Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women

Abstract

BackgroundIn 2009 the Uterine Bleeding and Pain Women's Research Study (UBP-WRS) was conducted interviewing 21,479 women across 8 countries in order to gain patient-based prevalence data on uterine pain and bleeding indications and investigate uterine symptoms and women's treatment experiences. This article shows relevant results of the study for the indication uterine fibroids providing data on self-reported prevalence, symptomatology and management of uterine fibroids.Methods2,500 women (USA: 4,500 women) in each country (Brazil, Canada, France, Germany, Italy, South Korea, the UK, the USA) completed an online survey. Women included were in their reproductive age (age group 15-49 years; USA: 18-49 years) and had ever experienced menstrual bleedings. Quotas were applied for age, region, level of education and household income of respondents. Variables have been analyzed descriptively and exploratory statistical tests have been performed.ResultsThe self-reported prevalence of uterine fibroids ranged from 4.5% (UK) to 9.8% (Italy), reaching 9.4% (UK) to 17.8% (Italy) in the age group of 40-49 years. Women with a diagnosis of uterine fibroids reported significantly more often about bleeding symptoms than women without a diagnosis: heavy bleedings (59.8% vs. 37.4%), prolonged bleedings (37.3% vs. 15.6%), bleeding between periods (33.3% vs. 13.5%), frequent periods (28.4% vs. 15.2%), irregular and predictable periods (36.3% vs. 23.9%). Furthermore women with diagnosed uterine fibroids reported significantly more often about the following pain symptoms: pressure on the bladder (32.6% vs. 15.0%), chronic pelvic pain (14.5% vs. 2.9%), painful sexual intercourse (23.5% vs. 9.1%) and pain occurring mid-cycle, after and during menstrual bleeding (31.3%, 16.7%, 59.7%, vs. 17.1%, 6.4%, 52.0%). 53.7% of women reported that their symptoms had a negative impact on their life in the last 12 month, influencing their sexual life (42.9%), performance at work (27.7%) and relationship & family (27.2%).ConclusionsUterine fibroid is a common concern in women at fertile age causing multiple bleeding and pain symptoms which can have a negative impact on different aspects in women's life.

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“…[1][2][3] Fibroids are associated with health problems such as menorrhagia, infertility, pelvic pain, and are the most frequent indication for hysterectomy in the United States. 4,5 There are many risk factors associated with the occurrence of uterine fibroids such as obesity, nulliparity, and untreated high blood pressure.…”

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“…The real prevalence of uterine fibroids is difficult to assess (ranges from 5% to 77% in different age groups) because many of them might be symptomless and could be detected only occasionally [2]. A large, multinational survey based on self-reported fibroids in non-pregnant women in the age group 40-49 years revealed considerable differences in their prevalence across the countries, from 4.5% in the United Kingdom to 17.8% in Italy, as well as across the ethnicity of women [3]. First-trimester ultrasound scans revealed the presence of symptomless fibroids in 8% to 18% of pregnant women of white and black ethnicity, respectively [4].…”

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“…При больших размерах миомы появля-ются «объемные» симптомы, такие как сдавление органов малого таза, тазовая боль и прочие. При миоме матки возможно также нарушение репродуктивной функции и снижение фертильности [3,4]. Вместе с тем у многих жен-щин заболевание может протекать бессимптомно, в этих случаях миома диагностируется случайно при плановом обследовании.…”

“…Современная стратегия лечения миомы матки в зна-чительной степени индивидуализирована, зависит от воз-раста пациентки, ее желания сохранить репродуктивную функцию, а также от размеров, локализации, темпов роста узлов, возможности проведения гормонотерапии [4,6]. В настоящее время, помимо хирургических методов лече-ния миомы матки (миомэктомия гистероскопическим, лапароскопическим или лапаротомическим доступом), используются методы альтернативного лечения -эмбо-лизация маточных артерий, фокусированная ультразвуко-вая абляция [7][8][9], а также медикаментозная терапия, проводимая преимущественно в предоперационном периоде.…”