July 10, 2023

Opportunities for Minimally Invasive Treatment for Uterine Fibroids 

Guest blog by Laura Marrone and Pratik Shukla, MD, assistant professor of radiology at Rutgers New Jersey Medical School

Uterine fibroids are one of the most common types of gynecologic conditions we see as interventional radiologists (IRs). Uterine fibroids affect 20% to 50% of women of reproductive age, with even higher rates among Black women. Patients with uterine fibroids often have them for many years before symptoms, such as heavy menstrual bleeding, pelvic pain, and infertility, eventually bring them to a physician.

Several options are available to treat uterine fibroids, including surgery, medication, and minimally invasive interventional procedures, such as uterine fibroid embolization (UFE). But unfortunately, many women are effectively denied access to less invasive treatments because the health care system fails to inform them about the full range of options, especially UFE.

To find out more about the lack of awareness of this treatment and why so many women aren’t made aware of UFE as an option, our team at Rutgers New Jersey Medical School conducted a study to understand women’s awareness of treatment options for UFE. We interviewed 24 patients who underwent hysterectomy, including 11 who identified as Black and nine as Hispanic. The unpublished findings were presented at this year’s Society of Interventional Radiology Annual Scientific Meeting, and helped shed light on current gaps in knowledge. With July being Fibroids Awareness Month, there’s no better time to share this knowledge with women who may be living with uterine fibroids and looking for answers.

What is Uterine Fibroid Embolization?

UFE is a minimally invasive treatment option that blocks the blood supply to the fibroid tumors, shrinking or even eliminating them. UFE often helps to avoid surgery, preserve the uterus, control symptoms, and improve quality of life. Approximately nine out of 10 women who undergo UFE will experience significant improvement, or their symptoms will go away completely. With sedation and a small incision in the wrist or groin, IRs use X-ray guidance to thread a spaghetti-thin catheter through the blood vessels to block the specific artery that is supplying blood to the fibroid. UFE requires minimal or no hospital stay and a much shorter recovery time than more invasive procedures.

Black and Hispanic Women Are Offered Different Treatment Options for Fibroids

Black women are three times more likely to be diagnosed with fibroids than white women, and they are also more likely to have more severe symptoms. Some studies have suggested that Hispanic women also have an increased risk compared to white women. At Rutgers University Hospital, the study’s research team saw that many Black and Hispanic women were undergoing hysterectomies to treat their uterine fibroids and sought to find out why.

We interviewed 24 patients who underwent hysterectomy, including 11 who identified as Black and nine as Hispanic. We found that 18 of the 24 women said that hysterectomy was the only option presented to them, and it that they were not aware of the full range of treatment options available to them. In fact, one of the questions on our survey specially asked participants if, during the fibroid treatment option conversation, physicians had discussed “non-surgical, minimally invasive treatments” such as “fibroid embolization”. Eighty-seven percent of surveyed women specifically stated that they had not been made aware of UFE prior to undergoing hysterectomy.

Patient Empowerment and Physician Education Can Help Disparities

More research is needed to understand what can be done to minimize the disparities that exist among women with uterine fibroids. We believe that several actions could help close these gaps. These include:

It is important to address disparities in the treatment of uterine fibroids to ensure that women of color have equitable access to the latest and most effective care for their condition. By educating patients and health care providers, we can improve the lives of countless women.

If you’re living with uterine fibroids and interested in learning more about this or other minimally invasive treatment options, contact an interventional radiologist near you.