A Bump in the Road | My Experience with Uterine Fibroids
My mother routinely uses the borrowed quote from Pulitzer Prize Award winning columnist Leonard Pitts, Jr.: "Clear the wreckage and wait for the next crisis." Pitts used this headline in his editorial on the decision of the 2000 Presidential Election and my mother has since used the saying to help my sisters and I work through various life challenges, both big and small. When my gynecologist told me that my uterine fibroids could affect my ability to have children, I was scared, angry, and sad but what I remember the most is feeling very eager to get through the crisis. Learning about the condition and my treatment options indeed helped me to do so.
I was 29-years-old and just a year out of dental school when I was first diagnosed with fibroids. My ultrasound showed evidence of several small growths, but since I wasn't experiencing any symptoms and my husband and I were not engaged yet, my doctor decided to put me on a wait and see treatment plan. He explained that fibroids were benign tumors that grow on the uterus. He noted that they are influenced by estrogen and they are most prevalent in black women. Finally, he clarified that fibroids can cause symptoms of pain, heavy periods as well as discomfort and in many cases, can affect pregnancy and childbirth. Since I wasn't trying to have a baby at that time, I decided not to worry about my fibroids.
Fast forward to three years later, I was married, employed full-time with a great healthcare benefits package, and ready for a baby but a few small bumps had become a huge roadblock. My fibroids had grown significantly and one in particular was growing in a position that my doctor feared would potentially threaten pregnancy. He recommended surgery without debate. Specifically, an abdominal myomectomy with a lengthy recovery and a six-month delay in child planning.
Wow! It was a lot to digest but I wanted to know more than just the basics about this condition that had now become one of possible infertility. Did my mom have fibroids? Do any of my three sisters? The answer was, no. I felt alone. I was angry and bitter. I was frustrated with my delay in marriage and family planning. I pondered that had I not gone to dental school and perhaps gotten married and started my family earlier that I wouldn't be in this situation. A fertility problem fueled by estrogen? How was that possible? I felt compromised as a woman.
My fibroids threatening my fertility put me in crisis mode. It was from speaking with family, friends, and experts in reproductive endocrinology, that I began to feel empowered. I gathered all the information and my husband and I followed the recommendations of our medical team. As my mother in law said at the time, "we'll pray and wait for good news." Two years later that news was delivered with the birth of our son. I am so fortunate to have had access to great medical treatment and the support of loved ones to help me get through the tough period. I was unaware of the myriad of different fertility conditions that can impact the lives of so many women and I am sharing this post to encourage women to seek information about their health and how to best navigate their family planning decisions.
I leave you with a note on uterine fibroids from Dr. Eva Martin, the founder of Elm Tree Medical, a medical device company focused on women’s health. Eva has an extensive background in women’s health and clinical research. She graduated cum laude from Harvard College and earned her MD from Harvard Medical School. You can follow her on Facebook and Twitter.
Facts on Fibroid Incidence
Fibroids are most common between 40 to 60 years of age. Fibroids occur in about:
· 4% of women 20-30 years of age
· 15% of women 30-40 years of age
· 33% of women 40 to 60 years of age
Fibroids are more common in black women and tend to progress more quickly. Fibroids occur in about:
· 18% of black women
· 8% of white women
· 10% of Hispanic women
Questions for Your Doctor, for Women with Fibroids Trying to Conceive
What is the location and size of the fibroid(s)? These factors can help determine if the fibroid is affecting your ability to get pregnant. For instance, fibroids on the inner wall of the uterus are known to cause difficulty conceiving, but it is controversial whether fibroids on the outside of the uterus affect fertility at all.
What treatments might increase my chances of becoming pregnant? Surgery may increase the chances of becoming pregnant, depending on the specific characteristics of your fibroid(s).
Does the type of treatment or surgery I receive now for fibroids affect pregnancies in the future? Depending on the type of surgery, Cesarean delivery may be recommended for future pregnancies.
· Lurie S, Piper I, Woliovitch I, Glezerman M. Age-related prevalence of sonographically confirmed uterine myomas. J ObstetGynaecol. 2005;25:42–4.
· Laughlin SK, Baird DD, Savitz DA, Herring AH, Hartmann KE. Prevalence of uterine leiomyomas in the first trimester of pregnancy: an ultrasound-screening study. Obstet Gynecol. 2009;113(3):630–635.
· Purohit P, Vigneswaran K. Fibroids and Infertility. CurrObstetGynecol Rep. 2016; 5: 81-88.
· Casini ML, Rossi F, Agostini R, Unfer V. Effects of the position of fibroids on fertility.GynecolEndocrinol. 2006 Feb; 22(2):106-9.