Letters to the Editor
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An Important Issue, With More Study Needed
So that it is clear, this is not a "nuisance" ailment. It can be debilitating, as well as difficult to diagnose. The symptoms can be unrelated to menstruation - such as androgenic hormone related issues, depression and other mood disorders and paralyzing abdominal pain. As a consequence, women do not necessarily realize that the problem they have is gyn related, and misdiagnosis by generalists and others may occur. This is a serious condition, and I applaud the author for bringing attention to it.
That having been said, I echo the sentiment that it is exceptionally frustrating and disappointing that there seems to be nothing in this article (and it sounds like in this book) that discusses precisely why 3 in 4 black women contract fibroids. Further, the failure of the article's author to follow up on the mention of this statistic is a sad omission, and it mirrors the seeming societal ambivalence concerning why certain ailments disproportionately effect people of color. Perhaps if there was more of a focus on the "why," the 75% statistic could become a thing of the past.
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Why?
Apparently the scientific community does not yet know why black women are more likely to get fibroids. I don't think this fact is the author's fault. What was she supposed to do? How was she supposed to focus on "why", when the "why" isn't known? I'm not sure they know why anyone gets them, much less why one group gets more of them. It's unfortunate that the author doesn't know the answer, either? Hmm.
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Fighting to keep my uterus
I have been fighting to keep my uterus since I was diagnosed with fibroids when I was in my twenties. I am now 48, my mother and both my sisters have had hysterectomies because of fibroids, but I have stubbornly held on to mine, although I have gone against the advice of several doctors. I am caucasion, had a baby at 32, after one myomectomy (surgery to remove fibroids). I was told I would have a hard time getting pregnant, and staying pregnant, but after four months of bed-rest, I carried my daughter full term. When I lived in California, I had a wonderful doctor who was completely sympathetic about my wanting to hold onto my uterus. I wanted to have the option to have another child, and my sisters had confided that their sex lives had changed after the hysterectomy, and darn it, I just wanted to keep my uterus. I have had two more myomectomies, and menopause is right around the corner, and I have been told that fibroids shrink after menopause. My doctor now, in Arkansas, asks me at every annual exam if I am ready for my hysterectomy yet. I just smile and say no.
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hysterectomy for fibroids
After decades of struggling with fibroids, and having 3 major surgeries (myomectomies) to remove them, I finally had a hysterectomy. I had told myself, and my doctors, that I didn't want to surrender my uterus to "the patriarchal hegemony," and I still think that's a valid reason for not heading down the hysterectomy highway at the merest sign of trouble. But now that I don't have to wonder if I can travel--or even go to a movie, not to mention get a good night's sleep--I'm so relieved to have removed my pesky uterus. I never wanted kids anyway, and if I had to do it all over again, would have had the hysterectomy about 20 years ago (I'm in my early 50s).
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Unncessary Abdominal Surgeries
There could be an entire second article written about the huge number of unnecesary abdominal surgeries, such as Total Abdominal Hysterectomy (TAH) that women are undergoing to relieve fibroid symptoms, resulting in much pain and a debilitating 6 week recovery time.
My case of fibroids was extreme. I had an 850 gram, 13 cm uterus containing a 10 cm (mango-size) fibroid. My gynecologist told me I needed to have it removed through an abdominal incision. A second opinion from another gynecologist produced the same answer - abdominal surgery. I said "no way," and began a panicked search for an alternative. I found it in Laparascopic Supracervical Hysterectomy (LSH), a less invasive outpatient procedure. I had the surgery 2 weeks ago today. I was home the same day and back to full physical activities, (including kickboxing!!) within a week. I only missed 3 days of work. I feel great!
My LSH surgeons told me that they often perform LSH for fibroids as large as mine while, in the next operating room, another surgeon is performing an abdominal hysterectomy on a woman with a little bitty fibroid. My surgeons said that the nurses get very upset when they see this.
So, why don't gynecologists recommend the laparascopic option to their patients? Seems to me there are only 2 explanations:
1. They don't know about the procedure or its applicability to large fibroids/uteruses such as mine. If that is true, then I believe these doctors should not be practicing medicine, because you are not keeping up with the latest advances in their field.
2. They know about the applicability of the procedure for large fibroids/uteruses such as mine, but decline to make patients aware of them because they do not have the training or skill to perform the procedure themselves. If that is true, those doctors also should not be practicing medicine, because withholding information on treatment alternatives puts your their own interests ahead of their patients’.
You can probably tell by the tone of my post that I am on the warpath about this. If I can save even one woman the pain and debilitation of an unnecessary abdominal surgery, then the effort to write this as well as tell my story to all who will listen will have been worthwhile.
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fibroids can mask other problems
I always agreed that hysterectomies were too prevalent, and resisted repeated suggestions from my physician and knowledgeable friends that I would have to "just get it out of there." I considered the UAE/embolization, but was told my "grapefruit" (and its several satellites) was just too large. This was lucky, as I was found to have stage 1b endometreoid adenocarcinoma after my hysterectomy. I had worked in a GYN office, and am an educated professional with a Ph.D., but I didn't know that light "spotting" is a sign of uterine cancer. I thought it was caused by my fibroids. Women should be aware that the pain, urinary and sexual symptoms of fibroids can mask more serious trouble. Sometimes you really do need to have a hysterectomy.