A look at the current state of uterine fibroid care

Irene Aninye, PhD, chief science officer for the Society for Women’s Health Research (SWHR) in Washington, D.C.

A review of the current state of research and clinical care for uterine fibroids in the Journal of Women’s Health identified many areas for improvement, calling for increased research investment; improved fibroid assessment via pelvic imaging; addressing factors that contribute to disease disparities—especially among women of color—and developing fertility-friendly treatment options.¹

“Over 70% of women are estimated to develop uterine fibroids by age 50,” said senior author Irene Aninye, PhD, chief science officer for the Society for Women’s Health Research (SWHR) in Washington, D.C. “Fibroids are a complex condition that can range from being asymptomatic to having deleterious effects on a woman’s health and quality of life.”

SWHR assembled an interdisciplinary working group of expert researchers, gynecology-focused health care providers, patients, patient advocates and policy leaders to discuss key deficits within the areas of research, clinical care, and federal policy that are needed from bench to bedside.

During a 2-day roundtable meeting, participants discussed updates on key literature, research, clinical practices, and public health data on uterine fibroids.

Expanding awareness and education of uterine fibroids beyond gynecologic specialists, along with advancing personalized patient care through shared decision-making, were also flagged as ways to address unmet needs in the review.

Additionally, exploring novel non-hormonal medical therapies might lead to fertility-friendly options to treat fibroids. For instance, upregulation of vitamin D could have protective effects against fibroid growth without negatively impacting ovarian function.

“The findings of the working group may not particularly come as a surprise to many clinicians; however, the review’s presentation across research, clinical and policy landscapes offers a vantage point that may be overlooked when professionals are intently working in their respective niches,” Aninye told Contemporary OB/GYN®.

For example, providers routinely ask about gynecological health during a well-woman exam. “We suggest reconsidering a patient’s use of the word ‘normal’ or ‘fine’ when describing menstrual flow or pain because they may not realize that their normal may actually warrant medical concern,” Aninye said. “Quantifying the use of feminine products or the duration of pain and its influence on daily activities is likely to better inform an assessment.”

Furthermore, patient outcomes and personal stories are essential to understanding the full scope of impact that uterine fibroids have on women’s health.

It helps if patients articulate their experiences, “which is important for clinical care and identifying needs that should inform future research focuses and policy interventions,” said Aninye, noting that the disease burden factors in both financial and health data.

The review offers recommendations that individual clinicians can incorporate in their practice. “It also highlights areas and potential solutions that require more systemic attention, such as basic and clinical research investments, addressing stigma and biases that can contribute to delays in diagnosing and treating fibroids, and barriers to accessing care that affect overall and disparate populations of women,” Aninye said.

The working group hopes that the review will shed light on the growing public health burden of uterine fibroids and reinforce the need to address persistent gaps with an interdisciplinary and multisector approach.

“SWHR is committed to building awareness and support for the Stephanie Tubbs Jones Uterine Fibroids Research and Education Act of 2021, and will continue to promote provider, patient and policymaker education so that women are empowered throughout their life-course to live well and manage uterine fibroid disease,” Aninye said.

Reference

1. Aninye IO, Laitner MH. Uterine fibroids: assessing unmet needs from bench to bedside. J Womens Health (Larchmt). 2021 Aug:30(8):1060-1067. doi:10.1089/jwh.2021.0280