This One Tool Could Help Predict Fibroid Growth
Alicia Armeli

Wouldn’t it be great if there were a tool that could help predict how much and how fast your fibroids grow? Keep reading.

A study by researchers at the VU University Medical Center in Amsterdam, The Netherlands, found that by measuring the vascular index of a fibroid, also known as its vascularization or the amount of blood vessels within the fibroid tissue, they could predict how much and how fast a fibroid would grow a year into the future.1

Between March 2012 and March 2014, 66 premenopausal women diagnosed with a max of two fibroids 8 cm or smaller participated in 1 year of follow-up care without undergoing fibroid treatment.1 The researchers used a three-dimensional (3D) ultrasound with power Doppler, a tool that can detect blood flow in vessels, especially those found inside organs. To measure the ongoing fibroid vascular index, each woman had a 3D ultrasound with power Doppler at the start of the study and then at 3, 6, and 12 months. Change in fibroid volume and fibroid growth rate were also calculated.

Results showed that fibroid volume and growth rate were related to its initial vascular index.1 Over 12 months, the average fibroid growth rate was 8.98%. But for fibroids that were highly vascularized, or in other words had more blood vessels present, the fibroid growth rate was greater and detected at 10.5%. If a fibroid’s vascular index increased by just 1%, it was linked with a 7-cm3 larger fibroid volume at the one-year mark.

How can determining fibroid growth better the care women receive?

Uterine fibroids are noncancerous tumors that grow in the wall of the uterus. They can be the cause of heavy periods, pelvic pain and pressure, painful sex, and infertility. Predicting fibroid growth, especially among women with fast-growing fibroids, can help doctors narrow down which treatments could be the most effective for each individual.

For example, if fast-growing fibroids are detected early, medications that prevent fibroid growth might be helpful to these women.2 Among those who desire pregnancy, fast-growing fibroids that could potentially impair fertility can be detected and treated early on.2 Even if a woman has fibroids and isn’t having symptoms, predicting their growth rate can help in creating an effective follow-up care plan.2

Using fibroid vascularization as a tool can especially be helpful when treating women with minimally invasive procedures like uterine fibroid embolization (UFE). UFE works by targeting and blocking blood flow to the fibroids, causing them to shrink and symptoms to improve. By investigating which fibroids are highly vascularized and which aren’t may be helpful in determining how effective UFE will be, as UFE success may be limited among fibroids that aren’t vascularized.2

According to the researchers, we don’t yet have a way to strongly predict fibroid growth that can be used in everyday practice.1 Although this method of fibroid care seems promising, more research is needed to confirm the results of this study. Because of this, coverage by health insurance is not yet determined. But with additional data, predicting fibroid growth could become more economical and accessible to women, helping them to receive the best treatment and avoid unnecessary therapies.

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. She is a paid consultant of Merit Medical.

REFERENCES

  1. Nieuwenhuis, L. L., Keizer, A. L., Stoelinga, B., et al. (2017). Fibroid vascularisation assessed with three-dimensional power Doppler ultrasound is a predictor for uterine fibroid growth: A prospectie cohort study. BJOG2017. doi: 1111/1471-0528.14608.
  2. Dueholm, M. (2017). Fibroid vascularisation as a predictor for uterine fibroid growth. BJOG, May 9. doi: 10.1111/1471-0528.14727.
Anxious? Why Women Worry More Than Men & What We Can Do About It.
Alicia Armeli

A bit of anxiety every now and then is part of being human. For many of us, worrying and uneasiness are only temporary. But if you suffer from an anxiety disorder, you’re probably all too familiar with that nagging feeling that lasts for months, fears that get bigger as time goes on, and how all of this interferes with your everyday life.

As women, research shows, we’re almost twice as likely as men to get an anxiety disorder in our lifetime.1 The million-dollar question is why.

“In its most simple form, anxiety is the experience of tension between you and the present moment,” explains Katherine Schafler, LMHC, NYC-based women’s emotional health expert. And it can come in many forms, including generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, obsessive compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). Although anxiety doesn’t discriminate from one person to the next, it does seem to affect women more.

Fluctuations in sex hormones have been tagged as a possible cause for our boost in anxiety. But according to Margaret Altemus, MD, Director of the Payne Whitney Women’s Program at Weill Medical College Department of Psychiatry, we don’t know exactly why anxiety differs between women and men.2

“It doesn’t seem to be related to estrogen,” Dr. Altemus said in an Anxiety and Depression Association of America podcast. “In children, girls are twice as anxious as boys, so it’s even before the menstrual cycle starts that you see sex differences.”2 Being susceptible to anxiety, she explained, could go as far back as hormone levels in utero that may affect a developing fetus. Other possibilities that could contribute to the gender anxiety gap are major reproductive events and illnesses. Childbirth and the postpartum period have been seen to increase anxiety in women, as have reproductive diseases, such as uterine fibroids and endometriosis.3,4,5

And as if being from Mars and Venus weren’t enough, a woman’s brain chemistry differs greatly from that of a man’s, as do our coping mechanisms. When women face stress, they’re more likely to ruminate about their problems, writes Olivia Remes, anxiety researcher and doctoral candidate at the University of Cambridge in England.6 This can amplify anxiety. In contrast, she explains, men engage more in active, problem-focused coping.

Data has also shown that girls and women are more likely to encounter physical or mental abuse, and this experience is a known risk factor for PTSD. Childhood abuse may also change brain chemistry, affecting individuals as adults, predisposing them to anxiety disorders.7

Given all the potential associations and what-ifs, it’s clear more research needs to be done on behalf of our anxious minds. Science may not yet understand the connection between women and anxiety, but the good news is it’s treatable.

“When anxiety is ongoing, you may experience regular trouble sleeping, eating, and/or socializing. These are immediate signs that you need to get professional help,” Schafler tells Ask4UFE. It depends highly on the individual, she notes, but therapeutic interventions can include talk therapy, psychotropic medication, support groups, assertiveness training, animal-assisted therapy, and mindfulness exercises.

Women can also play an active role in their own treatment and engage in positive lifestyle changes like incorporating regular exercise, a healthy diet, and keeping positive relationships—this includes the relationship we have with ourselves.

“Surround yourself with people, places, and things that help you feel a sense of expansion, as opposed to contraction,” Schafler suggests. “Just as important as understanding who you are is understanding what you need.”

And never hesitate for one second to ask for it.

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. She is a paid consultant of Merit Medical.

ABOUT THE THERAPIST  Katherine Schafler, LMHC, is an NYC-based women’s emotional health expert. With dual master’s degrees in clinical assessment and psychological counseling from Columbia University and post-graduate training and certification from the Association for Spirituality and Psychotherapy in NYC, Katherine helps women change their lives for the better through counseling and tailoring her approach to meet the unique needs of each of her clients. You can find her at https://www.katherineschafler.com  

REFERENCES

  1. Anxiety and Depression Association of America. (n.d.). Women and Anxiety. Retrieved from https://adaa.org/find-help-for/women/anxiety#
  2. Anxiety and Depression Association of America. (Producer). (n.d.). Anxiety Disorders in Women [Audio podcast]. Retrieved from https://adaa.org/learn-from-us/from-the-experts/podcasts/anxiety-disorders-women
  3. Shlomi, P. I., Huller, H. L., Baum, M., et al. (2014). Postpartum anxiety in a cohort of women from the general population: Risk factors and association with depression during last week of pregnancy, postpartum depression, and postpartum PTSD. Sr J Psychiatry Relat Sci, 51(2):128-134.
  4. Ghant, M. S., Sengoba, K. S., Recht, H., et al. (2015). Beyond the physical: A qualitative assessment of the burden of symptomatic uterine fibroids on women’s emotional and psychosocial health. J Psychosom Res, May;78(5):499-503.
  5. Friedl, F., Riedl, D., Fessler, S., et al. (2015). Impact of endometriosis on quality of life, anxiety, and depression: An Austrian perspective. Arch Gynecol Obstet, Dec;292(6):1393-1399.
  6. Remes, O. (2016, Jun 10). Women are far more anxious than men—here’s the science. Retrieved from https://theconversation.com/women-are-far-more-anxious-than-men-heres-the-science-60458
  7. Harvard Medical School. (2002). Coping with Anxiety and Phobias. Retrieved from http://hrccatalog.hrrh.on.ca/InmagicGenie/DocumentFolder/copinganxietyphobias.pdf