Get Well Wednesday: Fibroids And How To Treat Them

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Dr. Whitney Dunham is a Board certified OBGYN, with concentration in routine and high risk obstetrics, adolescent gynecology and Robotic surgery. A native of Philadelphia, she obtained her undergraduate degree with honors, from Howard University and Medical Degree from Meharry Medical College, graduating at the top of her class.

After completing her training in OB/GYN, Dr Dunham moved to Huntsville in 2001 where she started and successfully ran her own practice for nearly a decade. Currently, Dr. Dunham holds a Medical Director position for the North Alabama Hospitalist program at Huntsville Hospital while continuing her clinical duties. Dr Dunham is also a proud mom, spending most of her free time with her two very active daughters.

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WHAT ARE FIBROIDS AND WHAT CAUSES THEM?

Fibroids are benign (non-cancerous) growths in the uterus (womb). They are made of up the muscle fibers of the uterus. Fibroids grow in different areas of the uterus; within the lining, within the wall, close to the surface and sometimes attached by a stalk. At this point, there are no definitive causes. There is research to show that fibroids are stimulated by hormonal production. They are more common in women of African descent, but are seen in most races and nationalities. Fibroids are common in families. More research is necessary.

 \WHAT ARE THE MOST COMMON SYMPTOMS OF UTERINE FIBROIDS?

Most common symptoms include: heavy bleeding, severe cramping with menses,  pain – with urination and with intercourse, pelvic pressure sensation due to uterine enlargement, changes in bowel habits, complications with pregnancy (pain, bleeding, miscarriage, preterm labor, preterm delivery),  infertility

 WHY DO FIBROIDS CONTINUE TO RETURN IN SOME WOMEN FOLLOWING TREATMENT?

Every woman should be counseled prior to any type of management decision that fibroids will return as long as there is continued stimulation by hormones and the uterus is present. The only way to insure that they will not return is to remove the uterus.

HOW ARE BIRTH CONTROL PILLS USED TO TREAT FIBROIDS?

Birth control pills can be taken daily to control bleeding and regulate menstrual patterns.

 WHAT IS THE FIBROID EMBOLIZATION PROCEDURE USED FOR TREATMENT?

Uterine fibroid embolization (UFE) is a procedure used to treat fibroid in an outpatient setting. It is performed by an interventional radiologist in the radiology department. This procedure is not performed by a gynecologist in the operating room. During this procedure, under x-ray, a catheter is introduced through their groin and travels to the blood vessels that supply the targeted fibroids.

Particles are then injected into those blood vessels to block that blood supply. This then causes the fibroids to be without nutrition for further growth and they recede. Prior to this procedure the patient has had a consultation with the radiologist and has had an MRI performed which will delineate the fibroids. The patient then stays overnight for observation for any potential side effects like pain and fever. The patient then has a follow ultrasound in 6 to 9 months. Patients have to be counseled that they may not be able to get pregnant following this procedure.

UNDER WHAT CIRCUMSTANCES SHOULD A HYSTERECTOMY BE CONSIDERED?

A hysterectomy can be considered in patients who have completed childbearing or do not desire the ability to bear children. The decision to have a hysterectomy should be made following a discussion of all options available based on that woman’s individual situation.  A hysterectomy is not necessary in every situation. There are other methods to manage and treat fibroids that do not require complete removal of the uterus.

 WHAT’S THE DIFFERENCE BETWEEN A MYOMECTOMY AND A HYSTERECTOMY?

 A myomectomy is the removal of the fibroid from their uterus. A total hysterectomy is the removal of the uterus and cervix. (this can occur while leaving the ovaries intact). (Misnomer: Many people have been told that a partial hysterectomy means the ovaries are left behind. It actually refers to the retention of the cervix following the removal of the uterus.)There are multiple ways to do both of those procedures including laparoscopically, with or without the assistance of robotic technology, open incision (abdominally), vaginally. The methods for each depends on the woman’s individual situation regarding the size of her uterus and number of fibroids in the skill level of the surgeon.

 CAN DIET AND EXERCISE AFFECT FIBROIDS?

 Yes. If you research or speak with a naturopath or nutritionist, they will suggest you avoid certain types of unhealthy food including high fat, processed meat, certain types of dairy, refined sugar, refined carbohydrates, alcohol, caffeine, food preservatives, food dyes, foods treated with pesticides and herbicides, bleach, and many others. There is also the suggestion to add certain essential oils and nutritional supplements. And although these will definitely improve your overall health and well-being, one cannot say that absolutely these will target fibroids specifically.

ARE THERE NATUROPATHIC TREATMENT OPTIONS THAT WORK?

To my knowledge there are no naturopathic treatment options that have been proven scientifically to work. But there are many women who have had some relief and will attribute a decrease in their symptoms and in the size of their fibroids to various methods that day personally utilized. But as with any type of treatment method, medication, supplement, each person may have a different outcome.

WHAT’S THE BEST WAY TO FIND AN AFRICAN-AMERICAN FEMALE GYN WHO SPECIALIZES IN THE TREATMENT OF FIBROIDS? CAN YOU RECOMMEND A DIRECTORY OR SITE TO FIND A PHYSICIAN?

To my knowledge there are no specific sites or lists of African-American female gynecologist exclusively. But if you do an Internet search and put in the parameters you’re looking for in your area you should be able to find us. In addition contacting your local medical society or ACOG.org (the American College of Obstetricians and Gynecologists), may be helpful. One website that I found with good information: Hystersisters.com. Many women find that they are more comfortable with referrals from family, friends, and/or coworkers.

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