Getting a Second Opinion Reduces Number of Hysterectomies
Alicia Armeli

secondopinion

Get a second opinion. How many times have you heard that before? If you’re a woman with uterine fibroids, maybe not enough. A study by researchers at the UCLA School of Medicine showed that the simple act of getting a second opinion meant women with fibroids were more likely to choose uterus-sparing treatment options, avoiding hysterectomy altogether.1

Uterine fibroids, although noncancerous, are common tumors that grow in the wall of the uterus and can be the source of heavy painful periods, pelvic pressure, and incontinence. While the majority of fibroids don’t cause symptoms, up to 50% of women with fibroids will seek treatment for relief.2

From July 2008 to August 2011, Nelly Tan, MD, and a team of UCLA radiologists and gynecologists at a multidisciplinary fibroid treatment center investigated over 200 women who visited the clinic for a second opinion concerning treatment options. Previous to their visit, the majority of these women had only been offered hysterectomy as a form of treatment.

After physical examinations that included an MRI scan, each patient met with a gynecologist and radiologist separately to discuss all options. Results published in the Journal of Therapeutic Ultrasound showed that of the 109 women who decided to transfer their care to the fibroid center, 70% chose uterine-sparing procedures and over 20% chose medical therapy or no treatment at all.

These numbers contradict what’s happening nationally. Found to be the most common major gynecologic surgery, 400,000 hysterectomies are performed annually in the US alone.3 And statistics show that nearly 70% are done to treat noncancerous conditions like fibroids.3  “We suggested hysterectomy in 4.4% of our patients although the majority had been offered hysterectomy at other facilities,” Dr. Tan and her team write.

This study mirrors other research that has shown nearly 40% of women seeking fibroid treatment aren’t given any other options besides hysterectomy.3 Many times it’s not OB/GYNs who tell their patients about minimally invasive options—but media, friends, and family who are the sources of this information.1

Dr. Tan and her team discuss that even though these women were already seeking a second opinion, which could’ve increased the likelihood of choosing an alternative to hysterectomy, their study showed how fibroid centers with both interventional radiologists and gynecologists working together could benefit women.

“In our patient population, most women were candidates for uterine-preserving options and chose to undergo a minimally invasive uterine-preserving treatment,” the authors conclude. “Our findings suggest that women desire minimally invasive therapies, and a joint effort between gynecology and radiology may be one option for institutions to improve access to most, if not all, of the therapeutic options available for symptomatic uterine fibroids.”

ABOUT THE AUTHOR   Alicia Armeli is a Health Freelance Writer, Registered Dietitian Nutritionist, and Certified Holistic Life Coach. She has master’s degrees in English Education and Nutrition. Through her writing, she empowers readers to live optimally by building awareness surrounding issues that impact health and wellbeing. In addition to writing, she enjoys singing, traveling abroad and volunteering in her community.

REFERENCES

  1. Tan, N., McClure, T., Tarnay, C., Johnson, M., Lu, D., & Raman, S. (2014). Women seeking second opinion for symptomatic uterine leiomyoma: role of comprehensive fibroid center. Journal of Therapeutic Ultrawound, 2:3, doi: 10.1186/2050-5736-2-3
  1. Soliman, A. M., Yang, H., Du, E. X., Kelkar, S. S., & Winkel, C. (2015). The direct and indirect costs of uterine fibroid tumors: a systematic review of the literature between 2000 and 2013. American Journal of Obstetrics and Gynecology, 213(2): 141-160. doi: 10.1016/j.ajog.2015.03.019
  1. Corona, L. E., Swenson, C. W., Sheetz, K. H., Shelby, G., Berger, M. B., Pearlman, M. D., Campbell, D. A., Delancey, J. O., & Morgan, D. M. (2015) Use of other treatments before hysterectomy for benign conditions in a statewide hospital collaborative. American Journal of Obstetrics & Gynecology, 212(3): 304.e1-7. doi:10.1016/j.ajog.2014.11.031
Food Intolerances & Fibroids: A Possible Link to Consider?
Alicia Armeli

grocerystore

Food intolerances can be sneaky. More common than food allergies, intolerances may not be life threatening but can contribute to other insidious problems like digestive upset, headaches, joint pain, skin rashes, and fatigue. Food intolerances can also exacerbate a woman’s cycle and may influence chronic conditions like fibroids.

Specific to each person, food intolerances are challenging to pinpoint. The following are the most common.1

Alcohol

Because of fermented fruit used to make wine or hard cider, grains used to make beer or whiskey, and sulfites added as preservatives—alcoholic beverages can be triggers.

Histamine and Other Vasoactive Amine Foods

Coffee, soy, cocoa products, fermented foods, cheeses, cured meats, canned and processed fish, pickled foods, nuts, and certain fruits like citrus and bananas can pose a problem to histamine-sensitive individuals.

Wheat & Gluten

Any foods that contain wheat, barley, or rye are included in this category. Examples include baked goods, cereals, flours, pasta, and breadcrumbs. Not so obvious examples are prepared foods, condiments, desserts, beverages, and even medications. Always scan ingredient labels to make sure products are wheat and gluten-free.

Dairy

Although some research shows dairy products to protect against fibroids, every woman is different. Milk, cheese, yogurt, sour cream, and powdered milk products belong to this category. Dairy can also be a hidden ingredient in prepared foods. Some sneaky ingredients to avoid are lactose, casein, and whey. Checking labels is important, especially when purchasing processed foods, as dairy-containing foods can be made on the same equipment as non-dairy containing foods.

Yeast

Pastries, baked goods, stocks and gravies, vinegar and vinegar products, and fermented foods all contain yeast. Other not so obvious offenders include mycoprotein, hydrolysed proteins, and monosodium glutamate.

Artificial Additives

Not considered a common food intolerance, artificial additives like colors and preservatives found in processed foods can be an issue for some individuals.2

Food intolerance symptoms are not always immediate but can take hours to manifest, lasting hours to days.2 What’s more, if unknowingly triggering foods are eaten on a regular basis, symptoms can be ongoing and become “the norm.” Multiple food intolerances can coincide, making it difficult to know which is the problem.

Unlike the immune reaction of an allergy, food intolerance is often linked to digestion issues—for example, not having enough of a particular digestive enzyme needed to breakdown food components.2 For this reason, people who have a food intolerance can often eat small amounts of that food, but consuming too much or too often can trigger symptoms.

This is especially important for a woman to recognize during her cycle when cravings can be most intense. Keeping a diary of all foods eaten—highlighting which foods are eaten most—along with symptoms throughout a monthly cycle could help define which foods to avoid. With food intolerances, individualization is key.

Trying to eliminate the aforementioned common culprits one at a time could also provide insight. Working with a dietitian during the process of tracking, eliminating, and reintroducing foods can ensure it is done safely and accurately—as well as definitively rule out any food allergies.

The field of food intolerance is continuously evolving and although more studies are needed to confirm its relationship with fibroids, good nutrition habits can only improve overall health, which could in turn help manage symptoms.

REFERENCES

  1. Allergy UK. (2016). Common Food Intolerances. Retrieved September 18, 2016, from https://www.allergyuk.org/common-food-intolerances/common-food-intolerances
  1. Allergy UK. (2016). What is Food Intolerance. Retrieved September 18, 2016, from https://www.allergyuk.org/food-intolerance/what-is-food-intolerance

 

Uterine Fibroids Before 30 May Increase Risk for Early Onset Breast Cancer
Alicia Armeli

breastcancerblog

Uterine fibroids are hormone-sensitive growths that develop in the uterine wall. And although noncancerous, a common concern for women with fibroids is whether they’re at risk for other hormone-responsive conditions like breast cancer.

A study published in Cancer Causes & Control showed that while having a history of uterine fibroids was unrelated to developing breast cancer overall, this might not be the case for younger women who were diagnosed with fibroids before age 30.1

A first in the field of fibroids and breast cancer research, the study was led by Dr. Lauren A. Wise, Sc.D., of Slone Epidemiology Center at Boston University. With a team of researchers, Wise monitored over 57,000 women enrolled in the Black Women’s Health Study.

Through self-reported or physician diagnosed uterine fibroids and recorded incidences of breast cancer, their findings revealed that an early diagnosis of fibroids—before age 30—was associated with an elevated risk for both premenopausal breast cancer and early onset breast cancer.

“An association between tumors of the uterus and the breast via hormonal pathways is biologically plausible,” Dr. Wise and her team write. “Pathologies of the uterus and breast are associated with sex steroid hormones.”

One particular hormone called estradiol—a type of estrogen hormone—has been shown to promote growth in breast ducts and glands. Similarly, fibroid cells have estrogen-regulated hormone receptors, as well as estrogen levels that are higher in comparison to normal uterine tissue.

Progesterone, another sex hormone, encourages cell division in both normal breast tissue and uterine fibroid tissue. The authors speculate that the same hormonal pathways that contribute to fibroid growth may also make a woman more susceptible to estrogen-responsive breast cancers.

Uterine fibroids can be the cause of heavy periods, pelvic pain, and urinary incontinence and are more prevalent in a woman’s 30s and 40s when estrogen levels tend to increase prior to the onset of menopause.

And like fibroids, breast cancer also seems to be age-related. Statistically, a woman at age 20 has a 0.06% risk of developing breast cancer within the next decade.2 At age 30, this rate jumps to 0.4% and nearly quadruples by age 40.2 African American women are at a higher risk for both premenopausal breast cancer and early-diagnosed fibroids.2

Although more studies are needed to confirm the relationship between fibroids and breast cancer, because of its potential link, it’s important for women to talk to their doctors about their own personal risk.

ABOUT THE AUTHOR   Alicia Armeli is a Health Freelance Writer, Registered Dietitian Nutritionist, and Certified Holistic Life Coach. She has master’s degrees in English Education and Nutrition. Through her writing, she empowers readers to live optimally by building awareness surrounding issues that impact health and wellbeing. In addition to writing, she enjoys singing, traveling abroad and volunteering in her community.

REFERENCES

  1. Wise, L. A., Radin, R. G., Rosenberg, L., & Adams-Campbell, L. (2015). History of uterine leiomyomata and incidence of breast cancer. Cancer Causes & Control, 26(10), 1487-1493. doi: 10.1007/s10552-015-0647-8
  1. Susan G. Komen. (2014). Breast Cancer In Women Younger Than 40. Retrieved September 17, 2016, from http://ww5.komen.org/KomenPerspectives/Breast-Cancer-in-Women-Younger-than-40.html
Later Menarche and Menopause Increases Likelihood of Living to 90
Alicia Armeli

menstruation90blog

Women are living longer. Over the last century, the number of US women reaching 90 years of age has increased dramatically. Currently, an estimated 1.3 million women already belong to this burgeoning demographic, which is only expected to quadruple by 2050.1

Why are women living longer? Much speculation exists, yet specific factors that predispose a woman to a longer lifespan aren’t entirely understood.

To investigate, a team of researchers from the University of California San Diego School of Medicine began to look at reproductive factors—specifically time of menarche and menopause.1  They found that women who started menstruation and experienced menopause later in life were more likely to live to be 90.

Led by Dr. Aladdin H. Shadyab, PhD, the study investigated a racially and ethnically diverse group of over 16,000 women recruited through the Women’s Health Initiative—a long-term national study that examined health issues among postmenopausal women.

The results published in Menopause showed that 55 percent lived to age 90. Women who lived longer were more likely to be at least 12 years of age when starting menstruation. The probability of longevity increased even more so for women who experienced menopause (natural or surgical) at 50 or older, in comparison to those who underwent menopause at 40 years or younger.

“Our team found that women who started menstruation at a later age were less likely to have certain health issues, like coronary heart disease, and those who experienced menopause later in life were more likely to be in excellent health overall, which may be a possible explanation for our findings,” Dr. Shadyab told UC San Diego Health.2

The authors further explained that a longer reproductive lifespan—as seen among women with more than 40 reproductive years—may give more time for heart-protective ovarian hormones to circulate throughout the body.

Genes play a definite role in age of menarche, menopause, and lifespan. One particular gene called exonuclease repairs DNA damage and is significantly associated with age of menopause, as well as increased life expectancy among women who have lived to be 100 years or older.1

Conversely, lifestyle choices cannot be ignored. “Factors, such as smoking, can damage the cardiovascular system and ovaries, which can result in earlier menopause,” Dr. Shadyab continued. Women who smoke are seen to experience menopause earlier—two years earlier, according to the Fertility Coalition.3

Dr. Shadyab concluded that more studies are needed to determine how specific factors, like genetics and lifestyle, relate to reproductive benchmarks and longevity. “This study is just the beginning of looking at factors that can predict a woman’s likelihood of surviving to advanced age.”

ABOUT THE AUTHOR   Alicia Armeli is a Health Freelance Writer, Registered Dietitian Nutritionist, and Certified Holistic Life Coach. She has master’s degrees in English Education and Nutrition. Through her writing, she empowers readers to live optimally by building awareness surrounding issues that impact health and wellbeing. In addition to writing, she enjoys singing, traveling abroad and volunteering in her community.

REFERENCES

  1. Shadyab, A., Macera, C., Shaffer, R., Jain, S., Gallo, L., & Gass, M. et al. (2016). Ages at menarche and menopause and reproductive lifespan as predictors of exceptional longevity in women. Menopause, 1. http://dx.doi.org/10.1097/gme.0000000000000710
  1. Brubaker, M. (2016, July). Hot Flash: Women Who Start Menstruation and Menopause Later More Likely to Live to 90. UC San Diego Health. Retrieved September 14, 2016, from https://health.ucsd.edu/news/releases/Pages/2016-07-27-women-live-longer-if-menstuation-and-menopause-begins-later.aspx
  1. Fertility Coalition. (2016). Your fertility—Smoking and fertility. Retrieved 15 September 2016, from http://yourfertility.org.au/for-women/smoking-and-fertility/