Statin Use: Protecting More Than Just Your Heart?
Alicia Armeli

Between 2011–2012, more than one in four adults (27.9%) 40 years of age and older reported using cholesterol-lowering medications like statins within the last 30 days—a number that increased from one in five adults (19.9%) almost a decade earlier.1 Statins are primarily used to lower the risk of cardiovascular disease, but a recent study showed that it might protect more than just your heart.

Researchers at the University of Texas found that taking statins is linked to a lower risk of uterine fibroids and fibroid-related symptoms.2

“Recently, [statins] have been shown to inhibit proliferation of uterine fibroid cells and inhibit tumor growth in fibroid animal models,” Mostafa A. Borahay, MD, PhD, and his team write. “We sought to examine the association between statin use and the risk of uterine fibroids and fibroid-related symptoms in a nationally representative sample of commercially insured women diagnosed with hyperlipidemia.”2

The study sample involved more than 190,000 women enrolled in one of the nation’s largest health insurance programs.2 Of these women, those aged 18-65 years diagnosed during the study with hyperlipidemia—a condition that involves high levels of fats like cholesterol in the blood—were investigated. Out of the women with hyperlipidemia, the researchers found 47,713 who had been diagnosed with uterine fibroids and 142,139 women without fibroids—an approximate 1 to 3 ratio. The researchers analyzed these numbers to see if there was any connection between the risk of fibroids, fibroid-related symptoms, and prior statin use.

The results of the study were published in the American Journal of Obstetrics & Gynecology and showed that taking statins within 2 years before fibroid diagnosis was associated with a decreased risk of developing the disease.2 In a separate analysis of the data, the researchers found that women taking statins also had a lower likelihood of fibroid-related symptoms, like heavy prolonged periods, anemia, and pelvic pain. In comparison to women who didn’t take statins, women who did were also less likely to undergo myomectomy—a type of surgery that removes fibroids.

Why statins have this effect on fibroids and fibroid symptoms isn’t entirely understood. Some laboratory studies show that statin use slows fibroid cell replication and tumor growth and encourages fibroid cell death.2 Whether this is how statins work against fibroids in humans is still unknown.

An exceedingly common condition, uterine fibroids are a type of noncancerous tumor that grows in the wall of the uterus. Some reports show that 70% of white women and 80%-90% of black women will develop fibroids by the time they reach 50.3

Fibroids may be common, but not every woman with fibroids experiences bothersome symptoms. Approximately 30%-50% of women with fibroids will seek treatment—with more than 200,000 women undergoing hysterectomy (surgical removal of the uterus) for fibroid relief each year.3,4

Despite its frequency, hysterectomy for noncancerous conditions has been linked to complications like infection and bladder injury.5 Even when the ovaries are spared, hysterectomy is still associated with early onset of menopause.6 Given these realities, finding a preventative pharmaceutical treatment for fibroids is essential.

Borahay and his team are optimistic. “The finding that statin use was associated with fewer symptoms in cases, such as [heavy prolonged periods], anemia, and pelvic pain, is clinically significant,” they note. “Uterine fibroids are very common…Therefore, this beneficial association of statins on fibroid-related symptoms is promising.”2 Although these results show potential in the field of fibroid treatment, the researchers conclude that future more rigorous studies should be conducted to understand this relationship.

ABOUT THE AUTHOR   Alicia Armeli is a Freelance Writer and Editor, Registered Dietitian Nutritionist, and Certified Holistic Life Coach, and a paid consultant of Merit Medical. 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. Gu, Q., Paulose-Ram, R., Burt. V. L., et al. (2014). Prescription cholesterol-lowering medication use in adults aged 40 and over: United States, 2003–2012. NCHS data brief, no 177. Hyattsville, MD: National Center for Health Statistics.
  2. Borahay, M. A., Fang, X., Baillargeon, J. G., et al. (2016). Statin use and uterine fibroid risk in hyperlipidemia patients: a nested case-control study. Am J Obstet Gynecol, Dec; 215(6): 750.e1-750.e8.
  3. How many people are affected by or at risk of uterine fibroids? (n.d.). Retrieved from https://www.nichd.nih.gov/health/topics/uterine/conditioninfo/Pages/people-affected.aspx
  4. Soliman, A. M., Yang, H., Du, E. X., et al. (2015). The direct and indirect costs of uterine fibroid tumors: a systematic review of the literature between 2000 and 2013. Am J Obstet Gynecol, 213(2): 141-160.
  5. Clarke-Pearson, D. L., Geller, E. J. (2013). Complications of hysterectomy. Obstet Gynecol, Mar; 121(3): 654-673.
  6. Trabuco, E., Moorman, P., Algeciras-Schimnich, A., et al. (2016). Association of ovary-sparing hysterectomy with ovarian reserve. Obstet Gynecol, May; 127(5): 819-827.

 

National Women’s Health Week: Empowering Health at Every Age
Alicia Armeli

Happy National Women’s Health Week! From May 14-20, we’re celebrating health at every age. But being healthy starts with you!

You may be familiar with the wise adage: Prevention is better than cure.1 Research has shown that leading a healthy lifestyle can reduce the risk of chronic diseases, like type 2 diabetes and heart disease.2,3 By taking preventative steps—no matter your age—you’re also taking control of your health!

Here are some everyday tips to be healthy at any age:4

  • Eat a balanced, healthy whole foods diet
  • Exercise for at least 30 minutes
  • Sleep for 7-8 hours per night
  • Reach and maintain a healthy weight
  • Don’t smoke or get help quitting
  • Limit alcohol to one drink or less per day
  • Avoid illegal drug use or misuse of prescription medications
  • Wear a bike helmet/protective gear when participating in sports
  • Wear a seatbelt in cars and don’t text and drive
  • Pay attention to your mental health—including ways to manage stress

Vitamin and mineral requirements differ from one life stage to the next.

If you’re premenopausal…

The US Department of Health and Human Services Office on Women’s Health recommends taking 400-800 mcg of folic acid each day.4 A B-vitamin, folic acid (or folate found in food) has many health benefits. Especially if you’re considering becoming pregnant, folic acid plays an important role in healthy fetal nervous system development. Talk to your doctor about which supplements and dosages are right for you.

If you’re 65 and older…

Vitamin D supplementation is recommended to support bone health and prevent falls.4 Talk to your doctor about which supplements and dosages are right for you.

Don’t forget your yearly check-up!

It’s important to schedule a yearly preventative check-up appointment with your doctor called a well-woman visit. This gives you and your doctor the opportunity to check your health, discuss health goals, personal disease risk factors, and what positive lifestyle changes you can make. It’s also the perfect time to talk about any medical tests or vaccines you may need, health questions and concerns you may have, and symptoms of life changes seen with perimenopause and menopause.4

This is a week of female empowerment! It’s never too late to start taking charge of your health. Schedule a sit-down with your doctor today to discuss how you personally can take steps to become the healthiest version of you!

ABOUT THE AUTHOR   Alicia Armeli is a Freelance Writer and Editor, 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. Erasmus, D. (n.d.). Desiderius Erasmus Quotes. Retrieved from https://www.brainyquote.com/quotes/quotes/d/desiderius148997.html
  2. American Diabetes Association. (n.d.). Prevention. Retrieved from http://www.diabetes.org/advocacy/advocacy-priorities/prevention/
  3. American Heart Association. (2016, Sept 16). Lifestyle Changes for Heart Attack Prevention. Retrieved from http://www.heart.org/HEARTORG/Conditions/HeartAttack/LifeAfteraHeartAttack/Lifestyle-Changes-for-Heart-Attack-Prevention_UCM_303934_Article.jsp#.WRX3PFLMwhs
  4. US Department of Health and Human Services Office on Women’s Health. (2017, Mar 31). Your Health at Every Age. Retrieved from https://www.womenshealth.gov/nwhw/by-age

 

Cutting-Edge IV Pain Management: Making UFE as Comfortable as Possible
Alicia Armeli

Almost four out of five women will have uterine fibroids by age 50.1 Although many women with fibroids don’t experience any bothersome symptoms, nearly half will seek treatment for relief from heavy painful periods, pelvic pressure, and urinary urgency.2 For these women, having effective treatment options is a must.

One such option, uterine fibroid embolization (UFE), is a minimally invasive uterine-sparing procedure that completely resolves symptoms in nearly 90% of women who undergo the treatment.3 Even with a stellar success rate, a team of researchers at University of California Los Angeles is continuously working to improve the procedure in areas of pain management with the goal of enhancing patient comfort and the overall UFE experience.

“With UFE, we’re always working on making it pain-free and nausea-free,” says Cheryl Hoffman, MD, co-author of the study, Health Sciences Associate Clinical Professor at the David Geffen School of Medicine at UCLA, and Medical Director at the Manhattan Beach Radiology Imaging and Interventional Center. “UFE is a very effective procedure, but the one downside is pain and nausea particularly in the first 6 to 12 hours after the procedure. Because of this, we’re constantly looking for techniques that can make the procedure more comfortable.”

The small study included 40 UFE patients randomly divided into four groups and assigned either 1 g of intravenous (IV) acetaminophen—commonly known as Tylenol® (4 patients), 800 mg of IV ibuprofen—commonly known as Advil® (4 patients), combined 1 g of IV acetaminophen and 800 mg of IV ibuprofen (16 patients), or 30 mg of IV ketorolac—a non-steroidal anti-inflammatory drug (NSAID) (16 patients).4

“In this study, instead of having a control group—a group that didn’t receive any pain medication—we gave one group ketorolac, which is the standard of care in pain management, to see how it measured up against the other medications,” Dr. Hoffman tells Ask4UFE. “The protocol is to layer an NSAID, followed by acetaminophen, followed by a higher opioid. Among other side effects, opioids can cause nausea. We compared reported pain and nausea and the amount of opioid and anti-nausea medication required by each group.”

At 6-hour intervals, patients reported pain using a 10-point visual analogue scale (VAS) and the total amounts of opioid (morphine) and anti-nausea medication (Zofran) use per group were recorded.

Results were presented at the 2017 Society of Interventional Radiology Scientific Session and are being submitted to the Journal of Vascular and Interventional Radiology.

Although there were no differences in pain scores among the groups, the researchers found that less total opioid medication was required for the combined acetaminophen/ibuprofen group (28.09 mg) in comparison to the ketorolac group (40.33 mg). No differences were seen in total anti-nausea medication required by both groups, but the combined acetaminophen/ibuprofen group reportedly experienced more nausea.

“It was good that the combined acetaminophen/ibuprofen group used less opioids because these medications can have other negative side effects like constipation and brain fog. Using less opioids allows patients to get up and walk around more and feel healthier after UFE,” Dr. Hoffman emphasizes. “What was confusing about our data, and what we’ll have to investigate further, is why the combined acetaminophen/ibuprofen group experienced more nausea.”

Even though Hoffman and her team are calculating their next steps in this area of research, they’ve already taken strides in other areas of UFE pain management and patient care. “My interventional radiology practice is now 100% radial access,” Dr. Hoffman says regarding an innovative approach to UFE that treats fibroids through a tiny pinhole made in the wrist. “We have IV pain management protocols that we’re perfecting for this approach that are effective and cost efficient. UFE patients are really happy and loving the radial approach.”

Data have shown that the radial approach is patient-preferred over the traditional femoral access site in the upper thigh.5 Patient comfort benefits of the radial approach include urinating without a foley catheter, walking around after the procedure, and the possibility of going home the same day.

“That’s what we’re all about,” Dr. Hoffman explains. “We’re always looking for cutting-edge ways to make UFE as comfortable and safe for patients as possible because it’s such a successful minimally invasive procedure that should be considered before surgical options.” 

ABOUT THE AUTHOR   Alicia Armeli is a Freelance Writer and Editor, 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.

ABOUT THE DOCTOR   Cheryl Hoffman is a Health Sciences Associate Clinical Professor at the David Geffen School of Medicine at UCLA and Medical Director at the Manhattan Beach Radiology Imaging and Interventional Center. She is American Board Certified in vascular and interventional radiology, as well as diagnostic radiology. Through patient care and research, Dr. Hoffman builds public awareness around uterine fibroids and all treatment options available with the goal of helping women everywhere live optimally. For more information regarding the study, please contact Dr. Hoffman, MD at [email protected]

 

REFERENCES

  1. Our Bodies Ourselves. (n.d.). Fibroids. Retrieved from http://www.ourbodiesourselves.org/health-info/fibroids/
  2. 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. Am J Obstet Gynecol, Aug; 213(2): 141-160.
  3. McLucas, B., Voorhees Iii, W. D., & Elliott, S. (2015). Fertility after uterine artery embolization: a review. Minim Invasive Ther Allied Technol, Aug; 2: 1-7.
  4. Chaabane, S., Hoffman, C., Kim, G., et al. (2017). A prospective, double-blind, randomized controlled study evaluating the effects of two new IV medications, IV acetaminophen and/or IV ibuprofen, on standard of care pain and antiemetic management in uterine fibroid embolization patients. J Vasc Interv Radiol, Feb; 28(2): S47-S48.
  5. Jolly, S. S., Yusuf, S., Cairns, J., et al. (2011). Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet, Apr; 377(9775): 1409-1420.