In early December, Rachel, 32, was on day four of a work trip when she felt her body telling her something was seriously wrong. She’d started her period at the beginning of the trip, and everything seemed normal. But when she took a quick bathroom break that afternoon, she realized she was bleeding way more than usual, and the amount of blood and tissue she was losing set off alarm bells.
“My initial thought was, This isn’t a regular period. Something’s happening. My body is trying to expel something toxic,” she says. “It was basically my regular period times 10.”
That night, Rachel considered going to the emergency room but ultimately decided against it. She called her sister, who told her to eat some red meat to counter all the iron she might have lost. Although she was worried, Rachel powered through the rest of her trip and tried to put it out of her mind.
Once she was back home (and still bleeding), Rachel made an appointment with her gynecologist, who did an in-office ultrasound. “My doctor could determine there was a mass in my uterus, but he couldn’t tell what the mass was or if there was more than one,” Rachel says. Her doctor said it could be a fibroid, a cyst, or both. To find out for sure, he needed Rachel to go to a women’s imaging center, a specialized place to get a uterus scan, for a saline sonogram, which would inflate her uterus enough to provide a 360-degree view of the inside of it. He also prescribed Rachel a high-estrogen birth control pill to ease the heavy bleeding she was still experiencing. Taking the Pill didn’t stop it completely, but it did help lessen it.
At her sonogram appointment two and a half weeks later, the imaging specialists told her she had a “large myoma,” or fibroid, which was about 11 centimeters (by comparison, a baby’s head is about 10 to 12 centimeters). They sent the images to her doctor, who they said would call Rachel to discuss exactly what that meant.
Rachel began doing online research to figure out what was going on inside her body. But she made sure not to fall down an Internet rabbit hole by trying to determine what she should do next. “I just wanted to educate myself about what a fibroid is,” Rachel says. “I didn’t want to read into removal that much. I wanted to talk about it with my doctor.”
The 411 on Uterine Fibroids
According to board-certified ob-gyn Pari Ghodsi, M.D., who does not treat Rachel, fibroids are growths developed out of the muscle tissue in the uterus. They’re usually smaller than three centimeters, and most of the time, women with them have more than one. “Fibroids are most common in women ages 30 to 40, but they can occur at any age,” Ghodsi explains. “Overall, they are very common.”
Jason James, M.D., medical director at FemCare Ob-Gyn in Miami, who also doesn’t treat Rachel, says that many women with fibroids don’t experience symptoms. Those who do, however, “may complain of pelvic pain or pressure, pressure on the bladder or rectum, discomfort during sexual intercourse, or heavier or more frequent periods,” James says, with symptoms more likely to occur as women approach menopause. He adds that there isn’t anything women can do to prevent fibroids, but cancerous fibroids are “quite rare."
Rachel’s doctor called about a week later. “That was the most torturous week ever,” she says. He confirmed that she had a large fibroid, which he believed could be removed via laparoscopic surgery. He told her that based on the images, he thought hers was benign, and he had his office send her a recommendation for a laparoscopic specialist.
Around the third week of January, Rachel met with the recommended specialist. It didn’t go well. “I asked a lot of questions because everyone should ask a lot of questions when in that position,” she says. But Rachel felt the specialist met her curiosity with annoyance and frustration.
Finally, Some Help
Upset after the consultation, Rachel spoke to a family member, who recommended a surgeon at a local hospital. During this consultation a couple of weeks later, Rachel and the surgeon hit it off right away, with this specialist taking the time to explain the ins and outs of the procedure, what the impact could be on her fertility, and how they’d address that during the surgery, even drawing a sketch for some of the harder-to-grasp concepts.
“She seemed so incredibly familiar with the procedure,” Rachel says. “She had a vested interest along with me in preserving the life and fertility of my uterus. She made me less afraid about the size of my fibroid.”
On March 14, Rachel’s fibroid was successfully removed—and it has since been confirmed to be benign. Her recovery is slated to take about six weeks. She already feels better with the fibroid gone, noting that her stomach isn’t as distended as it had been and she’s no longer rushing to the bathroom every 20 minutes without that mass weighing on her bladder. Looking back, Rachel realized she’d been having symptoms for about a year but chalked up the bloating and irregular periods she’d been experiencing to getting older, especially since she’d never had a problematic annual exam at the gyno.
James and Ghodsi explain that a fibroid would be detected during a routine pelvic exam only if it were large enough to be felt by the doctor. “Also, a woman’s body shape can affect the likelihood of detecting them during an exam,” James adds. “Women who are overweight or obese may be more difficult to assess.”
Though laparoscopic surgery is one method of removal, James says a woman can also have a hysterectomy if more conservative options don't work.
Before the surgery, Rachel’s surgeon told her that removing the fibroid could only improve her fertility, but there was a chance she might have to deliver via C-section instead of vaginally when the time comes.
James notes that women who have had fibroids are predisposed to their recurrence, and Rachel wants to make sure she's prepared in case she is one of them. She plans to ask her insurance company to clear her for regular ultrasounds or sonograms since her surgeon told her hers was likely growing for years before she started to experience symptoms.
Rachel cautions other women not to make assumptions when it comes to their health and to take action early because the time span between when the symptoms ramp up and diagnosis can be an emotional roller coaster.
“The weeks of unknown as I went for imaging and scans were really difficult emotionally, on top of dealing with the symptoms of the fibroid—I basically had my period for two months—so the sooner you can have an exam and dialogue with your gyno, the better," she says.