Uterine fibroids: they can affect women of all races, but as many as 50 percent of African-American women may have them.
A uterine fibroid is a benign tumor in the uterus. They can occur in women as young as their 20s and commonly affect women in their 40s and 50s.
Dr. Kannan Natarajan treats uterine fibroids at St. Vincent Hospital, Indianapolis. He said that while many African-American women may have fibroids, they don’t always experience symptoms.
“Difficulties include heavy bleeding that may last seven to eight days and some pain that is more severe than period pain,” he said. “Some patients after or during sex can be uncomfortable, and the tumors can compress the bladder and make you feel like you have to go frequently or more urgently. There could also be difficulty getting pregnant.”
In and of themselves, Dr. Natarajan said fibroids are not harmful. They are not cancerous and won’t spread throughout the body, but it is the symptoms that usually cause complications.
If women with fibroids experience extreme bleeding, they could become anemic, and on rare occasions, require blood transfusions.
“You can imagine that if your blood level gets low and you require blood transfusions, it can be disabling,” Dr. Natarajan said.
There is no research that explains why fibroids affect African-American women more, but for some reason they are more prevalent in that segment of the population.
Fortunately, for women experiencing problems with uterine fibroids, there are several options.
Some women who are older and do not desire to become pregnant may choose to have a hysterectomy, which is a complete removal of the uterus. The downside of a hysterectomy is that the procedure is more complicated than other options in that it requires the patient to be completely sedated and the recovery time could be longer.
Dr. Natarajan has performed another option, uterine fibroid embolization, for 13 years.
The procedure begins with “conscious sedation” to help relax the patient; some patients even fall asleep. The doctor will create a small incision and enter the uterus through the groin. The doctor will then put catheters into the arteries to the left and right of the pelvis, depending on where the fibroids are. Small plastic beads are injected to help cut off blood flow to the fibroids, preventing them from growing any larger.
The benefits of the procedure are that it is much less invasive than a hysterectomy, and patients are typically released from a hospital after 23 hours. Dr. Natarajan recommends a week of rest after the procedure has been performed.
E. Shelton, an African-American woman in her 40s, has had complications with uterine fibroids. Her symptoms became so severe they began affecting her day-to-day activities.
As a consultant, Shelton has to fly frequently for her job. Fibroids would create pressure on her bladder, giving her a more urgent feeling to urinate that was made more difficult when standard flight procedures wouldn’t allow her to get out of her seat.
Shelton had the embolization done last December.
“It’s been great,” she said. “The alleviation of pressure is definitely better. When symptoms change, that is naturally a real delight.”
Dr. Natarajan said patients who have received the procedure speak to its effectiveness.
“The odds of bleeding decreasing are around nine out of 10,” he said. “Pressure, pain and discomfort improve in about 80 to 85 percent of patients.”
If someone is curious as to whether or not to get a procedure done for fibroids, Dr. Natarajan said women should seek medical help and find out their options. Embolization is covered by insurance and Medicaid.
Finally, if someone chooses to get an embolization, they may wonder if they will require the procedure again after a few years.
“From research, the odds of someone needing a treatment in five to 10 years are 10 percent or less,” Dr. Natarajan said. “In the long run, they are going to do OK.”
