General Manager, Theramex UK
Dr Aziza Sesay
NHS GP with a special interest in Women’s Health and Health Inequity
Dr Natalie Cooper
Consultant Obstetrician and Gynaecologist, Barts Health NHS Trust and Academic Clinical Lecturer in Obstetrics and Gynaecology at Queen Mary University of London
The need for a better understanding of uterine fibroids in the general population is pressing, with many patients presenting late for specialist support.
Uterine fibroids (UF), also called leiomyomas or myomas, are growths that appear in the uterus. They are noncancerous and extremely common. When they enter the cavity of the womb, they can influence surface area and affect the functioning of the uterus.
Supporting women presenting symptoms
“Not everyone with fibroids has symptoms; and they can be small or large,” explains Dr Natalie Cooper, a consultant obstetrician and gynaecologist at Barts Health NHS Trust. However, many women do have symptoms including heavy or prolonged periods, bleeding between periods, abdominal discomfort, pelvic and lower back pain, plus bladder symptoms.
There are many myths and misconceptions surrounding period symptoms as well, according to Dr Aziza Sesay, an NHS GP specialising in women’s health and health inequity. “Many are not aware that having heavy periods is not normal, and this is a common symptom of fibroids. Many are unaware of what constitutes a heavy period,” she says.
Research calls for individualised care
Dr Cooper, who has conducted research on heavy menstrual bleeding, says: “Fibroids restrict women and affect their relationships.” She hopes her research will help to create standardised treatment outcomes.
“At the moment, there are several treatments suitable to manage individual symptoms of UF, such as heavy periods,” she adds. “So, we end up with too many options. However, through standardised data, we can better understand which treatments have the best outcomes for various UF symptoms. Women deserve individualised care. At present, they often feel misunderstood or ignored, which is utterly wrong.”
There is an attitude that, because it is not cancerous, it is seen as not that terrible. However, some patients end up needing a hysterectomy.
Diagnoses being missed
Many patients are still waiting well beyond the NHS standard of 18 weeks referral time for treatment. For patients who are in distress and may need surgery, this can be a life-changing wait, which can impact fertility. “We found, talking to experts, that the link between UFs and abnormal menstrual bleeding is being missed,” explains Tina Backhouse, General Manager of women’s health pharmaceutical company Theramex.
“There is an attitude that, because it is not cancerous, it is seen as not that terrible. However, some patients end up needing a hysterectomy.” She adds: “Women are encouraged to put up with heavy menstrual bleeding as they get older because no one likes to talk about blood loss even if it leads to iron deficiency.”
Dr Sesay also runs a health platform providing visual aids on fibroids. She says: “We need to ensure that the information is available and accessible to all — in a format that is easy to understand, inclusive and culturally sensitive.”
Fibroids occur more commonly in Black and South Asian groups compared to their White counterparts. “There is still not much understanding as to why this is the case, as more research is needed. The reality about its prevalence within our communities absolutely needs to be raised both within the communities themselves and to healthcare professionals.”
Drugs not being made available
Theramex worry that Government priorities and policymaking could slow down the availability of new drugs. “Gynaecology has been one of the worst hit specialisms since Covid; partly because of the consultant vacancies,” Backhouse explains. “However, even when NICE reviews have approved their clinical use, many health trusts fail to offer valuable UF medicines — which can improve symptoms and keep patients out of A&E. This is a travesty, as they should be prescribing them within 90 days of NICE approval.”
Postcode prescribing means that those who cannot afford private treatment are more likely to suffer in silence. This adds to the imperative to offer treatments at a nationwide level, insists Backhouse. The need for a better understanding of fibroids in the general population is pressing — starting from what exactly they are to the symptoms associated, their risk factors and all the treatment options available.
This article has been sponsored by Theramex with contribution by Tina Backhouse.
The views and opinions of the healthcare professionals are not necessarily those of Theramex.