5 Self-Care Tips for Women with Uterine Fibroids

Practicing self-care is essential for a woman’s mental, emotional, and physical well-being. And yet, a recent Jean Hailes Women’s Health Survey found that more than one in four women aged 36-50 don’t get enough time to themselves each month.1 Between demands at work and home, finding that “me time” can be tough. It gets even more complicated if you’re a woman with uterine fibroids—a condition where the concept of self-care extends far beyond the occasional candlelit bath.

Uterine fibroids are the most frequently seen tumors of the female reproductive system.2 They become more common as women age, especially during the 30s and 40s through menopause—a time when self-care is so often placed on the back burner.3 It’s predicted that by age 50, up to 80% of women will develop fibroids.3

We sat down with Linda Bradley, MD, OB/GYN and professor of surgery, vice chair of the OB/GYN & Women’s Health Institute, and director of the Center for Menstrual Disorders, Fibroids, and Hysterscopic Services at the Cleveland Clinic in Cleveland, Ohio, to discuss self-care tips that can keep women with fibroids healthy.

1. See Your Gynecologist Regularly

According to Dr. Bradley, this piece of advice is for all women with fibroids—with or without symptoms. “Staying in contact with your gynecologist will help monitor your fibroids and the development of any symptoms,” Dr. Bradley explains. “For women already with symptoms, it’s a good idea to see your gynecologist regularly to talk about improvement, no improvement, or worsening of symptoms.”

Open dialogue between gynecologists and patients can help to establish a partnership in care, which is especially important when discussing all available fibroid treatment options.

2. Keep a Symptom Journal

Fibroids are most commonly known for heavy, prolonged periods. As fibroids grow, a woman may also notice her belly getting larger. This growth can press on surrounding organs, like the bowel and bladder, resulting in constipation or urinary frequency. Other symptoms may include a chronic watery discharge and fertility issues.

Symptom journaling is a useful tool that can help a woman keep track over time of how she feels. By journaling symptoms with dates, it’s easier to be clear with your gynecologist about what you’re experiencing. “It’s important to notice trends,” Dr. Bradley clarifies. “If a woman has noticed her periods lasting longer or that she’s having increased discomfort and missing work, taking a moment to journal those dates and changes can help her be more objective with her doctor.”

3. Get Creative in the Kitchen

With blogs floating around encouraging women with fibroids to eat this and not that, it can get a bit confusing. Research has shown that eating a diet high in fruits and vegetables may be protective against fibroids—but to date we don’t have studies that definitively support any particular diet as a clear path to fibroid prevention or cure.4,5 “To put it simply, a healthy diet is good for everyone,” Dr. Bradley says.

Taking time to prepare a nutritious meal can count as self-care for both body and mind. Not only does cooking healthy meals at home help to ensure a diet full of the nutrients your body needs, it can also serve as a major stress reliever. Culinary therapy, or harnessing the calming therapeutic power of cooking, is now being used as part of treatment plans for conditions like anxiety and depression.6 And the best part? After all of the mindful meal prep, there’s always a delicious and nutritious meal that follows.

4. Move Your Body

Just like carving out the time to cook healthy meals, engaging in regular exercise can be a self-care practice that may help women with fibroids in several ways.

“Exercise may help with pain, cramping, and bloating,” Dr. Bradley says. “It can also help maintain a healthy weight.” Research suggests that being obese or overweight may potentially increase the risk of fibroids, so when it comes to weight management, both diet and exercise are important.

5. Find Ways to Reduce Stress

In addition to the physical symptoms fibroids may cause, the emotional toll they take can be a lot to handle and may impact other areas of well-being. “Fibroids can be quite symptomatic, and the stress that may follow can lead to poor sleep hygiene,” Dr. Bradley explains. “Without good sleep, it can be difficult for patients to deal with life’s uncertainties.”

Lack of sleep and the inability to cope may then contribute to an ongoing cycle of stress.

The American Institute of Stress explains in a recent blog that not getting enough sleep puts the body under additional stress, triggering an increase in stress hormones during the day.7 To help stay balanced, Dr. Bradley encourages self-care routines that include mindfulness practices, such as yoga, spirituality, and therapy.

Above all, it’s essential to notice if your periods are the source of your stress. “Menstruation can be a nuisance, but it should never interrupt a woman’s life or cause social embarrassment with bleeding through clothing. That’s not normal,” Dr. Bradley explains. “Patients get used to tolerating symptoms, but normal cycles shouldn’t derail your activities. It’s important to talk with your doctor to understand what’s normal and seek out the right care.”

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 well-being. She is a paid consultant of Merit Medical.

ABOUT THE DOCTOR  Linda Bradley, MD, is an internationally recognized gynecologic surgeon, professor of surgery, vice chair of the OB/GYN & Women’s Health Institute, and director of the Center for Menstrual Disorders, Fibroids, and Hysterscopic Services at the Cleveland Clinic in Cleveland, Ohio. As founder of the Celebrate Sisterhood program, Dr. Bradley is dedicated to empowering multicultural women to take charge of their health and embrace self-care.

REFERENCES

  1. Jean Hailes for Women’s Health. (2018). Women’s health survey 2018. Retrieved from https://jeanhailes.org.au/contents/documents/News/Womens-Health-Survey-Report-web.pdf
  2. UCLA Health. (n.d.). Fibroids. Retrieved from http://obgyn.ucla.edu/fibroids
  3. S. Department of Health & Human Services, Office on Women’s Health. (2018, Mar 16). Uterine fibroids. Retrieved from https://www.womenshealth.gov/a-z-topics/uterine-fibroids
  4. Chiaffarino, F., Parazzini, F., La Vecchia, C., et al. (1999). Diet and uterine myomas. Obstet Gynecol, Sep;94(3):395-398.
  5. He, Y., Zeng, Q., Dong, S., et al. (2013). Associations between uterine fibroids and lifestyles including diet, physical activity and stress: A case-control study in China. Asia Pac J Clin Nutr, 22(1):109-117.
  6. Wasmer Andres, L. (2015, May 19). Kitchen therapy: Cooking up mental well-being. Retrieved from https://www.psychologytoday.com/us/blog/minding-the-body/201505/kitchen-therapy-cooking-mental-well-being
  7. The American Institute of Stress. (2018, Jul 9). 10 tips to boost your vitamin Z—sleep strategies. Retrieved from https://www.stress.org/10-tips-to-boost-your-vitamin-z-sleep-strategies/

The content in this article is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of a qualified physician regarding any medical questions or conditions. 

Radiologists Travel to Kenya to Provide Women with Life-Saving UFE


It’s well documented in medical literature that women of African descent develop uterine fibroids five to six years earlier and are more than 5 times as likely to have severe symptoms than Caucasian women of a similar family history.1

With the increasing number of women requiring fibroid treatment, hospitals in Kenya have welcomed international doctors to treat their patients with uterine fibroid embolization (UFE).

In July 2018, Dr. Darren Klass, interventional radiologist with Vancouver Coastal Health in Vancouver, British Columbia, Canada, traveled to Kenya with Merit Medical Systems Inc.—sponsor of Ask4UFE—to educate Kenyan gynecologists and radiologists on this uterine-sparing, minimally invasive option. By providing one-on-one UFE training to gynecologists—the doctors responsible for referring patients to radiologists for treatment—they can start recommending and providing this option to their patients.

In an intensive 10 days, Dr. Klass hosted a number of UFE training courses to several clinical teams in Karen and Kenyatta National Hospital in Nairobi and Aga Khan in Mombasa. Patients were also scheduled to undergo UFE in both cities. To help make this treatment possible, Merit Medical donated a portion of the embolic particles used for UFE procedures, called Embosphere® Microspheres. Dr. Klass observed and trained the clinical teams while they treated their own patients.

Traditionally, UFE has been performed through the femoral artery in the groin area. However, UFE can now be done via the radial artery in the wrist—a technique known as transradial access. This approach proved to be an eye-opener to both the Kenyan interventional radiologists and their clinical teams. Doctors observed how their patients were able to move and walk immediately post UFE and how patients could make themselves comfortable without having to lay still on their backs, which is required with femoral UFE.

All of the clinical skills taught and the education provided proved especially useful on the eve of the final day in Mombasa. Following a long day of training, Dr. Klass was called by a gynecologist to discuss an emergency case. A bedside consultation was done together with the referring gynecologist at around 8pm. The patient underwent a successful UFE procedure the following day and was discharged 24 hours post UFE. In this particular case, due to extenuating patient circumstances, UFE provided not only a uterine-sparing therapy for symptomatic fibroids but also a life-saving option. This experience was more than enough to show referring gynecologists that UFE is an effective fibroid treatment option. The gynecologist presented the case to an audience of doctors at a weekly Kenyan Medical Association meeting the night following the procedure.

The skills learned by the Kenyan radiologists can have a far-reaching impact, even beyond UFE. Because of the training with Dr. Klass, radiologists in both Mombasa and Nairobi can now also perform embolization for post-partum hemorrhage. Statistics show that 6,300 women die in Kenya each year during pregnancy and childbirth.2 A 2015 Kenyan policy document reported the maternal mortality rate at over 2,000 per 100,000 live births in North Eastern Kenya, and 212 per 100,000 live births in Nairobi, with hemorrhage accounting for 44% of those deaths.2

“Post-partum hemorrhage is an avoidable complication of childbirth and providing the radiologists here with the ability to treat this devastating complication with an effective therapy will hopefully have a dramatic impact on this shocking statistic,” Dr. Klass explains.

The time spent in Kenya was brief, but the main objective was achieved. Kenyan doctors can now provide these essential services to women.

“I arrived here wanting to improve the lives and care of women in Kenya,” Dr. Klass tells Ask4UFE. “I am pleased that by training radiologists in Kenya to perform this life-changing procedure, I saw this happening. Every single person I met in Kenya was grateful for the purpose of this trip.”

REFERENCES
1. Huyck, K. L., Panhuysen, C. I., Cuenco, K. T., et al. (2008). The impact of race as a risk factor for symptom severity and age at diagnosis of uterine leiomyoma among affected sisters. Am J Obstet Gynecol, Feb;198(2):168.e1-9.
2. National Council for Population and Development. (2015, Jun). Reducing Maternal Deaths in Kenya (Policy Brief No. 46). Retrieved from http://www.ncpd.go.ke/wp-content/uploads/2016/11/Policy-Brief-46-Maternal-Deaths-in-Kenya-1.pdf.

Is There a Link Between Uterine Fibroids and Polycystic Ovary Syndrome (PCOS)?
Alicia Armeli

Uterine fibroids and polycystic ovary syndrome (PCOS) are two common reproductive health concerns for women. Both are hormone-related diseases that can affect the menstrual cycle, incite pelvic pain, and affect fertility. But beyond a few common symptoms and complications, are these two conditions linked?

A landmark study found that among African American women, the incidence of fibroids was 65% higher among those who have PCOS compared to women without PCOS.1

What Are Fibroids?
Uterine fibroids are the most common tumors within the female reproductive system and grow within the muscle tissue of the uterus. About 20% to 80% of women develop fibroids by the time they reach age 50.2 Fibroids are non-cancerous and may cause no symptoms at all, but for many women they bring about severe symptoms like heavy periods, pelvic pain or pressure, and frequent urination.

The cause of fibroids is still unknown, but research suggests that genetics, hormonal imbalance (particularly estrogen and progesterone), and naturally occurring substances in the body called growth factors may play a role in fibroid growth.3

Some risk factors for fibroids include heredity, onset of menstruation at an early age, obesity, vitamin D deficiency, use of birth control, alcohol consumption, and a diet high in red meat and low in green vegetables.3 Race also plays a role, as black women have been found more likely to have fibroids than other racial groups, develop fibroids at a younger age, and to have more or larger fibroids.3

What Is PCOS?
Both women and men produce male hormones called androgens, but when a woman has PCOS, she produces more than normal. This occurrence along with an imbalance of female hormones, such as luteinizing hormone (LH) and follicle stimulating hormone (FSH), make it difficult for the ovaries to develop and release an egg each month, as seen during the ovulation phase of a healthy menstrual cycle. This leads to multiple cysts, or fluid-filled sacs, that develop on the ovaries.

Between 5% and 10% of women of childbearing age have PCOS.4 PCOS symptoms include an irregular menstrual cycle, acne, excess facial hair, male-pattern baldness, and weight gain.

The cause of PCOS isn’t clear, but factors include heredity, inflammation, and elevated levels of male hormones as well as high levels of insulin—a hormone that regulates how the food you eat is changed into energy and used by your body.5 Obesity may worsen PCOS symptoms.5

Fibroids and PCOS: What the Research Says
To investigate the possible connection between fibroids and PCOS, researchers at Boston University Slone Epidemiology Center examined findings collected from a large ongoing study that took place in 1995 called the Black Women’s Health Study.1 Within a 6-year period, over 23,000 African American premenopausal women with no history of fibroids were followed. To track participants’ health status, women were asked to complete mailed questionnaires every 2 years.

During this follow up, 3,631 new cases of fibroids were confirmed and reported.1 The researchers found that the incidence of fibroids was 65% higher among women with PCOS than women without PCOS.

What’s the Connection?
Given these results, the researchers concluded that PCOS was associated with an increased risk of fibroids, at least among African American women. But why?

Although we don’t know for sure, the researchers had a few theories. One possibility is that women with PCOS commonly have high levels of LH—a hormone that stimulates ovulation.1 LH may not only affect the ovaries but also directly influence the uterus and at high levels is associated with an increased risk of fibroids.1,6 What’s more, because LH levels are constantly elevated, ovulation often doesn’t happen.7

That being said, irregular ovulation is a hallmark of PCOS, and the researchers note that this also might influence the risk of fibroids.1 When the ovaries don’t release an egg during the menstrual cycle, they explain, estrogen continues to be released in the body without being balanced by progesterone. This imbalance may encourage the development and growth of fibroids.1

Our Thoughts
It’s important to note that although some research, as mentioned in this article, found a link between fibroids and PCOS, other research hasn’t found such a connection.8 For this reason, more research needs to be dedicated to this topic. However, if you’re experiencing any of the aforementioned symptoms, it’s important to educate yourself on both conditions and talk to your doctor about your medical history, risks and complications involved, and the possible treatments available.

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. She is a paid consultant of Merit Medical.

REFERENCES
1. Wise, L. A., Palmer, J. R., Stewart, E. A., et al. (2007). Polycystic ovary syndrome and risk of uterine leiomyomata. Fertil Steril, May;87(5):1108-1115.
2. U.S. Department of Health and Human Services Office on Women’s Health. (2018, Mar 16). Uterine fibroids. Retrieved from https://www.womenshealth.gov/a-z-topics/uterine-fibroids
3. Mayo Clinic. (2018, Mar 06). Uterine fibroids. Retrieved from https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288
4. U.S. Department of Health and Human Services Office on Women’s Health. (2018, May 22). Polycystic ovary syndrome. Retrieved from https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome
5. Mayo Clinic. (2017, Aug 29. Polycystic ovary syndrome (PCOS). Retrieved from https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439
6. Baird, D. D., Kesner, J. S., & Dunson, D. B. (2006). Luteinizing hormone in premenopausal women may stimulate uterine leiomyomata development. J Soc Gynecol Investig, Feb;13(2):130-135.
7. Center for Young Women’s Health. (2016, May 25). PCOS (polycystic ovary syndrome): General information. Retrieved from https://youngwomenshealth.org/2014/02/25/polycystic-ovary-syndrome/
8. Abdel-Gadir, A., Oyawoye, O. O., & Chander, B. P. (2009). Coexistence of polycystic ovaries and uterine fibroids and their combined effect on the uterineartery blood flow in relation to age and parity. J Reprod Med, Jun;54(6):347-352.