Uterine Fibroids: The Emotional, Physical, and Economic Toll 

​​The more severe symptoms associated with uterine fibroids – such as frequent and severe pain, and heavy bleeding – can cause more than physical suffering. In many women, fibroids place a heavy toll on a woman’s emotional well-being and can lead to body-issue anxieties, lower self-esteem and worries about relationships and sexuality. The information included below details the significant emotional, physical, and economic toll taken by uterine fibroids. 

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• Emotional Toll
• Pregnancy
• Impact on Black Women
• Economic Impact

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A Significant Emotional Toll

• Fibroids Have a Negative Impact on Women’s Lives - Especially among younger women ages 29 to 39, uterine fibroids place a heavy toll on their ability to be active and affect their relationships with family and friends. According to a national survey of 968 women with fibroids conducted in 2013, [6]many younger women report “feeling tired or worn out” and say their fibroids interfere with their physical, daily and social activities. In fact, one in five say fibroids make it difficult for them to take care of their home and children (22 percent) and the condition gets in the way of relationships with family and friends (21 percent).

• Women Worry about Losing Their Femininity and Sexuality - Loss of sexual intimacy is one of the greatest fears among those with fibroids and for obvious reason: heavy bleeding, cramps, and bloating, plus pain during sex and a need to urinate often can interfere with a woman’s sex life. As documented in the 2013 national survey, the majority of women worry about their sexual function (52 percent). Among younger women ages 29 to 39, a third reported relationship problems with their partner; many worry about soiling their clothing or bedding and whether fibroids will affect their femininity. 

• Women Diagnosed with Fibroids Fear Potential Health Complications - The possibility of future health complications causes significant fear and anxiety for women with fibroids. Among the 968 women participating in the 2013 national survey, 79 percent worry their fibroids will grow, 63 percent fear they will experience future health complications, 55 percent have anxiety about the need for a hysterectomy, and 54 percent worry their fibroids could turn into cancer. 

• Women with Severe Symptoms Often Feel Helpless - In a 2014 report documenting the emotional impact of fibroids, researchers surveyed women experiencing severe symptoms from their fibroids. The majority expressed a range of emotions about living with fibroids, from general worry and concern to fear, anxiety, depression and sadness. Moreover, half said they believed they had no control over their fibroids, because of the difficulty managing and predicting the heavy menstrual flow. 

• Many Women Delay Diagnosis and Are Resigned to “Tough It Out” - One of the most troubling findings of the 2013 national survey is how many women with fibroids wait for years without seeking treatment. The survey revealed that 25 percent of women sought help within the first year of experiencing symptoms but 32 percent waited more than five years; the average amount of time was nearly four years. Additionally, a third report from 2014, provides one explanation for the delay in seeking treatment: many women put off seeing a doctor, believing that what they are going through is normal and something to “endure as a woman.”  Further, a June 2017 poll reveals that one-fifth of American women still believe hysterectomy is the only treatment for fibroids, despite the increased range of options available today.

Uterine Fibroids and Pregnancy

​Most women with fibroids can have a normal pregnancy and vaginal delivery, but uterine fibroids may be a contributing factor in 5 to 10 percent of women with infertility. Certain types of  (submucosal and intramural fibroids) that change the shape and size of the uterine cavity may affect a woman's ability to get pregnant, potentially reducing her ability to get pregnant by as much as 70 percent.  Fibroids can even cause a problem when in vitro fertilization is attempted.
 
Fibroids also may cause complications in between 10 and 40 percent of pregnancies. The problems are more likely encountered in women who are over age 35, have not given birth before or are African American. Pain is the most common complication of fibroids in pregnancy, and is seen most often in women with large fibroids (more than two inches) during the second and third trimesters. The most serious pregnancy complications result when the placenta grows near or over the sur­face of a fibroid or obstructs the birth canal, which can cause miscarriage, premature labor, C-section, heavy bleeding and other medical consequences.

The Unequal Burden for Black Women

​Uterine fibroids are especially acute for black women where research demonstrates that fibroids are a disproportionate health issue compared to other populations. 

Black women require more hospitalizations and surgeries than other racial groups and face higher medical costs for their fibroid treatment.

During a lifetime, Black women are 3 times more likely to develop fibroids than white women.

Fibroid disease starts earlier in black women and affects 25 percent by age 24.

It is common for a black woman to have multiple fibroids and the risk of having more than one increases with her a​ge.

Black women have 3.5 times higher rates of hospitalizations and are 2.4 times more likely to undergo a hysterectomy.

Black women with fibroids have bloating, pressure & swelling two times as often as white women and are three times more likely to experience anemia.

The Economic Cost of Fibroids in the U.S.

Up to 30 percent of U.S. women with fibroids face disabling pain, heavy bleeding during their periods, and other problems that require medical care. The cost to our nation in loss of productivity and medical costs associated with symptomatic fibroids is nearly $35 billion annually.

Uterine fibroids are responsible for up to $9.4 billion spent each year for surgery, hospital admissions, outpatient visits, medications, and other health-related expenditures. But this is only part of the picture. Among patients with more symptomatic fibroids, the toll on our economy related to absenteeism, lost work, and short-term disability is more than $17.2 billion. At the same time, fibroids are a cause of infertility and can lead to pregnancy complications that cost the health system up to $7.8 billion annually for treatment.

The chart below shows the many costs of uterine fibroids to the health system and the US economy.

Medical Expenditures
​
$4.1-$9.4 Billion

Pregnancy Complications

Up to $7.8 Billion

 Lost Work Hours

$1.5-$17.2 Billion

References

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• Pritts E, Parker W, Olive D. Fibroids and infertility: an updated systematic review of the evidence. Fertil Steril. 2009;91:1215–23
• Xiaoxiao CG, Segars JH. The Impact and Management of Fibroids for Fertility: An Evidence-Based Approach. Obstet Gynecol Clin North Am. 2012 Dec; 39(4): 521–533.
• Berger, L. (2008, October 23). A Decade of Developments in Fibroid Research. New York Times, http://www.nytreprints.com
• Lee HJ, Norwitz ER, Shaw J. Contemporary Management of Fibroids During Pregnancy. Rev Obstet Gynecol. 2010 Winter; 3(1): 20–27.
• Borah BJ, Nicholson WK, Bradley L, et al. The Impact of Uterine Leiomyomas: A National Survey of Affected Women. Am J Obstet Gynecol. 2013 Oct; 209(4): 319.e1–319.e20.
• Ghant, M.S. et al. “Beyond the physical: a qualitative assessment of the emotional burden of symptomatic uterine fibroids on women’s mental health”, Fertility & Sterility. Sept 2014; Vol. 102(3):329
• Ghant, M.S. et al. “An altered perception of normal: a qualitative assessment of women’s experiences with symptomatic uterine fibroids”, Fertility & Sterility. Sept 2014; Vol. 102(3):255.
• Society of Interventional Radiology press release. “Women largely unaware of minimally invasive treatment for uterine fibroids.” August 29, 2017. Available at: https://www.eurekalert.org/pub_releases/2017-08/soir-wlu082917.php
• Baird, D. D., Dunson, D. B., Hill, M. C., Cousins, D., and Schectman, J. M. (2003) High Cumulative Incidence of Uterine Leiomyoma in Black and White Women: Ultrasound Evidence. American Journal of Obstetrics and Gynecology, 188: 100–107.
• Segars SH, Akopians AL. Two Health Disparities of Uterine Fibroids. Fertil Steril. 2013 Jun; 99(7): 1851–1852.
• Laughlin, S.K., Baird, D.D., Savitz, D.A., Herring, A.H., and Hartmann, K. E. (2009). Prevalence of Uterine Leiomyomas in the First Trimester of Pregnancy: An Ultrasound-Screening Study. Obstetrics and Gynecology 113: 630–635.
• Wechter ME. Stewart EA. Myers ER. Kho RM. Wu JM. Leiomyoma-Related Hospitalization and Surgery: Prevalence and Predicted Growth Based on Population Trends. Am J Obstet Gynecol. 2011;205(492):e491–495.
• Steward, E. A., Nicholson, W.K., Bradley, L., and Borah, B.J. (2013) The Burden of Uterine Fibroids for African-American Women: Results of a National Survey. Journal of Women’s Health 22(10): 807-816.