by Julie Snyder Most women go about their lives oblivious to fibroids and if they have them or not. Other women aren't so lucky. They experience pain, prolonged periods with heavy bleeding, and even fertility problems.
A new report just released states that uterine fibroids are a significant economic drain on the U.S. healthcare system. The study's authors estimated fibroids cost the United States $5.9 to $34.4 billion each year in medical expenses and lost productivity. To put that in perspective, the military budget of the United States during FY 2011 was approximately $740 billion.
According to Dr. James Segars, who heads up the Reproductive Endocrinology and Infertility unit at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, uterine fibroids are one of the most common reproductive disorders in women.
These benign tumors appear in only one place in the body: the uterus. "It's like the uterus decided to be pregnant and it's not. Instead, it creates balls of proliferating stuff," Segar says.
Economic Cost of Fibroids
More than one out of two women in the United States will develop fibroids before menopause (50% white 80% African American). That adds up to nearly 64 million women. Looking at several sources of data, the study authors concluded that 1% or about half a million American women seek treatment for fibroids annually.
Surgeries include 30,000 myomectomies (removal of the fibroids) and 200,000 hysterectomies (complete removal of the uterus) among U.S. women each year. Even women who don't have surgery often are hospitalized or require medications and other treatments. The toll is especially high among pregnant women, according to the report.
Other studies have estimated the costs of fibroids, but none have included the cost of pregnancy complications attributable to uterine fibroids, said Segars, who spoke at a teleconference today. Costs include:
- Pregnancy-related costs of fibroids: $238 million to $7.7 billion a year
- Direct costs including surgery, hospitalization, medication and outpatient treatment: $4.1 billion to $9.1 billion a year
- Lost work: $1.5 billion to $17.2 billion a year
"If one could minimize the number of women undergoing hysterectomies, we would be able to save 25 percent annually due to lost work," Segars said. "These results emphasize the importance of developing new, effective treatments and earlier diagnosis for fibroids," he said.
Fibroids and Pregnancy
At least 10% of women in their childbearing years have fibroids. The number depends on age and on race. Fibroids occur more commonly in older women and African American women.
Most pregnant women who have fibroids will not experience any complications with their pregnancy either. However, fibroids during pregnancy do slightly increase your risk of:
- Preterm birth
- Breach births and other malpresentations
- Stalled labor
- C-section rate
- Postpartum hemorrhage
Your healthcare provider will monitor the growth of your fibroids in order to anticipate any complications.
Segars suggests that young woman get to know their family history. Talk with your mom and grandmother. They might consider this condition too unpleasant and embarrassing to bring up, even though nearly three-quarters of women are affected. If your mom has fibroids, your risk increases. Age and race also are factors.
All women might be able to lower their risk by:
- Reducing their weight
- Including foods rich in anti-oxidants in their diet
- Regularly eating foods with omega 3's
African American women tend to develop fibroids earlier and have more severe symptoms. Segar suggests pre-pregnancy African Americans take these steps to reduce preconception and pregnancy complications associated with fibroids. He also suggests a pre-pregnancy ultrasound to see where things stand. If issues show up, try medical therapy to reduce fibroid size before pregnancy.
Two newer, non-invasive treatments are:
1. Aromatase inhibitors reduce the size of fibroids. This recent treatment is not medically-induced menopause.
2. Antiprogestrones have good possibility of success reducing fibroid size. Presently these new drugs are winnowing their way through the FDA.
Source: James Segars, M.D., head, unit on reproductive endocrinology and infertility, Eunice Kennedy Shriver National Institute of Child Health and Human Development; Dec. 20, 2011, American Journal of Obstetrics and Gynecology online.
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