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It’s no secret that March is a month of celebration. In many homes across the country, and particularly in St. Louis, Mardi Gras is an annual tradition in which friends and families come together to celebrate, eating rich and fatty foods as a prelude to Lent. The month of March is often a chance for many young people, including high-school and college-age youth, to celebrate Spring Break, before completing the final weeks of the Spring semester. March 20 also marks the first day of Spring, and hopefully a promise of warmer weather, outdoor festivities, and the return of Cardinals baseball!

March also represents Women’s History Month. It is the month when men and women alike can honor and celebrate the contributions of women in American history. In 1980, then-President Carter designated March 2-8, Women’s History Week. It wasn’t until 1988 when it became a whole month. As part of the inaugural issue of our Newsletter and in recognition of its promise to improve access to vascular care for all men and women, Modern Vascular St. Louis would like to bring awareness to an issue that has affected women for many years: uterine fibroids.

Uterine fibroids1 (also called leiomyomas) are benign tumors of the uterus, found most often in women of childbearing age. Up to 70% of Caucasian women and greater than 80% of African American women2 have uterine fibroids. Like peripheral arterial disease, most individuals harbor no symptoms at first. However, over time, most will experience symptoms. The most common symptoms are pelvic pain, severe menstrual pain, abnormal vaginal bleeding, dull or achy belly or lower back pain at rest or during sexual intercourse, frequent urination, or problems with fertility. Treatment options begin with hormonal birth control methods to reduce heavy bleeding and painful menstrual periods. But many women may require surgical treatment to remove the painful fibroids (i.e. myomectomy) or even removal of the entire uterus (i.e. hysterectomy).

Personally, my first exposure to uterine fibroids occurred when I was a teenager. I have early memories from my teenage years, seeing my mother suffering intense pain and being rushed to the hospital. She ultimately required surgery to remove the painful fibroids, which left an impression on me. Seeing her in pain partly inspired me to pursue a medical career.

Uterine fibroid embolization (UFE) has emerged as an alternative non-surgical treatment option for patients with painful and symptomatic uterine fibroids. The procedure was first introduced in 1995 to treat fibroids in women wishing to preserve their uterus and their desire for future pregnancy. The principle of UFE is to cut off the blood supply to the uterine fibroid while maintaining blood supply to the non-diseased uterus and ovaries. Multiple trials and studies have shown similar short- and long-term outcomes between surgery (myomectomy and hysterectomy) and UFE.3

Furthermore, UFE has shown multiple benefits when compared to surgery. UFE is minimally invasive and results in no incisions or scars. UFE is a short (1-hour) outpatient procedure that is frequently performed without general anesthesia. Post-procedure recovery following UFE is quicker than it is following surgery. Finally, UFE preserves the uterus and is a great option for young women who desire future pregnancy.

Despite these more favorable outcomes, many patients are unaware of this treatment option. My mother was never offered this option. Fast-forward three decades, I can now educate patients and offer this option to those who are in pain. A 2017 Harris Poll found that 28% of female respondents had never even heard of uterine fibroids. Among those women who had fibroids, one-half had never been informed of UFE as an alternative to surgery, and only 1 in 4 women with fibroids found out about it from their obstetrician-gynecologist. The truth about uterine fibroid embolization is still a mystery to many patients, and even some providers. The reality is that UFE is a safe, effective, and minimally-invasive treatment option for most (if not all) women with symptomatic uterine fibroids. Treatment begins with awareness about the condition, but also requires awareness about the treatment options for women who desire future pregnancy. Give us a call at (888) 853-1278 today. We’re happy to discuss this alternative option with you.

Sources

  1. Uterine fibroids. Uterine fibroids | Office on Women’s Health. (n.d.). Retrieved March 9, 2022, from https://www.womenshealth.gov/a-z-topics/uterine-fibroids
  2. Eltoukhi, H. M., Modi, M. N., Weston, M., Armstrong, A. Y., & Stewart, E. A. (2014, March). The health disparities of uterine fibroid tumors for African American women: A public health issue. American journal of obstetrics and gynecology. Retrieved March 9, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874080/
  3. Van Der Kooij, S. M., & Hehenkamp, W. J. K. (n.d.). Uterine fibroids (leiomyomas): Treatment with uterine artery embolization. UpToDate. Retrieved March 9, 2022, from https://www.uptodate.com/contents/uterine-fibroids-leiomyomas-treatment-with-uterine-artery-embolization/
  4. Claire S. Kaufman, M. D. (2022, January 21). Improving access to UFE: What are the barriers? Endovascular Today. Retrieved March 9, 2022, from https://evtoday.com/articles/2022-jan/improving-access-to-ufe-what-are-the-barrier

Dr. Wande Pratt,
Vascular Surgeon and Managing Physician
Modern Vascular in St. Louis (Creve Coeur, MO)