Scientists Uncover Genetic Link for Uterine Fibroids

The tumors affect three-fourths of women of childbearing age

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_129929.html (*this news item will not be available after 01/02/2013)

  By  Robert Preidt

Thursday, October 4,  2012HealthDay Logo

HealthDay news image

 THURSDAY, Oct. 4 (HealthDay News) — Researchers who discovered genetic risk factors linked to uterine fibroids in white women say their findings will lead to new screening and treatment methods for the condition.

Uterine fibroids are the most common type of pelvic tumor in women — they occur in 75 percent of women of reproductive age — and the leading cause of hysterectomy in the United States. Uterine fibroids can lead to abnormal vaginal bleeding, infertility, pelvic pain and pregnancy complications.

Researchers at Brigham and Women’s Hospital in Boston analyzed genetic data from more than 7,000 white women and identified variations in three genes that are significantly associated with uterine fibroids.

One of these variations occurred in a gene called FASN, which encodes a protein called FAS (fatty acid synthase). Further investigation showed that FAS protein production was three times higher in uterine fibroid samples compared to normal tissue, according to the report published online Oct. 4 in the American Journal of Human Genetics.

Overproduction of FAS protein occurs in various types of tumors and is believed to be important for tumor cell survival, the study authors pointed out in a hospital news release.

“Our discovery foretells a path to personalized medicine for women who have a genetic basis for development of uterine fibroids,” senior study author Cynthia Morton, director of the Center for Uterine Fibroids, said in the news release. “Identification of genetic risk factors may provide valuable insight into medical management,” she concluded.

SOURCE: Brigham and Women’s Hospital, news release, Oct. 4, 2012

HealthDay
Copyright (c) 2012 HealthDay. All rights reserved.

Repairing Pelvic Organ Prolapse: What’s Best?

From FDA on Medscape > FDA Expert Commentary

Repairing Pelvic Organ Prolapse: What’s Best?

Diane Mitchell, MD

Posted: 04/18/2012

Hello, I am Dr. Diane Mitchell, Assistant Director for Science in the US Food and Drug Administration’s (FDA) Center for Devices and Radiological Health. I am also an obstetrician/gynecologist.

I am pleased to join you on Medscape today as part of the FDA’s Expert Commentary Series. I would like to talk to you about the risks of using surgical mesh to repair pelvic organ prolapse, also known as POP, especially when the mesh is placed through the vagina.

POP occurs when the tissues that hold the pelvic organs in place become weak or stretched. This can allow 1 or more pelvic organs into the vaginal vault.

Some women with POP do not experience any symptoms. Others have symptoms. Symptomatic women can be treated by both nonsurgical and surgical methods.

Surgery can include using sutures alone or using sutures with surgical mesh. It’s important to note that surgical mesh has been cleared by the FDA for use in treating many other conditions, such as stress urinary incontinence, abdominal and inguinal hernias.

But I’m talking to you today specifically about surgical mesh used to treat POP. According to industry estimates, in 2010 there were 100,000 POP surgeries with mesh performed in the United States.

At the FDA, we are particularly concerned about complications that can result when the mesh is placed through an incision in the vagina. When mesh is placed abdominally, there appear to be lower rates of complications.

Postmarketing data indicate that repair of POP with surgical mesh is no more effective than POP repair with sutures alone, particularly for certain types of prolapse.

Patients who undergo POP repair with mesh are often subject to complications not experienced by patients who undergo surgery without mesh. For some women, the adverse events of POP repair associated with mesh placement through the vagina can be permanent and life-altering.

Even with these concerns, mesh placed through the vagina for POP repair may be appropriate for patients whom the surgeon believes have a poor chance at success with other surgeries and for whom other treatments are not feasible.

To better understand the complications of using mesh for transvaginal repair of POP, the FDA reviewed scientific literature published from January 1996 through April 2011. We also evaluated the adverse events reported to us for 3 years, beginning in January 2008.

Our review indicates that urogynecologic surgical mesh products are associated with serious adverse events, including mesh erosion through the vaginal wall. This complication can require multiple surgeries to repair, and sometimes the mesh cannot be completely removed, which leads to continued symptoms.

In addition to safety concerns, the research on performance does not demonstrate that mesh repair of POP offers improved clinical benefit compared with non-mesh repair. This is particularly true for transvaginal mesh repair of enteroceles and rectoceles. Some studies do show an anatomic benefit when mesh is used for transvaginal repair of cystoceles, but this benefit may not result in superior clinical outcomes, such as improved patient satisfaction.

The literature review also showed that mesh erosion into the vagina is the most commonly reported mesh-related complication from transvaginal POP repairs. We also found a previously unidentified risk of transvaginal POP repair. That is mesh contraction or shrinkage, and it is associated with vaginal shortening, vaginal tightening, and pain.

Beyond our own review of the available data, we gathered input from the scientific community and the public by convening a panel of outside experts on September 8-9, 2011. The purpose of this meeting was to publicly discuss the existing clinical data and the safety and effectiveness of surgical mesh used to treat both POP and stress urinary incontinence.

The panel generally agreed that, depending on the anatomical areas involved, vaginal placement of mesh for POP repair may not be more effective than repair without mesh, and that clinical studies are needed for premarket evaluation of vaginal mesh for POP repair.

In January 2012, the FDA ordered manufacturers of urogynecologic surgical mesh products to conduct postmarket surveillance studies, also called “522 studies.”

These real-world studies will provide the FDA, manufacturers, and healthcare providers with data that can better improve our understanding of the benefits and risks of mesh placed through the vagina for POP repair.

If you as a clinician are asked to take part in postmarket studies, we strongly encourage you. Your involvement can help us provide better information to patients and to you, their healthcare providers. This information will lead to more informed decisions.

In light of our concerns about the use of surgical mesh to treat POP, we issued public safety notifications in 2008 and in 2011 with the following recommendations for surgeons:

  • Obtain specialized training for each surgical mesh placement technique and be aware of the risks of surgical mesh.
  • Choose mesh surgery only after weighing the risks and benefits of surgery with mesh vs. all surgical and nonsurgical alternatives.
  • Be vigilant for potential adverse events from the surgical mesh, especially erosion and infection.
  • Remember that surgical mesh is a permanent implant that may make future surgeries more challenging. Removal of mesh due to complications may involve multiple surgeries. Complete removal of mesh may not be possible and may not result in complete resolution of complications, which can include pain and the inability to have sexual intercourse.

The FDA continues to gather data and assess the safety and effectiveness of urogynecologic surgical mesh devices by analyzing the published literature, adverse event reports, and postapproval studies. We will also continue to collaborate with professional societies and other stakeholders to better understand the postmarket performance of urogynecologic surgical mesh devices.

As new information becomes available, we will share it promptly with healthcare providers and the public.

If you would like more detailed information about the FDA’s findings, as well as recommendations, please review our urogynecologic surgical mesh implants Web section.

And remember: If you have the opportunity to participate in one of the postmarket studies, please do so.

Thank you for taking the time to listen to this FDA Expert Commentary on use of surgical mesh for POP repair.

Additional Resources

Detailed findings of the FDA’s literature review: Urogynecologic Surgical Mesh: Update on the Safety and Effectiveness of Transvaginal Placement for Pelvic Organ Prolapse

For more information on patient counseling about POP, please visit the FDA Pelvic Organ Prolapse Website

  • © 2012  Public Information from the FDA and Medscape
    Information provided by FDA and/or its employees on this website is for educational purposes only, and does not constitute medical advice.  Any statement or advice given by an FDA employee on this website does not represent the formal position of FDA.  FDA and/or any FDA employee will not be liable for injury or other damages resulting to any individuals who view FDA-related materials on this website.

Affordable Care Act funds to enhance quality of care at community health centers – More women to be screened for cervical cancer

 

News Release

FOR IMMEDIATE RELEASE
September 27, 2012
Contact: HHS Press Office (202) 690-6343

Affordable Care Act funds to enhance quality of care at community health centers

More women to be screened for cervical cancer

Health and Human Services (HHS) Secretary Kathleen Sebelius today announced new grants that will improve the quality of care at community health centers and ensure more women are screened for cervical cancer. The grants will help 810 community health centers become patient-centered medical homes (PCMHs) and increase their rates of cervical cancer screening.

“Our health centers are committed to providing high quality health care services and today’s awards help continue these efforts,” said Secretary Sebelius.

The patient-centered medical home is a care delivery model designed to improve quality of care through better coordination, treating the many needs of the patient at once, increasing access, and empowering the patient to be a partner in their own care.

Today’s awards will provide assistance to 810 health centers as they make the practice changes, such as improved care coordination and management, that are necessary to become patient-centered medical homes. The awards will also support health centers’ efforts to increase the percentage of women screened for cervical cancer.

According to the Centers for Disease Control and Prevention, an estimated 12,000 new cases of cervical cancer and more than 4,000 deaths will occur across the United States in 2012 as a result of this preventable disease. Patients who receive their health care in a patient-centered practice have been shown to receive a higher rate of preventive services, including cervical cancer screening.

A list of grantees receiving Quality Improvement in Health Centers Supplemental Funding is available at http://www.hrsa.gov/about/news/2012tables/120927healthcentersquality.html.

To learn more about the Affordable Care Act, visit www.healthcare.gov.

For more information about HRSA’s Community Health Center Program, visit http://bphc.hrsa.gov/about/index.html.

To find a health center in your area, visit http://findahealthcenter.hrsa.gov.

Vaginal Discharge Std S

 

Vaginal Discharge Std S

Unusual mucus or other substances coming from the vagina is a common problem and this discharge is usually because of some infection and is associated with pain, burning, itching and painful urination. It is not necessary that all the infections are sexually transmitted so you should not assume that vaginal discharge is always an STD.
Irritation of the vagina also known as vaginitis is the most common reason for discharges and is usually caused by infection. There are mainly three types of vaginal infections and these all could be treated with oral or vaginal medications. Such infection tends to produce a distinct discharge:1. Usually there is a thick, white cottage cheese like discharge that is itching, irritated skin, yeast infection or candidiasis. Women those who suffer from diabetes and those who take antibiotics are more prone to develop such infection. Most of the women face at least one yeast infection at some point in their lives.

2. There is a thin, yellow, foul smelling discharge known as trichomonas that is also transmitted sexually.

3. Other symptoms include thin, gray or white foul smelling discharge known as bacterial vaginosis.

Pelvic inflammatory disease is frequently caused STD that infects the cervix, uterus, ovaries or fallopian tubes and is one of the most common and serious complications of an STD. Symptoms include vaginal discharge or bleeding with lower abdominal pain and fever. Chronic PID could result into one or more infections and the most common symptoms that could be identified are gonorrhea or Chlamydia that are sexually transmitted.

Genital Herpes can also produce vaginal discharge and it could affect the cervix. It includes features such as fever, itching, headache and general muscle aches. Some women also get infection inside the uterus and this condition is known as endometriosis causing fibroid tumors, cancer or STD’s.

Sometimes a hole develops in the vagina and because of the passageway caused stool or urine passes through the vagina. This problem can develop after a surgery or injury in the area, infection, inflammation or radiation.

Inflammation in the vagina is also caused because of lack of estrogen and as a woman enters into menopause her body produces increasing erratic amount of estrogen. This often makes the vagina dry out and get irritated. This condition is also known as atrophic vaginitis and could be treated by estrogen replacement therapy, vaginal creams or vaginal suppositories.

Copied with permission from: http://plrplr.com/71020/vaginal-discharge-std-s/

Vaginal cancer is a disease in which malignant (cancer) cells form in the vagina.

General Information About Vaginal Cancer

Key Points for This Section

  • Vaginal cancer is a disease in which malignant (cancer) cells form in the vagina.
  • Age and exposure to the drug DES (diethylstilbestrol) before birth affect a woman’s risk of developing vaginal cancer.
  • Possible signs of vaginal cancer include pain or abnormal vaginal bleeding.
  • Tests that examine the vagina and other organs in the pelvis are used to detect (find) and diagnose vaginal cancer.
  • Certain factors affect prognosis (chance of recovery) and treatment options.

Vaginal cancer is a disease in which malignant (cancer) cells form in the vagina.

The vagina is the canal leading from the cervix (the opening of uterus) to the outside of the body. At birth, a baby passes out of the body through the vagina (also called the birth canal).

Enlarge
Anatomy of the female reproductive system; drawing shows the uterus, myometrium (muscular outer layer of the uterus), endometrium (inner lining of the uterus), ovaries, fallopian tubes, cervix, and vagina.

Anatomy of the female reproductive system. The organs in the female reproductive system include the uterus, ovaries, fallopian tubes, cervix, and vagina. The uterus has a muscular outer layer called the myometrium and an inner lining called the endometrium.

Vaginal cancer is not common. When found in early stages, it can often be cured. There are two main types of vaginal cancer:

  • Squamous cell carcinoma: Cancer that forms in squamous cells, the thin, flat cells lining the vagina. Squamous cell vaginal cancer spreads slowly and usually stays near the vagina, but may spread to the lungs and liver. This is the most common type of vaginal cancer. It is found most often in women aged 60 or older.
  • Adenocarcinoma: Cancer that begins in glandular (secretory) cells. Glandular cells in the lining of the vagina make and release fluids such as mucus. Adenocarcinoma is more likely than squamous cell cancer to spread to the lungs and lymph nodes. It is found most often in women aged 30 or younger.

Age and exposure to the drug DES (diethylstilbestrol) before birth affect a woman’s risk of developing vaginal cancer.

Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. Risk factors for vaginal cancer include the following:

  • Being aged 60 or older.
  • Being exposed to DES while in the mother’s womb. In the 1950s, the drug DES was given to somepregnant women to prevent miscarriage (premature birth of a fetus that cannot survive). Women who were exposed to DES before birth have an increased risk of developing vaginal cancer. Some of these women develop a rare form of cancer called clear cell adenocarcinoma.
  • Having human papilloma virus (HPV) infection.
  • Having a history of abnormal cells in the cervix or cervical cancer.

Possible signs of vaginal cancer include pain or abnormal vaginal bleeding.

Vaginal cancer often does not cause early symptoms and may be found during a routine Pap test. When symptoms occur they may be caused by vaginal cancer or by other conditions. A doctor should be consulted if any of the following problems occur:

 

  • Bleeding or discharge not related to menstrual periods.
  • Pain during sexual intercourse.
  • Pain in the pelvic area.
  • A lump in the vagina.

Tests that examine the vagina and other organs in the pelvis are used to detect (find) and diagnose vaginal cancer.

The following tests and procedures may be used:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. The doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and places the other hand over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. A speculum is also inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. A Pap test or Pap smear of the cervix is usually done. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.
    Enlarge
    Pelvic exam; drawing shows a side view of the female reproductive anatomy during a pelvic exam. The uterus, left fallopian tube, left ovary, cervix, vagina, bladder, and rectum are shown. Two gloved fingers of one hand of the doctor or nurse are shown inserted into the vagina, while the other hand is shown pressing on the lower abdomen. The inset shows a woman covered by a drape on an exam table with her legs apart and her feet in stirrups.

    Pelvic exam. A doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and presses on the lower abdomen with the other hand. This is done to feel the size, shape, and position of the uterus and ovaries. The vagina, cervix, fallopian tubes, and rectum are also checked.
  • Pap smear: A procedure to collect cells from the surface of the cervix and vagina. A piece of cotton, a brush, or a small wooden stick is used to gently scrape cells from the cervix and vagina. The cells are viewed under a microscope to find out if they are abnormal. This procedure is also called a Pap test.
    Enlarge
    Pap smear; drawing shows a side view of the female reproductive anatomy during a Pap test. A speculum is shown widening the opening of the vagina. A brush is shown inserted into the open vagina and touching the cervix at the base of the uterus. The rectum is also shown. One inset shows the brush touching the center of the cervix. A second inset shows a woman covered by a drape on an exam table with her legs apart and her feet in stirrups.

    Pap smear. A speculum is inserted into the vagina to widen it. Then, a brush is inserted into the vagina to collect cells from the cervix. The cells are checked under a microscope for signs of disease.
  • Colposcopy: A procedure in which a colposcope (a lighted, magnifying instrument) is used to check the vagina and cervix for abnormal areas. Tissue samples may be taken using a curette (spoon-shaped instrument) and checked under a microscope for signs of disease.
  • Biopsy: The removal of cells or tissues from the vagina and cervix so they can be viewed under a microscope by a pathologist to check for signs of cancer. If a Pap smear shows abnormal cells in the vagina, a biopsy may be done during a colposcopy.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) depends on the following:

 

  • The stage of the cancer (whether it is in the vagina only or has spread to other areas).
  • The size of the tumor.
  • The grade of tumor cells (how different they are from normal cells).
  • Where the cancer is within the vagina.
  • Whether there are symptoms.
  • The patient’s age and general health.
  • Whether the cancer has just been diagnosed or has recurred (come back).

 

Treatment options depend on the following:

 

  • The stage, size, and location of the cancer.
  • Whether the tumor cells are squamous cell or adenocarcinoma.
  • Whether the patient has a uterus or has had a hysterectomy.
  • Whether the patient has had past radiation treatment to the pelvis.

Cited from : The National Cancer Institute

Please go to www.yeastinfectioncuresinfo.com for our products on vaginal infection.

 

 

Vaginal Cancer

Vaginal cancer is a rare type of cancer. It is more common in women 60 and older. You are also more likely to get it if you have a human papillomavirus (HPV) infection or if your mother took diethylstilbestrol (DES) when she was pregnant. Doctors prescribed DES in the 1950′s to prevent miscarriages.

It often doesn’t have early symptoms. However, see your doctor if you notice

  • Bleeding that is not your period
  • A vaginal lump
  • Pelvic pain

A Pap test can find abnormal cells that may be cancer. Vaginal cancer can often be cured in its early stages. Treatment might include surgery, radiation and chemotherapy.

Cited from: NIH: National Cancer Institute

Note: Please check out our website www.yeastinfectioncuresinfo.com for natural methods to treat vagina problems

Uterine Fibroids

The uterus is one of the first organs to manifest symptoms when a woman’s hormones are out of balance. Two of the most common uterine symptoms of premenopause syndrome are an enlarged uterus and uterine fibroids. Women with PMS often experience painful periods (dysmenorrhea) which are most often caused when the industrial lining of the uterus extends into the muscular wall of the uterus (adenomyosis). When shedding of the endometrium occurs (menstruation), the blood is released into the muscular lining causing severe pain. Conventional medicine treats this pain with NSAIDS (non-steroidal-anti-inflammatory drugs) such as ibuprofen, but ignores the underlying metabolic hormonal imbalance that caused it. The problem can often be simply resolved by restoring proper progesterone levels, which restores normal growth and shedding of the endometrium.

The cause of uterine fibroids are unknown, but estrogens, especially estradiol, promote their growth. After menopause fibroids disappear. But because estrogen levels can rise during the early menopausal years, previously asymptomatic fibroids may grow in the years just before the cessation of menses, resulting in symptoms such as feeling of heaviness in the belly, low back pain, pain with vaginal penetration, urinary frequency or incontinence, bowel difficulties, or severe menstrual pain and flooding.

Women of color are three to nine times more likely to have fibroids than white women, and their fibroids will grow more quickly.

Uterine fibroid tumors are not cancer, not malignant. Tumor means a swelling or a growth, not a malignancy, not cancer. Less than 0.1% of all uterine fibroids are malignant.

Small uterine fibroids often disappear spontaneously. Larger fibroids are more difficult to resolve, but not impossible to control with natural, healthy measures, not hysterectomies.

Some women’s uterine fibroids and menstrual cramps disappear within three months of beginning a vigorous exercise program. Exercise helps insure regular ovulation, and irregular ovulation seems to worsen fibroids.

Strengthening the liver with herbs such as dandelion, milk thistle or yellow dock root helps to metabolize excess estrogen out of the body, thus reducing  uterine fibroids.

Vitex or chaste berry taken two to four times daily, often shrinks small  uterine fibroids within two months. But continued results come from long-term use.

Reduce  uterine fibroids by reducing your exposure to estrogens(Xenohormones): avoid birth control pills, ERT/HRT, estrogen-mimicking residues from herbicides and pesticides used on food crops (eat organically-raised products). Tampons that are bleached with chlorine may mimic the bad effects of estrogen also.

Lupron (leuprolide acetate), a drug which induces artificial menopause by shutting down the body’s production of estradiol causes a decrease in fibroid size within 8-12 weeks. Fibroids do regrow to about 90 percent of their original size when the drug is withdrawn however.

Major advances have been made in surgical treatments for women with uterine fibroids. There are many options now besides hysterectomy(removal of the uterus), including hysteroscopic resection, uterine embolization, myomectomy, and suprecervical hysterectomy. Since these are fairly new procedures, take the time to find a surgeon who is skilled in the procedure.

Hysterectomy can be a life-saving procedure, but by the age of sixty, more than one-third of American women will have given up their wombs to the surgeons. The presence of non-symptomatic uterine  fibroids is never sufficient reason for a hysterectomy. Women who did their homework, that is helped themselves before and after their surgery with all the tools at their disposal seem to fare much better than those who do not.

With very few exceptions, no woman is healthier without her ovaries. So, even if you elect a hysterectomy, keep your ovaries.

If you have a uterine fibroid and it is a problem, begin with the mildest remedies first. Set a time limit for your use of any remedy, but, except in an emergency, don’t go on to stronger remedies until you are sure the safer ones aren’t effective for you. As with any advise, you are the best judge of what works for you after you weigh all the factors.

Estrogen dominance causes the uterus to grow and without the monthly balancing effect of progesterone it doesn’t have the proper signals to stop growing. In some women this results in an enlarged uterus that presses on other organs, such as the bladder and often on the digestive system and generally causes discomfort and heavy menstrual bleeding. In other women estrogen dominance results in uterine fibroids which are tough, fibrous, non-cancerous lumps that grow in the uterus. Some uterine fibroids can grow to the size of a grapefruit or cantaloupe causing constant bleeding and such heavy menstrual periods that the blood loss is akin to hemorrhaging.

Uterine fibroids always shrink at menopause, but the most common course of action a doctor takes when a patient comes in with a fibroid is to remove the uterus. The explanation given is that a fibroid is too difficult to remove without irreversibly damaging the uterus. But in most cases this is no longer true. If you do end up needing to have a fibroid surgically removed, find a doctor who can do it without removing your uterus with it. If you have many small fibroids, it may be more difficult to remove them. On the other hand, their smaller size may make it easier to treat them without surgery.

Natural Alternatives for Uterine Fibroids

Bioidentical Progesterone Cream (Progensa 20)

Bioidentical progesterone cream minimizes the size and frequency of uterine fibroids by balancing the excess estrogen levels.

Uterine Fibroid Formula (ProSoothe)
ProSoothe is an all natural herbal formula that significantly improves uterine fibroids and pelvic pain/cramps, irritability, tension, mood swings, acne, headaches, breast pain, bloating and weight gain.

Also found in this synergistic herbal formula is dandelion and vitex,(chaste tree) that helps the body remove exogenous,(external excess estrogen)from hormone therapy or contaminated food,(xenosteroids) which is a known cause of uterine fibroids.

Milk Thistle (Silymarin)

Beyond the treatment of liver disorders, everyday care of the liver lays a cornerstone for total body health. Naturopaths and others who look beneath the symptoms of an illness to its underlying cause, often discover that the liver has had a role to play. This is true across a vast range of different ailments including uterine fibroids.

Cited from:  Copyright© 2012 Womenlivingnaturally.com

Note: yeastinfectioncuresinfo.com has several products for the natural treatment of Uterine Fibroids.

 

Fibroid embolization “fails” more in young women

Reuters Health Information Logo

Fibroid embolization “fails” more in young women

Tuesday, July 31, 2012

By Amy Norton

NEW YORK (Reuters Health) – Young women who have a minimally invasive treatment for uterine fibroids are more likely to have a recurrence than older women are, a new study finds.

Fibroids are non-cancerous growths that form from muscle cells and other tissue in the wall of the uterus.

In the new study, Italian researchers looked at long-term results from one fibroid treatment option: uterine artery embolization, in which tiny particles are injected into blood vessels leading to the uterus, cutting off the fibroids’ blood supply and shrinking them.

They found that of 176 women treated with embolization, the “clinical failure” rate was 18 percent over seven years.

That meant that the women’s symptoms came back after initially getting better — typically after three years.

And women age 40 or younger accounted for a large share of those recurrences: They were almost six times more likely to see their symptoms come back, versus women who underwent embolization after age 40.

Dr. Giovanna Tropeano and colleagues at Catholic University of the Sacred Heart in Rome report the findings in the journal Obstetrics & Gynecology.

It’s not surprising that younger women have more recurrences, according to Dr. James Spies, a professor of radiology at Georgetown University Medical Center in Washington, D.C., who was not involved in the study.

Women who have fibroids treated after age 40 are closer to menopause, when fibroids will usually shrink on their own. But younger women have a longer time period in which a recurrence can happen, Spies explained in an interview.

On top of that, fibroids that arise at a young age are typically more severe.

According to Spies, women who need fibroid treatment should talk with their doctor about all their treatment options. The “right” therapy, he said, will largely depend on where you are in your life.

FIBROID REMOVAL VS. EMBOLIZATION

Uterine fibroids are very common. In the U.S., it’s estimated that up to 70 percent of white women and 80 percent of African Americans will develop fibroids at some point by age 50.

Often, the growths cause no problems. But at least one-quarter of women have symptoms like heavy menstrual periods, bleeding between periods, and abdominal or back pain. For some women, fibroids make it hard to get pregnant.

The most common treatment is a hysterectomy, or surgical removal of the uterus.

But women who want to avoid a hysterectomy have other options. Besides embolization, they can have a myomectomy, in which just the uterine fibroids are removed. There’s also endometrial ablation, in which the lining of the uterus is removed (which, like hysterectomy, renders you infertile.)

“For women in their 30s who want to become pregnant, myomectomy should be considered first,” Spies said.

That’s because, at least in the first few years after treatment, women’s fertility seems to be better after myomectomy versus embolization.

If a woman is done having children, though, embolization has the advantage of a shorter recovery time, Spies said.

As far as fibroid recurrence, the odds may be similar, or somewhat higher, with myomectomy. Spies pointed to one study of women who were part of a large Washington State HMO: Of 628 women who had a myomectomy, 23 percent needed a repeat procedure — most often a hysterectomy — after five years.

The 18 percent recurrence rate in the current study is actually a little lower than what’s been seen in others. In his own study of 200 embolization patients, Spies found that 20 percent had a recurrence within five years.

When a woman has a fibroid recurrence, she can get a repeat embolization. “It works as well the second time around,” Spies said.

In this study, though, nearly all of the women who had a repeat procedure had a myomectomy or hysterectomy. The authors did not respond to requests for comment.

The costs of the three procedures — hysterectomy, myomectomy and embolization – vary depending on where you live, but they are fall within a similar range. In the U.S. all three range from between $6,000 and $7,000 at the lower end, to between $12,000 and $15,000.

“It’s still the default in this country to offer hysterectomy,” Spies said. He suggested that if you want to avoid that, ask your gynecologist about the other options.

SOURCE: http://bit.ly/MQekrg Obstetrics & Gynecology, August 2012.

Reuters Health
(c) Copyright Thomson Reuters 2012. Check for restrictions at: http://about.reuters.com/fulllegal.asp

Uterine Diseases

The uterus, or womb, is an important female reproductive organ. It is the place where a baby grows when a woman is pregnant. If you have a uterine disease, the first sign may be bleeding between periods or after sex. Causes of abnormal bleeding include hormones, thyroid problems, fibroids, polyps, cancer, infection or pregnancy.Treatment depends on the cause. Sometimes birth control pills treat hormonal imbalances. If a thyroid problem is the cause, treating it may also stop the bleeding. If you have cancer or hyperplasia, an overgrowth of normal cells in the uterus, you may need surgery.Other uterine problems are endometriosis and adenomyosis. In endometriosis, the kind of tissue that lines the uterus grows outside the uterus. With adenomyosis, the tissue grows in the uterus’s outer walls. Pain medicine may help; other treatments include hormones and surgery.Article cited from:

 MedlinePlus Trusted Health Information for You
Note: Please discuss your uterine problem and also non-drug or surgical alternatives as suggested here at www.yeastinfectioncuresinfo.com.

Vitamin D shrinks fibroid tumors in rats

For Immediate Release
Thursday, March 1, 2012

Contact:
Robert Bock or Marianne Glass Miller
301-496-5133

Vitamin D shrinks fibroid tumors in rats

NIH-funded study suggests possible treatment for common condition

Treatment with vitamin D reduced the size of uterine fibroids in laboratory rats predisposed to developing the benign tumors, reported researchers funded by the National Institutes of Health.

Uterine fibroids are the most common noncancerous tumors in women of childbearing age. Fibroids grow within and around the wall of the uterus. Thirty percent of women 25 to 44 years of age report fibroid-related symptoms, such as lower back pain, heavy vaginal bleeding or painful menstrual periods. Uterine fibroids also are associated with infertility and such pregnancy complications as miscarriage or preterm labor. Other than surgical removal of the uterus, there are few treatment options for women experiencing severe fibroid-related symptoms and about 200,000 U.S. women undergo the procedure each year. A recent analysis by NIH scientists estimated that the economic cost of fibroids to the United States, in terms of health care expenses and lost productivity, may exceed $34 billion a year.

Fibroids are three to four times more common in African-American women than in white women. Moreover, African-American women are roughly 10 times more likely to be deficient in vitamin Dthan are white women. In previous research, the study authors found that vitamin D inhibited the growth of human fibroid cells in laboratory cultures.

“The study results provide a promising new lead in the search for a non-surgical treatment for fibroids that doesn’t affect fertility,” said Louis De Paolo, Ph.D., chief of the Reproductive Sciences Branch of the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development, which funded the study.

First author Sunil K. Halder, Ph.D., of Meharry Medical College in Nashville conducted the research with Meharry colleagues Chakradhari Sharan, Ph.D., and Ayman Al-Hendy, M.D., Ph.D., and with Kevin G. Osteen, Ph.D., of Vanderbilt University Medical Center, also in Nashville. The findings appeared online in the journal Biology of Reproduction.

For the current study, the researchers tested the vitamin D treatment on a strain of rats genetically predisposed to developing fibroid tumors. After examining the animals and confirming the presence of fibroids in 12 of them, the researchers divided the rats into two groups of six each: those that would receive vitamin D and those that would not.

In the first group, small pumps implanted under the skin delivered a continuous dose of vitamin D for three weeks. The researchers then examined the animals in both groups. Fibroids increased in size in the untreated rats, but, in the rats receiving vitamin D, the tumors had shrunk dramatically. On average, uterine fibroids in the group receiving vitamin D were 75 percent smaller than those in the untreated group.

The amount of vitamin D the rats received each day was equivalent to a human dose of roughly 1,400 international units. The recommended amount of vitamin D for teens and adults age 70 and under is 600 units daily, although up to 4,000 units is considered safe for children over age 9, adults, and for pregnant and breastfeeding females.

“Additional research is needed to confirm vitamin D as a potential treatment for women with uterine fibroids,” said Dr. Al-Hendy. “But it is also an essential nutrient for the health of muscle, bone and the immune system, and it is important for everyone to receive an adequate amount of the vitamin.”

Fatty fish such as salmon, mackerel and tuna are the best natural sources of the vitamin. Very few foods naturally contain vitamin D. Fortified milk and other fortified foods provide an additional source of the vitamin. Vitamin D is also produced when ultraviolet rays from sunlight strike the skin.

About the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the Institute’s website at http://www.nichd.nih.gov/.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

NIH…Turning Discovery Into Health