Raising awareness about fibroids, including those primarily affected by the condition, diagnostic, and treatment modalities.
Fibroids are growths that develop from the muscle layer of the uterus. They consist of muscle and connective tissues and are benign, or non-cancerous, tumors. Fibroids are very common, particularly among African American women when compared to White women, and may/not cause symptoms depending on their size, location, and number of fibroids present. In the United States, it is estimated that fibroids will affect between 20-80% of women by the age of 50.
Although fibroids do not always cause symptoms, when they do, these symptoms are often severe enough to impact an individual’s life and warrant therapeutic intervention. Common approaches for the treatment of symptomatic fibroids include medical and surgical management, with both approaches intended to alleviate symptoms. Although historically, invasive surgical procedures have been the focal point of the fibroid treatment care paradigm, advancements in science and technology have expanded access to alternative treatment pathways much less invasive than traditional surgeries.
At HerMD, we believe education is the cornerstone of change. That’s why we sat down with Dr. John White, board-certified OBGYN practicing at HerMD’s Cincinnati, OH center, to better understand the many therapeutic options available for the treatment of symptomatic fibroids.
Interested in learning about the newest innovations in fibroid care? Read more below:
If an individual suspects they might be living with fibroids that are causing symptoms, can you walk us through what they can expect as part of their fibroid evaluation & treatment discussion at HerMD?
JW: When being evaluated for a diagnosis of fibroids, your clinician will always begin by obtaining your detailed history and performing a physical exam. A detailed discussion of your symptoms, along with the vision for your long-term health goals, will also be conducted to help to inform treatment options. Finally, abdominal and transvaginal imaging will be critical in assessing the size of the fibroids, their location, and assisting in developing a treatment plan.
Surgery is a treatment option that is often the focal point of the treatment paradigm for fibroid care. Can you debunk the myth that surgery is the only treatment option for fibroids, and talk about the range of therapeutic options available?
JW: At HerMD, we offer a wide range of options for the treatment of symptomatic fibroids. Medical and surgical approaches to fibroid care form the basis of the treatment paradigm, and each modality listed below has their place in the management of symptomatic fibroids.
- Hormonal therapy, including combined oral contraceptives (OCPs), progestin-only OCPs, progestin-only intrauterine device (IUD), contraceptive implant, gonadotropin-releasing hormone (GnRH) analogues (with or without addback therapies which can reduce the side effects of treatment)
- Non-hormonal medication, such as tranexamic acid, to control heavy menstrual bleeding
- Hysteroscopy & hysteroscopic myomectomy, performed in-office or in the hospital
- Uterine artery embolization, to block blood supply to fibroids, thereby shrinking the fibroids and minimizing symptoms
- Radiofrequency ablation, incision-free and minimally-invasive techniques available, which harness the power of radiofrequency energy to reduce the size of fibroids (these are newer treatments)
- Endometrial ablation, for smaller fibroids causing heavy menstrual bleeding (inside the cavity of the uterus)
- Myomectomy, including hysteroscopic, laparoscopic, or abdominal, to remove fibroids
- Hysterectomy, including vaginal, laparoscopic, or abdominal, as definitive surgical treatment
You mentioned non- and minimally-invasive procedural approaches for the treatment of symptomatic fibroids. These approaches seem innovative and promising. Can you explain these new technologies in more detail?
JW: The use of radiofrequency energy to improve treatment outcomes is growing in popularity. In the setting of fibroid treatment, there are 2 radiofrequency ablation techniques used: the Sonata® Sonography-Guided Transcervical Fibroid Ablation System and the Acessa® procedure. These are new technologies that have given patients more options in the management of symptomatic fibroids. Sonata®, a transcervical approach, offers patients an incision-free treatment option to shrink fibroids and thereby reduce symptoms. Acessa®, a laparoscopic approach, is a minimally-invasive procedure that is performed through the abdomen to treat fibroids in select cases. HerMD is on a mission to offer treatments that are minimally invasive and have faster recovery time, and was also one of the first in the state of Ohio to perform treatment with Sonata®. Other HerMD physicians are currently being trained in radiofrequency ablation techniques for the treatment of fibroids.
When it comes to fibroid care, what sets HerMD apart?
JW: At HerMD, we are on a mission to revolutionize women’s healthcare. Our approach to care is individualized and tailored to each person’s unique needs. The approach to treatment for symptomatic fibroids is not “one-size-fits-all”, and you will find our clinicians partner with patients to come up with the best treatment plan for this very common and variable medical condition.
Interested in learning more? Below, please find a list of carefully curated resources and tools intended to help increase awareness of and education on fibroid care:
- The White Dress Project https://www.thewhitedressproject.org/
- The Fibroid Foundation https://www.fibroidfoundation.org/
- Resilient Sisterhood Project https://rsphealth.org/
References:
Stewart EA, Laughlin-Tommaso SK. Patient education: Uterine fibroids (Beyond the Basics). In: UpToDate, Chakrabarti A (Ed), Wolters Kluwer. Accessed July 24, 2024. https://www.uptodate.com/contents/uterine-fibroids-beyond-the-basics/print
Sohn GS, Cho SH, Kim YM, Cho CH, Kim MR, Lee SR. Current medical treatment of uterine fibroids. Obstet Gynecol Sci. 2018;61(2):192. doi:10.5468/OGS.2018.61.2.192
Office on Women’s Health. Uterine fibroids. U.S. Department of Health and Human Services. Accessed July 24, 2024. https://www.womenshealth.gov/a-z-topics/uterine-fibroids
Gynesonics, Inc. Why Sonata? – Sonata Treatment. Accessed July 25, 2024. https://sonatatreatment.com/why-sonata/#how-sonata-works
Hologic. Acessa – GYN Surgical Solutions For Patients. Accessed July 25, 2024. https://gynsurgicalsolutions.com/patients/treatment-options/acessa/
The medical content in this article has been reviewed by Karla Loken, DO, OBGYN, FACOOG for accuracy.