It's common for women to experience weariness and discomfort during their periods. Yet few want anyone else to know they're having such symptoms. Menstruation, in the words of Karen Houppert, author of The Curse: Confronting the Last Unmentionable Taboo, has a "culture of concealment" that associates periods with embarrassment and disgust.
In part because of this stigma, women with heavy periods often presume they just have to suffer with their symptoms and may take a long time to get medical care. Physicians also sometimes don't view menstrual problems as particularly serious. They may fail to fully evaluate conditions such as iron-deficiency anemia, a common result of heavy bleeding that can leave women exhausted and prevent them from fully functioning both at work and in their personal lives.
As a result, a common condition and frequent cause of heavy bleeding -- fibroids -- are often under-diagnosed and under-treated. Fibroids are benign growths in the uterus and occur in a majority of women younger than 50. They can be tiny and assymptomatic, and sometimes go away on their own. The most common treatment for fibroids has historically been hysterectomy, in which the uterus is removed surgically. But hysterectomy can have significant physical and emotional consequences, as outlined in a presentation last year at the national Patient-Centered Outcomes Research Institute. "My greatest regret is that I never had children of my own," said one woman quoted in the presentation. "A large fibroid causing great pain, pressure, and debilitating bleeding necessitated a hysterectomy in my 30s."
Despite their prevalence, fibroids have been understudied, especially among black women, who suffer disproportionately from the condition. My article in this week's Washington Post health section explores the consequences of fibroids and includes the story of Sateria Venable, an engineer who courageously discusses her experiences. The article is accompanied by a sidebar that discusses newer, less-invasive therapies for the condition. There's no good reason for fibroids to continue to cause such a high degree of suffering. But awareness of the condition is key if women are to get prompt and appropriate treatment.
Follow Erin N. Marcus, M.D. on Twitter: www.twitter.com/ErinNMarcusMD