Holly Bridges says she doesn't even have Gr. 10 biology. Now she's an expert on uterine fibroids. How did that happen?
For almost three years she was challenged by painful, debilitating periods. Then, 47 years old, the single mom was plagued by periods so heavy that she was afraid to walk across a room for fear of flooding through her clothes.
"A gynecologist finally diagnosed grapefruit sized fibroids," says Bridges who is now 54. "I was given two choices: Do nothing, just soldier on until I had gone through menopause and hope it gets better then. Or have a full surgical hysterectomy and be done with it."
She decided to do neither and instead committed herself to learning all she could about her condition. Was she unique? Was she normal? And were there any alternatives to the treatment advice her gynecologist had given her?
She found that every year in North America, some 700,000 women undergo hysterectomy, most of them performed for benign conditions such as uterine fibroids, cysts, polyps and endometriosis. Uterine fibroids cost the Canadian healthcare system more than $130 million annually for surgical procedures; women with moderate to severe symptoms usually have more absenteeism from work and decreased productivity.
After reading research on treatments, Bridges discovered high tech alternatives such as hysteroscopic myomectomy and hysteroscopic endometrial ablation -- less invasive day surgeries to treat fibroids, treatments that worked for her.
Today, Bridges blogs on her website where she tells visitors to her site that there are alternatives to major surgery; she raises awareness on the condition, provides charts for tracking symptoms, and tells women to value a second opinion.
She also describes various treatments in her book The UnHysterectomy. "The awareness of other procedures is just not there," she told me. Her mission is to talk about heavy periods: "It's time to take the shame out of it. In 2013 we have ads for adult incontinence. Well, it's about frigging time we started talking about periods!"
Indeed we should. After all, fibroids were documented in 400 B.C. Nobody understands Bridges' frustration better than Dr. Guylaine Lefebvre, Chief of Obstetrics and Gynecology at Toronto's St. Michael's Hospital. "Although one in three women is diagnosed with fibroids, we have very few treatments available for them. Surgery carries risks of complications and these risks can be increased when women have very large fibroids or anemia because they are bleeding too much."
When diagnosing fibroids in her patients, Dr. Lefebvre reassures them that the condition is incredibly common and, most important, that fibroids are benign. Fibroids are balls of smooth muscle within the uterus, she explains. They are very easy to diagnose and Dr. Lefebvre says that if they are not giving women any problems, the best way to treat them is to leave them alone.
More women today seem to be "victims of technology," says Dr. Lefebvre, explaining that even very small fibroids are found today with ultrasound screening that may have been ordered by a doctor for a variety of reasons. "Once properly diagnosed, if fibroids are not causing problems then we don't need to intervene." Find a tutorial on uterine fibroids here.
Heavy periods are often treated with medications which control excessive bleeding and can even reduce the size of some fibroids; they include androgens, birth control hormones, a medicated IUD, and pharmaceuticals such as Lupron and Fibristal.
However, if the problems include both heavy bleeding and pressure symptoms from the weight of the fibroids, surgery is often the best option, she says. "If a woman is finished having kids and she is close to menopause, then a hysterectomy is a permanent solution. You take out the uterus and are cured. If the woman is younger and would still like to have children, then hysterectomy is not an option and myectomy, the surgical removal of fibroids from the uterus can be considered."
Fibroids seem mysterious. They can magically stop growing at menopause, and they could even shrink a bit. Their growth is linked to hormones, yet having them does not mean you have too high estrogen or not enough or too much progesterone.
Dr. Lefebvresays that fibroids are more common today perhaps because women have fewer children now compared to a few generations ago: "It may be linked to the fact that women are living longer, that not having as many pregnancies means the uterus is not being suppressed as much."
And it seems you're either fibroid prone or you are not. "The cause is likely genetic," says Dr. Lefebvre. " I see women who watch what they eat, they are fit and go to the gym, and they manage their lives and their careers so well. And then this thing happens to them and they have no control over it. It's very frustrating."