'Listen to your body.' Doctors, patients at Aurora Sinai Medical Center champion less-invasive surgery for uterine fibroids (2022)

'Listen to your body.' Doctors, patients at Aurora Sinai Medical Center champion less-invasive surgery for uterine fibroids (1)

Like countless other women, Therese Jones didn't initially know what to make of the symptoms she was experiencing.

When she was on her period, she'd experience very heavy bleeding. There was a pain in her abdomen. She was anemic.

"I didn't really know what it was," Jones, of Milwaukee,said."I didn't think about it too much."

Now 44, she was 37 at the time.

At her annual appointment with her OB/GYN, she found out right away. Her uterinefibroids were growing.

There was one in particular that her doctor had noticed the year before. But at this visit, the non-cancerous tumor was 10 centimeters larger. Too large to keep being ignored.

The doctor prescribed medications aimed atshrinking the fibroids. The medication stopped her body from producing the hormones that are thought to feed the growths, essentially putting her body into temporary, early menopause.

"It was horrible, I had the sweats, I gained probably 50 pounds," she said."And this was right around the time I wanted to have a baby."

She decided to take the medication and seeif there would be any improvement over the subsequent three months. But the time passed with no shrinkage of the fibroid. Another three months, still no change.

At that point, her doctor had to stop giving her the medication. Her only options left were surgical. She couldhave a myomectomy, in which doctors would cut outthe fibroids and leave the rest of the uterus intact. Other options would have made her unable to have children, like a hysterectomy, in which the patient's entire uterus is removed.

Jones opted for the myomectomy.

Her recovery from the surgery was lengthy: She needed assistance walking and dressing herselffor about three weeks. For about four months, she was in pain.

She spent at least a month out of work, unable to run her prominent Milwaukee-basedfashion collection. Jones has shown her designs at Fashion Weeks in New York, Los Angeles,Paris and Milan, and has even dressedcelebrity clients for the Oscar and Emmy red carpets.

But the surgery worked, and for a while, Jones was in the clear.

Until, about two years later, when she felt the pressure building in her abdomen again.

Her old doctorhad moved, so Jones set up an appointment with Dr. Marie Forgie, an OB/GYN at Aurora Sinai Medical Center. Forgie confirmed Jones' suspicions: Her fibroids were growing back.

"Little monsters in there," Jones thought.

A less invasive, less painfuloption

Jones was not only more aware of her fibroids the second time they started growing;she had also learned of a different, potentially less painful way to treat them.

She first heard about new efforts to treat fibroids while watching the Real Housewives of Atlanta.

Many of the shows cast members have talkedopenly about their experiences dealing with uterine fibroids, including Kandi Burrus andCynthia Bailey. Baileyhad herfibroids removed through a less-invasive procedurecalled uterine fibroid embolization. The procedure blocks the bloodflow to the fibroid, cutting off its supply of nutrients and causing it to shrink.

Jones mentioned the housewives toForgie. Was there something less-invasive that she could try this time around?

'Listen to your body.' Doctors, patients at Aurora Sinai Medical Center champion less-invasive surgery for uterine fibroids (2)

It turned out the doctors at Aurora Sinai had a different, but equally appealing treatment available. Thehospital had actually become quite well-known for performing it.

Theminimally-invasive surgery, called radiofrequency ablation or (its trade name) Acessa, usesradiofrequency energy and heat to shrink fibroids to the point where they are much smaller, and can even bereabsorbed intothe healthy uterine tissue that surrounds them.

"Even if the fibroid is still there, it changes the consistency of the fibroid from something like a baseball to something like a marshmallow. It's a lot softer," Forgie said."Then it's less likely to cause pressure on things like your bladder or other structures within your pelvis which then, of course, is less likely to cause you pain and discomfort."

Instead of a large abdominal cut, staples and a long recovery time, doctors would only have to make a few small laparoscopicincisions to perform the surgery. In the year following the surgery, the fibroids can continue to shrink even more, Forgie said. Most patients go home the same day as the surgeryand are back at work in three to five days.

In January of this year, Jones told Forgie she was going to opt for the Acessa procedure. The fibroids were continuing to grow, and the symptoms were getting worse.

In early April, she got the surgery.

"I came out of surgery feeling the pressure gone," she said. "As soonas I woke up, I was like 'Oh! They're gone!'"

She was sore for a couple days. Aftera week and a half, the cuts were healed, and Jones was back to her life.

Fibroids have a disproportionate impact on Black women

Fibroids are very common, with some experts estimating 50% of people with uteruses will develop them at some point in their lives. Others estimate up to 70% or 80% of women will develop them at some point.

It's not known what causes fibroids. Doctors also don't know of concrete measures that can help prevent them.

The benign tumorsappear during a person's childbearing years. For many people they shrink after the person enters into menopause, according to the Cleveland Clinic. Fibroids are rarely cancerous. But they can cause many other problems for people who have them.

"Sometimes they're small and they don't really impact a person at all. But sometimes they can grow to be quite large andsomeone may not even know that they have them," Forgie said."They may just be living with these really heavy or really painful periods. And so what I've seen often is that women will have these horrible periods and think that it's just normal."

While people of all races and backgrounds develop fibroids, the tumors are disproportionality common among Black women. A March 2014research reviewin the American Journal of Obstetrics and Gynecology estimated more than 80% of African American women will have fibroids by the age of 50. The tumors are also known to be larger thanaveragein Black women — more likely to cause symptoms like abdominal pain, heavy menstrual bleeding andbloating— and they seem to appear at younger ages, according to the Mayo Clinic.

More:Medical bias: From pain pillsto COVID-19, racial discrimination in health care festers

Black women are also more likely than women of other racial backgrounds to be hospitalized because of their fibroids, and more likely to have to get myomectomies, the surgery Jones first had, and hysterectomies because of them.

Recurring fibroids are the No. 1 reason for hysterectomies in the U.S., according to Johns Hopkins Medicine. According to data from Hologic, the women'shealth-focused medical devicecompany that owns Acessa, of the 2.1 million women annually seeking treatment for fibroids, roughly 240,000 women every year choose to have a hysterectomy.

Increasingly, however, women are calling for more conservative treatments for these painful growths.

"I think that people deserve options," Forgie said. "And people are coming in expecting options, asthey should. So it's really nice to have another tool that can help treat their symptoms but also not take them out of their lives for quite as long."

Aurora Sinai docs fight for change, and fewer hysterectomies

As with any new medical treatment or technology, there are some concerns with the Acessa procedure that still have to be worked out.

It is possible that the fibroids can come back. The only treatment where fibroids cannot grow back is the hysterectomy.

Forgie also noted that while women can become pregnant after getting the Acessa procedure, and experts have seen thatthe surgery doesn't appear to impact pregnancies, there is still not enough clinical data to support recommending the option to women who are considering future fertility.

The procedure is approved by the U.S. Food and Drug Administration and is recognized bythe American College of Obstetricians and Gynecologists as an evidence-based treatment for fibroids.

One of the biggest barriers tomaking the procedure more available to interested patients has been making sure that the procedure is covered by insurance, saidTyler Roosa, a territory manager for Hologic who focuses on southeast Wisconsin.

When Hologic acquired Acessa in 2020, some 20% of procedures were being approved for insurance coverage. Now, that percentage is up to 65%, Roosa said.

In particular, Forgie and her colleagues at Aurora Sinai have worked to establish the hospital as a destination for the procedure. Aurora Sinai was the first hospital in the state to buy the technology so doctors can perform the procedure routinely.

OB/GYN's there have alsofought to convincemore insurers— public and private— to cover the treatment for their patients. In January, the state Department of Health Services added coverage for the procedure to Medicaid and BadgerCare Plus members following the doctors' advocacy. Forgie said the hospital continues to work with insurers to help get the procedure covered, even if it's not listed as covered to begin with.

Forgie said that she wants women to know that they don't have to just suffer through dealing with their fibroids.

"Women are notorious for just putting their health care aside and being caretakers for other people," she said. "I want people to know right away that theydon't have to suffer and that their health is important."

Today, Jones is back to traveling the world, running her fashion design business.Though dealing with her fibroids has delayed plans to grow her family, she still hopes to do so.

She said she feels "amazing," and wants more women to advocate for the health care they need.

"Listen to your body," she said. "If you feel something that's wrong, go get it checked."

Symptoms and resources

For many people, uterine fibroids do not cause symptoms. But in the cases where they do cause symptoms, these are among the most common, according to the Mayo Clinic:

  • Heavy menstrual bleeding
  • Menstrual periods lasting more than a week
  • Pelvic pressure or pain
  • Frequent urination
  • Difficulty emptying the bladder
  • Constipation
  • Backache or leg pains

You should see your doctor if you have:

  • Pelvic pain that doesn't go away
  • Overly heavy, prolonged or painful periods
  • Spotting or bleeding between periods
  • Difficulty emptying your bladder
  • Unexplained low red blood cell count (anemia)

More information about the Acessa procedure is available here:https://gynsurgicalsolutions.com/patients/treatment-options/acessa/

A guide on fibroids and various ways to treat them is available here:https://www.hopkinsmedicine.org/health/conditions-and-diseases/uterine-fibroids

Q and A on fibroids and menopause from the Cleveland Clinic:https://health.clevelandclinic.org/uterine-fibroids-after-menopause/

Contact Devi Shastri at 414-224-2193 or DAShastri@jrn.com. Follow her on Twitter at @DeviShastri.

FAQs

What is the best treatment for fibroids? ›

Myomectomy. A myomectomy is an operation to remove fibroids while preserving the uterus. For women who have fibroid symptoms and want to have children in the future, myomectomy is the best treatment option. Myomectomy is very effective, but fibroids can re-grow.

Can radio frequency shrink fibroids? ›

Radiofrequency ablation is a minimally invasive procedure that uses heat to target fibroids one by one, reducing their size significantly. By shrinking the fibroids, patients enjoy less severe symptoms and a better quality of life.

Does endometrial ablation stop fibroids from growing? ›

Endometrial ablation — Endometrial ablation destroys the lining of the uterus. The treatment does not shrink the fibroid(s) but can help to decrease heavy menstrual bleeding caused by fibroids.

Is a hysterectomy the best option for fibroids? ›

Total abdominal hysterectomy (TAH) has been the traditional procedure. It is an invasive procedure that is best suited for women with large fibroids, when the ovaries also need to be removed, or when cancer or pelvic disease is present.

What vitamins shrink fibroids? ›

Some types of vitamins may also help reduce the growth and size of fibroids.
...
A number of vitamins may help ease these symptoms:
  • vitamin B-1.
  • vitamin B-6.
  • vitamin E.
  • magnesium.
  • omega-3 fatty acids.

What is the treatment for fibroids without surgery? ›

Certain procedures can destroy uterine fibroids without actually removing them through surgery. They include: Uterine artery embolization. Small particles (embolic agents) are injected into the arteries supplying the uterus, cutting off blood flow to fibroids, causing them to shrink and die.

What other options than hysterectomy for fibroids? ›

There are two techniques available to treat fibroid tumors without hysterectomy: myomectomy and uterine artery embolization.

Which is better ablation or embolization? ›

Uterine Fibroid Embolization (UFE)

Compared to endometrial ablation, UFE is more effective, less invasive, and allows women to keep their uterus and often, fertility (while endometrial ablation is NOT for women interested in having children).

Does heat shrink fibroids? ›

It shrinks fibroids by 40 percent, reduces pain and reduces bleeding during periods. RADIOFREQUENCY ABLATION: Radiofrequency ablation was approved by the FDA to treat fibroids in 2012. Dr.

Are you put to sleep for endometrial ablation? ›

Some methods of endometrial ablation require general anesthesia, so you're asleep during the procedure. Other types of endometrial ablation might be performed with conscious sedation or with numbing shots into your cervix and uterus.

How painful is endometrial ablation? ›

Depending on the type of endometrial ablation, the device sends energy, heat or cold to destroy part of the lining. The technology makes things quick and you should have minimal or no discomfort during the procedure.

What are the long term side effects of endometrial ablation? ›

Intrauterine contracture and scarring can occur after the procedure, which may obstruct bleeding from persistent viable or regenerating endometrial glands causing central hematometra, CH, PATSS, and retrograde bleeding and potentially delay the diagnosis of endometrial cancer.

What fills the space after a hysterectomy? ›

After you have a hysterectomy, your other organs move to fill the space. Your small and large intestines mainly fill the space once occupied by the uterus.

Can fibroids give you a big belly? ›

Larger fibroids may cause a woman to gain weight in the abdomen, giving the appearance of normal belly fat. Simply put, the more a fibroid grows, the heavier it will become. Consequently, weight gain and discomfort will follow as some fibroids can weigh up to as much as 20-40 pounds.

Can a man feel the difference after a hysterectomy? ›

The reality is that sex after hysterectomy for the man may feel surprisingly similar. In all procedures, the surgeon takes steps to maintain vaginal functionality. A hysterectomy is simply a surgery that removes the uterus.

What does vitamin D do to fibroids? ›

Additionally, recent studies have demonstrated that vitamin D3 is a potent antitumor agent that effectively inhibits human uterine fibroid cells in vitro and shrinks fibroid lesions in preclinical animal studies; however, no human trials have been conducted in this area thus far.

What can shrink fibroid fast? ›

Here are eight ways you may be able to shrink those fibroids, potentially avoiding hysterectomy.
  • Do nothing (Watchful Waiting) ...
  • Have a baby. ...
  • Mifepristone. ...
  • Ulipristal. ...
  • Leuprolide. ...
  • Myolysis. ...
  • Uterine artery embolization (UAE) ...
  • Focused ultrasound (FUS)
15 Mar 2018

Can zinc shrink fibroids? ›

Taking just 30 mg of zinc a day may help to decrease the size of inflamed fibroids, thus increasing the chance for a pregnancy to occur.

What size should a fibroid be removed? ›

What Size Fibroids Should Be Removed? If large fibroids (those over 10 cm) are left untreated, they may grow even larger and potentially rupture or degenerate. Large fibroids can distort your uterus' shape and cause damage to surrounding organs, such as your bladder and bowel.

Can uterine fibroids be removed without hysterectomy? ›

Unlike a hysterectomy, which removes your entire uterus, a myomectomy removes only the fibroids and leaves your uterus. Women who undergo myomectomy report improvement in fibroid symptoms, including decreased heavy menstrual bleeding and pelvic pressure.

What is the recovery time for fibroid surgery? ›

Your Recovery

Your doctor made a cut (incision) in your lower belly to remove the fibroids. You can expect to feel better and stronger each day. But you may tire quickly and need pain medicine for a week or two. You may need about 4 to 6 weeks to fully recover.

What can you do instead of a hysterectomy? ›

The alternatives to total abdominal hysterectomy include denial of service, vaginal hysterectomy, laparoscopic-assisted vaginal hysterectomy, laparoscopic supracervical hysterectomy, endometrial ablation, and myomectomy/myolysis.

What are the signs of needing a hysterectomy? ›

The most common reasons for having a hysterectomy include:
  • heavy periods – which can be caused by fibroids.
  • pelvic pain – which may be caused by endometriosis, unsuccessfully treated pelvic inflammatory disease (PID), adenomyosis or fibroids.
  • prolapse of the uterus.
  • cancer of the womb, ovaries or cervix.

What are the negative effects of a hysterectomy? ›

You might have some light bleeding and discharge after your surgery, and you'll no longer get regular menstrual periods. Pain, burning, and itching around the incision site are also normal. If your ovaries were removed, you'll likely have menopause-like side effects like hot flashes and night sweats.

What is better hysterectomy or endometrial ablation? ›

Laparoscopic supracervical hysterectomy is superior to endometrial ablation in terms of clinical effectiveness and has a similar proportion of complications, but takes longer to perform and is associated with a longer recovery.

What is an alternative to endometrial ablation? ›

Alternatives to endometrial ablation include re-education of the 20% or more women complaining of menorrhagia whose blood loss is normal, less than 35 ml, and the use of an increasing variety of drugs to find an effective regime with minimal side effects.

How long does tumor embolization take? ›

The procedure will take about 1 to 3 hours. After the procedure, pressure will be applied to the area where the catheter was put in your blood vessel. Then the area may be covered with a bandage or a compression device.

Do fibroids make you tired? ›

Why do uterine fibroids cause fatigue? Fatigue is something many of us experience — but there's a specific reason you may be feeling dizzy, nauseous or tired due to uterine fibroids. This feeling of fatigue is related to the loss of blood you may be experiencing due to heavy periods brought on by fibroids.

Can fibroids affect sleep? ›

If you have symptoms of uterine fibroids, you know fibroids can prevent you from getting a good night of rest. Many women with fibroids can't sleep because of excessive bleeding or abdominal discomfort. They may need to get up and change their tampons or pads multiple times during the night.

Does apple cider vinegar shrink fibroids? ›

Does Apple Cider Vinegar Shrink Fibroids? Although apple cider vinegar is sometimes viewed as a cure-all, it does not shrink fibroids. It may, however, offer other health benefits, such as aiding in weight loss and helping to control diabetes.

What can dissolve fibroids? ›

Here are eight ways you may be able to shrink those fibroids, potentially avoiding hysterectomy.
  • Do nothing (Watchful Waiting) ...
  • Have a baby. ...
  • Mifepristone. ...
  • Ulipristal. ...
  • Leuprolide. ...
  • Myolysis. ...
  • Uterine artery embolization (UAE) ...
  • Focused ultrasound (FUS)
15 Mar 2018

When do fibroids need to be removed? ›

If a woman has severe symptoms, and if the fibroids are in the muscle or outside of the uterus, surgery may be the best option. In that case, robotic-assisted laparoscopic myomectomy is more common. This is a minimally invasive procedure that involves making four to five small incisions in the abdomen.

What foods make fibroids worse? ›

Don't eat a diet full of processed foods, red meats, and high-fat dairy. Studies show that eating these foods can make your fibroids worse. The same goes for alcohol and caffeine.

What size fibroids need surgery? ›

Most experts believe that about 9-10 centimeters (about 4 inches) diameter is the largest size fibroid that should be removed laparoscopically.

Does Apple Cider shrink fibroids? ›

Does Apple Cider Vinegar Shrink Fibroids? Although apple cider vinegar is sometimes viewed as a cure-all, it does not shrink fibroids. It may, however, offer other health benefits, such as aiding in weight loss and helping to control diabetes.

Do fibroids make you tired? ›

Why do uterine fibroids cause fatigue? Fatigue is something many of us experience — but there's a specific reason you may be feeling dizzy, nauseous or tired due to uterine fibroids. This feeling of fatigue is related to the loss of blood you may be experiencing due to heavy periods brought on by fibroids.

Can stress cause fibroids? ›

Stress is the body's biochemical response to life challenges. To handle stress, the brain tells our body to produce extra hormones. As a result, hormone levels rise, which stimulates fibroid growth and causes symptoms to flare up. Stress can cause fibroids that were once asymptomatic to grow at an alarming rate.

Can fibroids give you a big belly? ›

Larger fibroids may cause a woman to gain weight in the abdomen, giving the appearance of normal belly fat. Simply put, the more a fibroid grows, the heavier it will become. Consequently, weight gain and discomfort will follow as some fibroids can weigh up to as much as 20-40 pounds.

What happens if fibroids are not removed? ›

If left untreated, fibroids can continue to grow, both in size and number. As these tumors take over the uterus the symptoms will become worse. The fibroids pain will increase. The heavy bleeding will become heavier and it may be accompanied by severe cramping.

Is fibroid surgery a major surgery? ›

Also known as an "open" myomectomy, an abdominal myomectomy is a major surgical procedure. It involves making an incision through the skin on the lower abdomen, known as a "bikini cut," and removing the fibroids from the wall of the uterus.

Do fibroids feed on sugar? ›

Refined Carbohydrates and Sugar.

Carbohydrates which include white foods like pasta, bread, rice, cakes, and cookies can alter your estrogen levels. Estrogen causes fibroids to grow. Consuming large amounts of sugar causes inflammation and weight gain.

What type of milk is good for fibroids? ›

Yet the hormones in dairy, particularly estrogen, can contribute to fibroid growth, so it's best to avoid it as much as possible. Look for alternative milk sources such as almond milk, which comes in many different delicious flavors to enjoy.

Is Sweet potatoes good for fibroid? ›

Best Foods to Eat With Fibroids

Beta-carotene rich foods (such as carrots and sweet potatoes). These can also help boost your fertility, something that can be impacted by fibroid growth.

How long does fibroid surgery take? ›

Laparoscopic myomectomy can take two to four hours, based on the number of fibroids and their size. You can go home the same day or spend a night in the hospital, depending on how you feel after the procedure. Overall recovery is about two to four weeks.

How much does a large fibroid weigh? ›

Larger fibroids may cause a woman to gain weight in the abdomen. Simply put, the more a fibroid grows, the heavier it will become. Consequently, weight gain and discomfort will follow as some fibroids weigh as much as 20-40 pounds.

How long does it take to recover from fibroid surgery? ›

Your doctor made a cut (incision) in your lower belly to remove the fibroids. You can expect to feel better and stronger each day. But you may tire quickly and need pain medicine for a week or two. You may need about 4 to 6 weeks to fully recover.

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