MEMPHIS, Tenn. — They’re as common as a mole yet there’s so much we still don’t know about uterine fibroids, or typically benign tumors that grow inside a woman’s uterus.
“Virtually everybody forms a fibroid eventually,” said Dr. Katherine Hartmann, an OB-GYN and epidemiologist, at Vanderbilt University Medical Center.
Dr. Hartmann also served as the Associate Dean for Clinical & Translational Scientist Development and the Deputy Director for the Institute of Medicine and Public Health at VUMC.
After looking at images and pouring over the electronic medical records of thousands of women, her research showed more than 95% of black women and more than 90% of white women form a fibroid at some point.
“African-American women tend to get fibroids younger and form more. White women tend to have the initial fibroid form later and to form fewer, but we all arrive in a similar place by the time of menopause,” said Hartmann who has researched and published countless papers regarding women and fibroids.
Dr. Hartmann said they also learned black women, past a certain age, have higher rates of intervention, particularly hysterectomy.
Maudie Catron eventually had a robotic hysterectomy.
“You just can’t take the pain anymore,” said Catron about the worst of her symptoms which also included heavy bleeding and anemia.
She opted for the hysterectomy after having two myomectomies and fibroid embolization.
Two of her sisters had similar procedures.
Her grandmother died during childbirth.
“I was always asking them was it hereditary and they told me no,” Catron said.
Which leads to the question all women want the answer to: What causes fibroids?
When we asked Dr. Hartmann, she said because fibroids were so common, it has become a difficult research question.
However genetics was changing the game.
“We’re about to turn that on its head and ask the other question, which is how do these other women, these five percent, these two to six-percent across racial groups, how do they avoid forming a fibroid?” she asked.
That answer is likely years away, but what Hartmann already learned could change treatment options for women like Catron and her sisters.
“If they don’t affect your quality of life or it’s not the right time, or you have child bearing considerations or other things, wait,” Dr. Hartmann advised.
Watchful waiting.
Dr. Hartmann told WREG generations of women didn’t hear that message from their physician, and now there’s even more proof that surgical intervention for younger women with fibroids may not be necessary.
Right From the Start was a study of more than 8,000 pregnant women without fertility issues across the country.
The women underwent ultrasound early in the pregnancy.
Among many things, the study closely examined the effects of fibroids on a woman’s pregnancy.
Hartmann said one common myth was that fibroids change a woman’s ability to conceive.
While this can certainly be true for women who suffer from other infertility issues, Dr. Hartmann said it’s different with fibroids.
“That unfortunately got generalized to all women everywhere. That maybe getting your fibroids removed could help with conception.”
A move Hartmann said may not be necessary.
Their study showed women with fibroids didn’t have a harder time getting pregnant.
“For an uncomplicated pregnancy in an otherwise healthy woman, in the middle of her reproductive age span, don’t stress about that fibroid,”said Hartmann of the cue women should take from that research.
Hartmann’s research also debunked another common myth which was that pregnancy hormones feed the fibroid and caused them to get bigger.
They found some fibroids actually got smaller during pregnancy.
Also, among their participants, there was only a slightly higher risk of having a cesarean.
Of the group, women with larger fibroids had the highest risk.
“It allows women and their providers to relax more, about not jumping the gun,” Dr. Hartmann said. “Let’s not schedule a cesarean, let’s see how it goes.”
Hartmann said the take away was for women to explore their options, talk to their doctors about treating the symptoms, and opt for surgery as a last resort.
It’s what Catron did and she’s glad to have gone that route.
“He waited until I was ready so there was always options for me,” she said.
Phase two of Right from the Start will begin soon which will examine treatment methods the women had to remove their fibroids.
Another study, led by a team at Duke University, is underway that will build a national, patient registry of more than 10,000 women having treatment for fibroids.
Recruitment will begin this summer and one of the participating hospitals is the University of Mississippi Medical Center in Jackson.
