With fibroids, sometimes the best thing to do is watch and wait.
By Alicia Armeli

FibroidsWait

Painful periods, abnormal uterine bleeding, and pelvic pressure. These are only a handful of classic symptoms associated with having uterine fibroids—common benign tumors found in 20 to 80 percent of women by age 50.1

But even though a substantial percentage of women may have fibroids, a mere 10-20 percent experience symptoms serious enough to require treatment.2 For women who don’t have symptoms, is medical intervention even necessary?

“The most important thing to know is that fibroids are exceedingly common and many women don’t know they have them,” explained Dr. Christopher Tarnay, Clinical Professor of Obstetrics & Gynecology and Urology at UCLA School of Medicine, Chief of the Division of Female Pelvic Medicine and Reconstructive Surgery, and Co-Director of the Comprehensive Fibroid Treatment Program at UCLA. “Just because a woman is diagnosed with a fibroid based on an imaging test doesn’t mean any treatment needs to be done. Fibroids are not dangerous and many are often asymptomatic.”

And the research agrees. Instead of seeking out treatment for asymptomatic fibroids, for some women the best thing to do may be to watch and wait.

“First we need to separate patients who are diagnosed with fibroids and have symptoms from those without symptoms,” Dr. Tarnay clarified. “Watchful waiting”—an approach that postpones treatment while still keeping an eye on the progress of a disease—“is a common treatment plan for a patient with fibroids but without symptoms.” And for these patients, watchful waiting could prove more beneficial than medical therapy or surgery.3

The purpose of this method is to see if fibroids progress and if symptoms develop. In this way, patients and physicians can make informed decisions concerning which kinds of treatments, if any, are needed.3 What’s more, according to an article published earlier this year by Current Medical Research and Opinion4, watchful waiting could also be useful for women close to menopause. After menopause, fibroids tend to shrink and symptoms may improve.

And with the right candidate, watchful waiting is considered safe. “For women without symptoms, the risks of watchful waiting are often very minimal,” Dr. Tarnay told Ask4UFE. “One of the only risks would be if there was any concern that symptoms were caused by something other than a fibroid. The other risk of watchful waiting is when patients have symptoms, such as heavy bleeding caused by fibroids, and continue to wait and not treat the fibroid. This could cause severe persistent bleeding and subsequent anemia.”

Anemia,5 a serious health condition where there aren’t enough red blood cells, could lead to complications like weakness, dizziness, fatigue, and in some cases, heart failure.

If you’ve been diagnosed with fibroids and are considering watchful waiting, it’s necessary to first discuss this with your physician to see if it’s the right course of treatment for you. According to Dr. Tarnay, screening for symptoms is a significant part of this process. If a woman doesn’t have symptoms, to watch and wait may be fitting. Once this is established, a fibroid care management plan can then be put into place.

“I educate patients about symptoms,” Dr. Tarnay emphasized. “That way, if they develop symptoms later on or if symptoms get worse, it would be time to stop watchful waiting and revisit other therapy options. However, if symptoms don’t develop, then simply following up with an ultrasound in 6-12 months to look for whether the fibroid grows or not would be appropriate.”

Before rushing into medical therapy or unnecessary procedures, women should learn of all their options. Many may find that responsibly monitoring fibroids could be the only therapy ever needed.

 

ABOUT THE AUTHOR   Alicia Armeli is a Freelance Writer and Photographer, 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 with her local animal shelter.

ABOUT THE DOCTOR  Christopher Tarnay is a Clinical Professor of Obstetrics & Gynecology and Urology at UCLA School of Medicine, Chief of the Division of Female Pelvic Medicine and Reconstructive Surgery, and Co-Director of the Comprehensive Fibroid Treatment Program at UCLA. Dr. Tarnay incorporates the latest advances in minimally invasive surgery emphasizing the importance of uterine and fertility preservation. Named a Super Doctor of Southern California Los Angeles, Dr. Tarnay is American Board Certified in Obstetrics & Gynecology and Female Pelvic Medicine and Reconstructive Surgery.

REFERENCES

  1. Office of Women’s Health, U.S. Department of Health & Human Services. (2015). Uterine Fibroids Fact Sheet. Retrieved October 14, 2015, from http://www.womenshealth.gov/publications/our-publications/fact-sheet/uterine-fibroids.html
  2. Society of Interventional Radiology. (2015). Uterine Fibroid Symptoms, Diagnosis, and Treatment. Retrieved October 14, 2015, from http://www.sirweb.org/patients/uterine-fibroids/
  3. Center for Advancing Health. (2013). What Is Watchful Waiting? Retrieved October 14, 2015, from http://www.cfah.org/prepared-patient/make-good-treatment-decisions/what-is-watchful-waiting
  4. Singh, S. S., & Belland, L. (2015). Contemporary management of uterine fibroids: focus on emerging medical treatments. Current Medical Research and Opinion, 31(1): 1-12. doi: 10.1185/03007995.2014.982246
  5. National Heart, Lung, and Blood Institute, US Department of Health & Human Services. (2012). What Are the Signs and Symptoms of Anemia? Retrieved October 14, 2015, from http://www.nhlbi.nih.gov/health/health-topics/topics/anemia/signs