, including uterine conserving methods like Acessa Procedure, it’s not necessary to endure long-term suffering!

 

SOURCES:

American Society for Reproductive Medicine, “What Are Fibroids? Fact Sheet”, Resources, ReproductiveFacts.org: rev. 2012. Retrieved Aug 26, 2015, from http://www.reproductivefacts.org/FACTSHEET_What_are_Fibroids/

Levine, D.J. et al. “Sensitivity of Myoma Imaging Using Laparoscopic Ultrasound Compared With Magnetic Resonance Imaging and Transvaginal Ultrasound”, Journal of Minimally Invasive Gynecology. Nov/Dec 2013; Vol 20(6): 770-4

Burbank, Fred. Fibroids, Menstruation, Childbirth and Evolution: The Fascinating Story of Uterine Blood Vessels. Tucson, AZ: Wheatmark, 2009. 135. Print.

 

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