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

14 Scopus citations

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

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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 and Gynecology and Reproductive Biology, 182, 220-225. https://doi.org/10.1016/j.ejogrb.2014.09.004