The impact of uterine leiomyomas: a national survey of affected women

Abstract

Objectives To characterize the impact of uterine leiomyomas (fibroids) in a racially diverse sample of women in the United States. Study Design A total of 968 women (573 White, 268 African-American, 127 other races) aged 29–59 with self-reported symptomatic uterine leiomyomas participated in a national survey. We assessed diagnosis, information seeking, attitudes about fertility, impact on work, and treatment preferences. Frequencies and percentages were summarized. Chi-square test was used to compare age groups. Results Women waited an average of 3.6 years before seeking treatment for leiomyomas, and 41% saw two or more healthcare providers for diagnosis. Almost a third of employed respondents (28%) reported missing work due to leiomyoma symptoms, and 24% felt that their symptoms prevented them from reaching their career potential. Women expressed desire for treatments that do not involve invasive surgery (79%), preserve the uterus (51%), and preserve fertility (43% of women under 40). Conclusions Uterine leiomyomas cause significant morbidity. When considering treatment, women are most concerned about surgical options, especially women under 40 who want to preserve fertility.

Correlation between the Types of Myoma and the Pathological Process

“…Важкі симптоми можуть розвива-тися у 15-30% випадків, а ступінь маніфестації симптомів залежить від розміщення, кількості і роз-мірів вузлів [4]. Також міома матки може протікати безсимптомно [14].…”

Is ulipristal acetate the new drug of choice for the medical management of uterine fibroids? Res ipsa loquitur?

“…Fibroids can have a significant impact on quality of life, 5 with many women having to wait an average of 3.6 years before seeking medical help and often having to be seen by more than two medical practitioners before an intervention decision is reached. 6 Fibroids also contribute significantly to both personal and social financial burden with an annual cost to the US economy estimated at approximately 4 billion dollars. 7 …”

“…6 Additionally, we now have a potential drug that could revolutionise our approach to uterine fibroids. Despite all the above knowledge, there are no national repositories that record, collate and analyse what is known and what the outcome would be if UPA is used for the right indication, on the right patients and for the right desired outcome.…”

“…In a national survey in the United States, 79% of women preferred a uterine-saving procedure irrespective of fertility desires. 6 Currently, depending on symptoms, the treatment options are medical, surgical or radiological. Surgical treatments include myomectomy, hysteroscopic, laparoscopic or open, and ultimately hysterectomy.…”

Uterine leiomyomata: the snowball effect

“…The strong psychological distress they have to live with is, most of the time, characterized by a sense of helplessness in managing their condition. They fear heavy bleeding accidents and feel "not in control" of their lives 8 . Additionally, many women express some concerns about their body image.…”