Use of medical, surgical and complementary treatments among women with fibroids

Vanessa L. Jacoby, Alison Jacoby, Lee A. Learman, Michael Schembri, Steven E. Gregorich, Rebecca Jackson, Miriam Kuppermann

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objective To examine the use of medical management, uterus-preserving surgery (UPS), and complementary treatments among women with uterine fibroids. Study design Prospective cohort study of 933 premenopausal women ages 31-54 years with symptomatic fibroids who participated in the Study of Pelvic Problems, Hysterectomy, and Intervention Alternatives (SOPHIA) for an average of 4.3 years (SD 2.5 years). Incident use of fibroid treatments was determined through annual interviews. Linear regression models were used to compare changes in fibroid-related symptoms among women who underwent UPS versus those who did not undergo surgery. Results Participants were racially and ethnically diverse, with a mean age of 43 years. During study follow-up, 531 participants (57%) did not undergo UPS or hysterectomy, 250 (27%) had at least one UPS, and 152 (16%) underwent hysterectomy. Complementary and alternative treatments were commonly used, including exercise (45%), diet (34%), herbs (37%), and acupuncture (16%): participants reported significant symptom improvement and few side effects with these interventions. In multivariable linear regression models, women who did not undergo surgery during the study reported improvement in dyspareunia (p <.001), pelvic pain (p <.001), and menstrual cramps (p <.001). However, women who underwent UPS reported greater overall resolution of "pelvic problems" compared with women who did not have surgical treatment (difference in change score 1.18 on a four-point Likert scale, p <.001). Conclusion UPS are effective treatments for women with fibroids, but many women use hormonal or complementary treatments and report significant symptom improvement without surgical intervention.

Original languageEnglish
Pages (from-to)220-225
Number of pages6
JournalEuropean Journal of Obstetrics Gynecology and Reproductive Biology
Volume182
DOIs
StatePublished - Nov 1 2014

Fingerprint

Leiomyoma
Uterus
Linear Models
Hysterectomy
Therapeutics
Dyspareunia
Muscle Cramp
Pelvic Pain
Acupuncture
Cohort Studies
Prospective Studies
Interviews
Exercise
Diet

Keywords

  • Complementary treatments
  • Myomectomy
  • Uterine artery embolization
  • Uterine fibroids

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine
  • Medicine(all)

Cite this

Jacoby, V. L., Jacoby, A., Learman, L. A., Schembri, M., Gregorich, S. E., Jackson, R., & Kuppermann, M. (2014). Use of medical, surgical and complementary treatments among women with fibroids. European Journal of Obstetrics Gynecology and Reproductive Biology, 182, 220-225. https://doi.org/10.1016/j.ejogrb.2014.09.004

Use of medical, surgical and complementary treatments among women with fibroids. / Jacoby, Vanessa L.; Jacoby, Alison; Learman, Lee A.; Schembri, Michael; Gregorich, Steven E.; Jackson, Rebecca; Kuppermann, Miriam.

In: European Journal of Obstetrics Gynecology and Reproductive Biology, Vol. 182, 01.11.2014, p. 220-225.

Research output: Contribution to journalArticle

Jacoby, VL, Jacoby, A, Learman, LA, Schembri, M, Gregorich, SE, Jackson, R & Kuppermann, M 2014, 'Use of medical, surgical and complementary treatments among women with fibroids', European Journal of Obstetrics Gynecology and Reproductive Biology, vol. 182, pp. 220-225. https://doi.org/10.1016/j.ejogrb.2014.09.004
Jacoby, Vanessa L. ; Jacoby, Alison ; Learman, Lee A. ; Schembri, Michael ; Gregorich, Steven E. ; Jackson, Rebecca ; Kuppermann, Miriam. / Use of medical, surgical and complementary treatments among women with fibroids. In: European Journal of Obstetrics Gynecology and Reproductive Biology. 2014 ; Vol. 182. pp. 220-225.
@article{700019a0708b4658860051611c3de3ce,
title = "Use of medical, surgical and complementary treatments among women with fibroids",
abstract = "Objective To examine the use of medical management, uterus-preserving surgery (UPS), and complementary treatments among women with uterine fibroids. Study design Prospective cohort study of 933 premenopausal women ages 31-54 years with symptomatic fibroids who participated in the Study of Pelvic Problems, Hysterectomy, and Intervention Alternatives (SOPHIA) for an average of 4.3 years (SD 2.5 years). Incident use of fibroid treatments was determined through annual interviews. Linear regression models were used to compare changes in fibroid-related symptoms among women who underwent UPS versus those who did not undergo surgery. Results Participants were racially and ethnically diverse, with a mean age of 43 years. During study follow-up, 531 participants (57{\%}) did not undergo UPS or hysterectomy, 250 (27{\%}) had at least one UPS, and 152 (16{\%}) underwent hysterectomy. Complementary and alternative treatments were commonly used, including exercise (45{\%}), diet (34{\%}), herbs (37{\%}), and acupuncture (16{\%}): participants reported significant symptom improvement and few side effects with these interventions. In multivariable linear regression models, women who did not undergo surgery during the study reported improvement in dyspareunia (p <.001), pelvic pain (p <.001), and menstrual cramps (p <.001). However, women who underwent UPS reported greater overall resolution of {"}pelvic problems{"} compared with women who did not have surgical treatment (difference in change score 1.18 on a four-point Likert scale, p <.001). Conclusion UPS are effective treatments for women with fibroids, but many women use hormonal or complementary treatments and report significant symptom improvement without surgical intervention.",
keywords = "Complementary treatments, Myomectomy, Uterine artery embolization, Uterine fibroids",
author = "Jacoby, {Vanessa L.} and Alison Jacoby and Learman, {Lee A.} and Michael Schembri and Gregorich, {Steven E.} and Rebecca Jackson and Miriam Kuppermann",
year = "2014",
month = "11",
day = "1",
doi = "10.1016/j.ejogrb.2014.09.004",
language = "English",
volume = "182",
pages = "220--225",
journal = "European Journal of Obstetrics and Gynecology and Reproductive Biology",
issn = "0028-2243",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Use of medical, surgical and complementary treatments among women with fibroids

AU - Jacoby, Vanessa L.

AU - Jacoby, Alison

AU - Learman, Lee A.

AU - Schembri, Michael

AU - Gregorich, Steven E.

AU - Jackson, Rebecca

AU - Kuppermann, Miriam

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Objective To examine the use of medical management, uterus-preserving surgery (UPS), and complementary treatments among women with uterine fibroids. Study design Prospective cohort study of 933 premenopausal women ages 31-54 years with symptomatic fibroids who participated in the Study of Pelvic Problems, Hysterectomy, and Intervention Alternatives (SOPHIA) for an average of 4.3 years (SD 2.5 years). Incident use of fibroid treatments was determined through annual interviews. Linear regression models were used to compare changes in fibroid-related symptoms among women who underwent UPS versus those who did not undergo surgery. Results Participants were racially and ethnically diverse, with a mean age of 43 years. During study follow-up, 531 participants (57%) did not undergo UPS or hysterectomy, 250 (27%) had at least one UPS, and 152 (16%) underwent hysterectomy. Complementary and alternative treatments were commonly used, including exercise (45%), diet (34%), herbs (37%), and acupuncture (16%): participants reported significant symptom improvement and few side effects with these interventions. In multivariable linear regression models, women who did not undergo surgery during the study reported improvement in dyspareunia (p <.001), pelvic pain (p <.001), and menstrual cramps (p <.001). However, women who underwent UPS reported greater overall resolution of "pelvic problems" compared with women who did not have surgical treatment (difference in change score 1.18 on a four-point Likert scale, p <.001). Conclusion UPS are effective treatments for women with fibroids, but many women use hormonal or complementary treatments and report significant symptom improvement without surgical intervention.

AB - Objective To examine the use of medical management, uterus-preserving surgery (UPS), and complementary treatments among women with uterine fibroids. Study design Prospective cohort study of 933 premenopausal women ages 31-54 years with symptomatic fibroids who participated in the Study of Pelvic Problems, Hysterectomy, and Intervention Alternatives (SOPHIA) for an average of 4.3 years (SD 2.5 years). Incident use of fibroid treatments was determined through annual interviews. Linear regression models were used to compare changes in fibroid-related symptoms among women who underwent UPS versus those who did not undergo surgery. Results Participants were racially and ethnically diverse, with a mean age of 43 years. During study follow-up, 531 participants (57%) did not undergo UPS or hysterectomy, 250 (27%) had at least one UPS, and 152 (16%) underwent hysterectomy. Complementary and alternative treatments were commonly used, including exercise (45%), diet (34%), herbs (37%), and acupuncture (16%): participants reported significant symptom improvement and few side effects with these interventions. In multivariable linear regression models, women who did not undergo surgery during the study reported improvement in dyspareunia (p <.001), pelvic pain (p <.001), and menstrual cramps (p <.001). However, women who underwent UPS reported greater overall resolution of "pelvic problems" compared with women who did not have surgical treatment (difference in change score 1.18 on a four-point Likert scale, p <.001). Conclusion UPS are effective treatments for women with fibroids, but many women use hormonal or complementary treatments and report significant symptom improvement without surgical intervention.

KW - Complementary treatments

KW - Myomectomy

KW - Uterine artery embolization

KW - Uterine fibroids

UR - http://www.scopus.com/inward/record.url?scp=84920703015&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84920703015&partnerID=8YFLogxK

U2 - 10.1016/j.ejogrb.2014.09.004

DO - 10.1016/j.ejogrb.2014.09.004

M3 - Article

VL - 182

SP - 220

EP - 225

JO - European Journal of Obstetrics and Gynecology and Reproductive Biology

JF - European Journal of Obstetrics and Gynecology and Reproductive Biology

SN - 0028-2243

ER -