When Ms. B., a 28-year-old black woman, noticed last spring that she looked pregnant, she assumed she was just deconditioned after a long winter and a stressful job transition. But her annual gynecologic exam revealed several uterine fibroids, one of them 12 cm long on the outside of the uterus. She soon developed debilitating abdominal pain and one night presented to the emergency department thinking she had appendicitis. She didn’t, but her fibroids were so large that on abdominal CT, her appendix could not be visualized.
The lifetime prevalence of uterine fibroids is over 80% among black women and nearly 70% among white women.1 When fibroids become symptomatic, there are surgical and nonsurgical treatment options. The position of Ms. B.’s fibroids, however, was likely to impede conception and pregnancy, and she wanted to start a family. Told that she needed a surgical myomectomy, which meant 6 to 8 weeks of recovery, she asked for other options.
Read Full Article »