Uterine Fibroid Embolization

The information below is based on a presentation provided by James Spies, M. D., MPH, Professor and Chairman, Dept. Of Radiology
Georgetown University Hospital


The information below is from the presentation handouts:


Symptoms of Uterine Fibroids

• heavy menstrual periods
• severe menstrual cramps
• pelvic or back pain
• pelvic pressure or abdominal bloating
• urinary frequency or urgency
• difficulty becoming pregnant or carrying pregnancy

- Impact of fibroids?  Location does matter!

• fibroids that distort the uterine lining can cause heavy bleeding
• bulk symptoms relate to all fibroids together
• pain may be caused by fibroids with local mass effect

Inquire with your doctor about the use of ultrasound versus MRI as an imaging tool for confirming, diagnosing, and estimating uterine and fibroid size. 

Choice of [surgical] treatments noted by Dr. Spies:  hysterectomy, myomectomy and UFE.  [Unfortunately] hysterectomy is the most commonly recommended therapy for symptomatic fibroids.  It is clearly not the only therapy.

- Myomectomy is more common in women in their 30s to preserve the uterus.

- UFE [uterine fibroid embolization] can be safely and effectively be used in most women with fibroids.  [In this procedure, plastic biocompatible beads are inserted into the blood vessels "feeding" the fibroid.  This permanent embolization causes scarring which is necessary to help plug the vessel cutting off the fibroids blood supply.]

This procedure usually requires an overnight stay, although some centers do as an outpatient procedure.  There is some pain after the procedure for about 2 -6 afterwards.  Hospital or center can provide pain relief intravenously.  One week off for recovery is recommended. 

Not all fibroids are treated just alike and not all fibroids are removed with myomectomy.

Women may have to have 3, 4, 5 interventions [surgeries] during the course of her reproductive years.

• Patients should try to get pregnant without surgeries first.
• Myomectomy [should be] the first therapeutic choice for those seeking pregnancy.
• While UFE still has a role in some patients, more study of the potential uterine and ovarian impacts of UFE are needed.

Again, according to Dr. Spies

Myomectomy may be preferred for those with strong interest in future childbearing.

UFE is the best choice for those patients done with childbearing wishing to avoid hysterectomy.

As always contact your health care provider (whomever that may be) regarding your personal and unique health concerns.

Disclaimer:  Howard University College of Medicine/Howard University Hospital, and their staffs, and the National Institutes of Health and staff and the doctor/presenter and the blogger for "Sorry But I Had To Scream" are not responsible for injury or illness resulting form the use of medications or modalities discussed during this educational activity.

The Endo Surgery - Round One (Entry # 7)

(Excerpt taken from previous document of my experiences - picking up from #5)


I am hopeful and prayerful that this surgery will close the book on all of this pain I’ve been dealing with. The doctor tells me that endometriosis can reoccur. He said that one of his patients told him that she was down on the floor on her knees and she just felt like she wanted to die. I said, "yep, that’s the feeling." I have felt like I wanted to die and actually thought and said I might be better if I were dead. I quickly had to take that back, but that accurately reflects the state of mind when going through that kind and intensity of pain.

May God bless us all and may the medical field, researchers and this country increase its emphasis on women’s issues (research and cures).

Well, I began writing again. I had the surgery in November 2004. I was in surgery for many hours because I just had so much Endo on the inside to deal with, according to the doctor. Endometriosis was all over the place. My uterus was attached to my rectum by endometriosis. Yes, you've read right.  I'll discuss this in further detail in another post.

The doctor was only able to partially separate my rectum from my uterus or else he would have had to cut out part of my rectum and said I might have to wear a body bag. Also, I had fibroids in my uterus which had to be removed to the extent possible. No one knew the extent of my problems until Doc G did this laparoscopy. I was in surgery longer than anyone expected. I was so doped up when I left the ambulatory center, I was unable to stand on my own and was not aware of my surroundings. My dad had to practically carry/drag me into the house (I had both arms around his neck). Thank God for Daddy.

Later in November after the surgery and in less pain and able to get around a little better, I went in to Doc’s office to get my shot of Lupron (see section on "Why is the medicine prescribed" and  "What side effects...") which covered 3 months. Doc believed I should get on this in order to be able to heal properly and hopefully get some relief from periods and period pain and shrink the endometriosis sites. I had a period in December and that was painful, but that was it for a while. I got my second shot of Lupron in February 2005.

The Impact of Uterine Fibroids on Infertility

The information below is based on a presentation provided by Valerie Montgomery Rice, M.D.  Dr. Rice is the Dean and Executive Vice President, Morehouse School of Medicine


The impact of fibroids on fertility studies have only started being pulled in their cumulative status and been deemed clinically relevant since 2002.

• Uterine Leiomyomas (fibroids) are benign tumors arising from the myometrium.
• Fibroids are the most common gynecologic tumor.
• They affect about 77% of reproductive age women.
• Fibroids will most likely come back after removal.
• Fibroids are the main indication in over 200,000 hysterectomies each year in the US.
• Vitamin D deficiency is associated with risk of uterine fibroids in African American women.
• Green Tea Extract may be a treatment for uterine fibroids.
• It is important to find out where your fibroids are, their size and whether they will prevent pregnancy.

Schematic drawing of various types of uterine fibroids: a=subserosal fibroids, b=intramural fibroids, c=submucosal fibroid, d=pedunculated submucosal fibroid, e=fibroid in statu nascendi
[Source:  Picture and description found on Wikipedia]

• Based on the presentation, it appears that intramural fibroids cause a negative outcome for trying to get pregnant.  More studies must be done as this conclusion is still controversial.

As always contact your health care provider (whomever that may be) regarding your personal and unique health concerns.

Disclaimer:  Howard University College of Medicine/Howard University Hospital, and their staffs, and the National Institutes of Health and staff and the doctor/presenter and the blogger for "Sorry But I Had To Scream" are not responsible for injury or illness resulting form the use of medications or modalities discussed during this educational activity.

Fibroids in African American Women Are Different

The summit was an excellent event that provided great information for researchers, doctors and the general public who are interested in fibroid treatment, pain management, causes and cures.


While, to date, detailed information regarding the presentations at the summit is not available via Internet, I believe plans may be in the works for Howard University's Department of Obstetrics and Gynecology to make this information available.  For the agenda, click here and scroll down. 


The information below is based on a presentation provided by James H. Segars, MD.  Dr. Segars is Head of the Unit on Reproduction Endocrinology and Infertility at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health


AA = African American
CC = Caucasian


What has been learned in the past 2 - 3 years (race related and general information):

• AA women are 3 times more likely to suffer from fibroids than CC women.
• The symptoms in AA women are more severe than in CC women.
• AA women don't get relief from fibroids during menopause as do CC women; fibroids continue to grow.
• An enzyme called aromatase is much higher in AA women than CC women.  It was stated that AA women may be able to use aromatase inhibitors to reduce fibroid size.  Discuss with your doctor or health care provider.
• Hysterectomies due to fibroids are much more common in AA women than CC women.
• For AA women, the link that genes are responsible for familial causes of fibroids has not been made.
• Vitamin D3 and vitamin A deficiencies were mentioned as a possible causes of fibroids.

In general, 

• Fibroids are uterine cells that got the wrong message.
• Not all fibroids are the same and not all fibroids behave the same.
• Fibroids sometimes shrink, but the reason for this is unknown.
• Fibroids can grow to a very large size, but do not metastasize.
• Fibroids have different rates of growth.

As always contact your health care provider (whomever that may be) regarding your own personal and unique health concerns.

Disclaimer:  Howard University College of Medicine/Howard University Hospital, and their staffs, and the National Institutes of Health and staff, and the presenters, and the blogger for "Sorry But I Had To Scream" are not responsible for injury or illness resulting form the use of medications or modalities discussed during this educational activity.

Prescription / Over-Counter Drug Breakout (Entry #6)

(Excerpt taken from previous document of my experiences)

October, vioxx was off the market so my gi doctor suggested using Aleve. He had also previously prescribed Percoset, if and only if I really really needed it. Well, I did need it. The pharmacy filled the generic brand for Percoset, which I think is called Oxycyclene. During my October period, I was taking, Aleve, Oxycyclene, Zelnorm, Pamine, and Lexapro. Oh, and by the way, I have high cholesterol so I was also taking Lipitor.

Not long after, by skin broke out into excessive itching and redness. I didn’t know what was causing this and thought it could have been something I’d experienced many many years ago. So I called my general doctor for a prescription of Lac Hydrin lotion. I had to use this several times a day. Without it I would break out in this maddening itching.

A thought came to me, and I stopped taking all the medication that the gi doctor gave me.  I only continued taking the lipitor. Within a day or two, the itching stopped. All of this medication had also taken a toll on my hair. My stylist informed that my hair had gotten really dry and was thinning.

Now that I think back on this time in my life, I just shake my head and thank God.  What was a putting my liver and my body through in taking all of those medications?  What in the world was I thinking?  I guess I just wanted to stop the pain and be well.

Somebody Does Care

Do you remember the song by Aaliyah called "I Care For You"? In an excerpt from those lyrics, the songstress stated

Hey my baby
Tell me, why you cry?
Here take my hand and yeah
Wipe those tears from your eyes

Can I talk to you
Comfort you?
Let you know
I care for you

Hold on, stay strong
Press on, I care for you
Hold on, stay strong
Press on, I care for you

Can I talk to you?
Comfort you?
Let you know
I care for you?

When dealing with the pain and simple reality of having of fibroids, you may cry, but you have to stay strong and press on.  It's great when you have someone who cares and is there to comfort you and stand by you. 

I am deeply humbled. Being present at the Fibroid Summit and listening to the various speakers was a sobering experience. It was sobering just to hear all of the scientific, medical and research information that is and has been going on. Humbling to realize how much I don't know and how easy it is to get caught up in my own situation (as I had) and for my perspective to be skewed. But this was one of the reasons I wanted to attend the Summit; to dismantle some of my preconceptions. I already knew that I was / am or tend to be self-absorbed when comes to the issue of fibroids, endometriosis and such.

It was humbling and sobering to discover that "yes, indeed, somebody does care." A whole lot of somebodies care and these are people that can actually cause change in the way fibroids are researched, treated, managed and yes, one day, prevented.

For so long I have felt like no one out there in the world was doing anything in a large proportion to help all of us suffering, so to see this was amazing for me.

It was humbling because it's not for me to tell you your path, but to employ you to get as much information as possible and partner with those whom you entrust with your well-being to get to your best possible outcomes.  I feel more empowered after attending this event and more prepared to make the necessary decisions concerning this area of my life. 

Will I continue with the juicing and vegging out?  Absolutely!  Do I still believe exercise and thoughts are important in strengthening and maintaining good health?  No doubt!  And now I've been provided with other possible options should I so choose.

Howard University wants to create a Center for Excellence in the treatment/management/study of fibroids in African American women. Thank God! How great is that!

In my next post on the Summit I'll share why this focus is great and necessary.

There is no way I can discuss all of the information covered at the Summit in one post, so I'll be providing information over several posts.

Thank you Howard University!

Be well.