The Origins of Fibroid Awareness Week
Fibroid Awareness Week is an annual event that takes place from April 18 to 24, aiming to raise awareness about fibroids, a common health issue affecting millions of women worldwide. The week is dedicated to educating women about the symptoms, risks, and available treatment options for fibroids, as well as advocating for more research and funding to address this condition.
The history of Fibroid Awareness Week can be traced back to the introduction of the Texas House Bill by Senfronia Thompson, which designated July as Uterine Fibroids Awareness Month. The week is marked by educational community events across the country, reaching over 120,000 women with accurate information about fibroids.
Fibroid Awareness Week is an opportunity to promote awareness, encourage more research and funding, and support women who suffer from fibroids. The week aims to empower women to take control of their health by learning more about fibroids and advocating for better treatment options and policies.
What are fibroids?
Uterine fibroids, also known as leiomyomas, are benign tumors that originate from the uterine smooth muscle tissue (myometrium) whose growth is dependent on the hormone estrogen. They are rare before puberty, increase in prevalence during the reproductive years, and tend to shrink after menopause. Fibroids are the leading indication for hysterectomy, accounting for 39% of all hysterectomies performed annually in the United States.
The prevalence & epidemiology of fibroids
The prevalence of fibroids varies among different studies and countries (4.5%–68.6%) based on the type of investigation, method of diagnosis, and racial/ethnic background. The self-reported prevalence in a study ranged from 4.5% in the UK to 9.8% in Italy, with a higher prevalence in older women. The mean age at diagnosis is similar across countries, ranging from 33.5 to 36.1 years.
Fibroid symptoms
Fibroids can cause various symptoms, including heavy menstrual bleeding, pelvic pain, and frequent urination, which can lead to complications such as anemia or the need for a blood transfusion. They can also lead to complications during pregnancy, such as preterm labor, delivery before 37 weeks’ gestation, and intrauterine fetal death with growth restriction. In the postpartum period, women with fibroids have an increased risk of postpartum hemorrhage secondary to an increased risk of uterine atony.
How are fibroids detected or diagnosed?
The evaluation of fibroids is based mainly on the patient’s presenting symptoms and imaging modalities such as ultrasonography, sonohysterography, hysteroscopy, and magnetic resonance imaging (MRI). Ultrasonography is the preferred initial imaging modality, with transvaginal ultrasonography being about 90% to 99% sensitive for detecting uterine fibroids. Adding sonohysterography or hysteroscopy improves sensitivity for detecting submucosal myomas. There are no reliable means to differentiate benign from malignant tumors without pathologic evaluation.
What mitigation or management strategies are there for fibroids?
Management of uterine fibroids should be tailored to the size and location of fibroids, the patient’s age, symptoms, desire to preserve fertility, and access to therapy, and the physician’s experience. Expectant management is appropriate for women with asymptomatic uterine fibroids. In women undergoing hysterectomy for treatment of uterine fibroids, the least invasive approach possible should be chosen.
So, what is missing from fibroid research and what new developments should we accelerate?
Despite the high medical costs related to fibroids, estimated at $35 billion per year in the United States alone, research funding for fibroids is relatively low, with only $17 million from the National Institutes of Health, placing it in the bottom 50 of nearly 300 funded conditions.
A better understanding of the etiology and risk factors for fibroids, as well as the development of non-surgical treatment options, would be beneficial. The use of risk-stratification algorithms for women at high risk of developing fibroids could help initiate primary preventive measures. More research is needed to determine the most effective and safe treatment options for women with fibroids, especially those who wish to preserve fertility.
