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More People Are Turning to the Emergency Room for Fibroid Care

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The central theses

  • A study shows that from 2006 to 2017, trips to the emergency room increased for women with fibroids.
  • These benign masses in the uterine wall can cause profuse bleeding.
  • Researchers believe patients go to the emergency room because they don’t have established relationships with long-term providers who can help treat their fibroids.

More and more people are coming to the emergency room for fibroid symptoms such as abdominal pain and heavy bleeding. However, research shows that regular care and checks could avoid these visits.

According to a new study published in the Obstetrics & Gynecology Green Journal, the number of ER admissions for women with fibroids rose from 28,732 in 2006 to 65,685 in 2017.

While the research found that the number of emergency room visits has increased, the admission rate for people with fibroids decreased from 23.9% in 2006 to 11.1% in 2017.

The researchers say this drop in hospital admissions suggests that the fibroid visits could have been treated in an alternative setting without emergencies.

“If we look at the overall low percentage of patients who are admitted, it suggests that many of these visits can be done on an outpatient basis with a trusted provider,” said study co-author, Erica E. Marsh, MD, MSCI, FACOG , S. Jan Behrman College Professor of Reproductive Medicine at the University of Michigan Medical School, says Verywell.

Why are visits to the emergency room increasing?

Fibroids are benign, non-cancerous masses or tumors in the wall of the uterus, according to Marsh. These masses vary in size from the size of a seed to the size of a watermelon.

“We do not know, why [fibroids] develop, “says Marsh. It is known that fibroids” increase the overall size of the uterus and cause more menstrual bleeding “.

In some cases, it is this bleeding that causes people to see a doctor. The results of the study show that although many people with fibroids go to the emergency room, they are not hospitalized for the condition.

The researchers analyzed over 487 million emergency room records of women aged 18 to 55 that were made between 2006 and 2017. In particular, they examined access to fibroid care and the use of the emergency room to treat fibroid symptoms.

The study found that emergency room visits were highest among low-income women between the ages of 36 and 45.

While the study specifically looked at women with fibroids, the condition can affect anyone with a uterus.

Marsh points to several factors explaining the trend towards emergency room visits for people with fibroids.

“One concern is that patients don’t have an established relationship with a gynecologist who allows them to manage their fibroid symptoms in a trustworthy environment,” she says. “One of the other challenges is that they may not have this relationship with the provider due to a lack of insurance.”

Even if they have insurance, people may not know who to turn to for treatment. “Some patients may not understand that the problem is gynecological and that they need to see a gynecologist or other gynecologist,” says Marsh.

Fibroids are difficult to diagnose

Fibroids can be difficult to diagnose because they often don’t cause symptoms – only 25 to 50% of people with the condition have symptoms such as abdominal pain or heavy bleeding.

When these symptoms are intense, a person’s concern may cause them to go to the emergency room even though the location is not an ideal location for the fibroid care.

Marsh says emergency room doctors typically don’t have the time to fully advise patients about uterine fibroid treatment options – a specialist might be more likely to help.

“Obstetricians have special training that enables us to advise patients on their treatment options for fibroids,” says Marsh. “This includes medical, surgical and interventional radiology treatments.”

In addition to the fast-paced emergency room environment, visits are typically costly: treating fibroids in the emergency room is ten times more expensive than care in an emergency clinic.

What that means for you

If you have uterine fibroid symptoms such as excessive bleeding and abdominal pain, you should contact a doctor or gynecologist for treatment. This can be a cheaper option than paying for an expensive emergency room visit.

Delayed diagnosis and treatment

Alexis May Kimble, DO, a two-time certified physician in gynecology and female pelvic medicine based in California, says Verywell that untreated fibroids can lead to long-term health consequences.

“If fibroids are not diagnosed, misdiagnosed, or treated improperly, patients can experience the benign tumor growth and the associated symptoms of pain or excessive bleeding worsening,” says Kimble.

According to Marsh, fibroids can also cause:

  • Pelvic pain
  • Lower back pain
  • Infertility,
  • Painful intercourse
  • Urinary frequency

“The symptoms that [fibroids] Causes are mainly determined by where they are in the uterine wall and how big they are, ”says Marsh.

Lack of equal access to fibroid care

For people with fibroids, Marsh emphasizes the importance of the patient-provider relationship in accessing care.

“When a patient has a relationship with their provider, they know their provider,” says Marsh. “You’re talking to someone you think knows and cares for you. The patients are properly cared for at the right time. ”

And while fibroids are the most common benign gynecological disease in the United States, they disproportionately affect patients with specific racial and ethnic backgrounds.

“We know that the prevalence of fibroids in women of African descent is higher than in women of European descent,” says Marsh.

About 80% of African American women will have fibroids by the age of 50. They are also two to three times more likely to have a hysterectomy for fibroids than other ethnic groups.

Growing awareness

Marsh stresses the need for more national campaigns to educate people about fibroids and how to treat them.

“A lot of people don’t know about fibroids and that they are the main cause of heavy menstrual bleeding,” adds Marsh. “I think we can really help educate people about their bodies and what is normal and what is abnormal so that individuals are able to go to health care providers.”

Women’s Health

Your Community: Health and wellness resources

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Taking care of your health, both body and mind, plays an important role in determining your quality of life. When you are so busy taking care of others it is easy to forget to take care of yourself. This can happen gradually, and you may not even realize that there is a problem until you reach a breaking point. You may have chosen to just “live with it” and let the problem persist even though treatment options are available. However, this is not always a choice as ignorance of who to turn to or the cost of treatment could be a major obstacle for many. Fortunately, the Johnson County Library has compiled health and wellness resources that will connect you with information and guidance to help you perform at your best.

These health-related and medical resources offer a variety of perspectives on complementary, holistic, and integrated approaches to health care and wellness presented in understandable language. Discover authoritative medical information on medicines, nursing, dentistry, the healthcare system, preclinical science, even veterinary medicine, and more. The resources also cover topics such as cancer, diabetes, drug and alcohol addiction, fitness, nutrition and dietetics, child health, aging, and men’s and women’s health. Find and browse medical encyclopedias, popular reference books, and magazine articles. You will find articles with detailed background guidance on diagnoses and treatments that have helpful descriptive images.

For those seeking healthcare help, resources are available to help the uninsured and underinsured. Find local, affordable health services, including primary care, emergency care, dental care, prescription help, and free helplines. Search a directory that enables caregivers in the greater Kansas City area to find resources for the elderly, including financial assistance, nutrition, legal assistance, health care providers, housing options such as assisted living facilities, and mental health services.

Discover, challenge and train your mind with articles and courses online. Access the world’s largest full-text database on psychology, with full articles from nearly 400 journals. Topics include emotional and behavioral traits, psychiatry and psychology, philosophy, theology, mental processes, anthropology, and observational and experimental methods. There are also convenient online courses. Explore the course catalog to see all the offers and to register for a course. With over 500 online courses on topics such as alternative medicine, health & medicine, personality development, psychology, and self-help, you’re sure to find something that piques your interest and occupies you.

Take care of your mind and body with resources designed for you. Check out the health and wellness resources at jocolibrary.org today.

Johnson County Library – Promoting the community’s collective wisdom

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Women’s Health

Medical failure with painful women

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I got sick 10 years ago. In October 2010, the cause of the strange pain that had plagued me for many years was finally revealed and I was diagnosed with systemic lupus erythematosus (SLE), the most common form of lupus, a chronic autoimmune disease. .. 90 percent of the estimated 3.5 million people who have it are women. Like many other autoimmune and chronic diseases that affect woman’s imbalance, such as polysclerosis, Graves disease, myasthenia gravis, rheumatoid arthritis, and endometriosis, SLE is incurable. The cause is not fully understood.

For years after being diagnosed, I learned to live with a mysterious and unpredictable disease, so I dug up my medical history for an answer. Like many Russian nest dolls, sick women appeared from the medical chronicles. Their medical history often followed a similar pattern: teething, years of pain and mysterious symptoms, and repeated misdiagnosis. These women were part of my story. However, observations of her disability and symptoms in clinical trials have told only a small part of her story. The records of their fall gave clues about their bodies but said nothing about the meaning of life within them.

I tried to imagine what it would feel like when a sick woman had a disease that was beyond medical understanding at these different points in history. I felt a close relationship. We shared the same basic biology. What has changed over time is that medicine understands him, not the female body.

The author, who suffers from the most common form of lupus, took a photo at her home on June 8th.

Photo:
The Wall Street Journal Dylan Thomas

Since ancient Greece, spirits of suspicion and discrimination have been plagued by medical treatises on women’s health. The author of Hippocrates Corpus, a seminal article on Western medical practice, spoke about “inexperience and ignorance” of female physical and disease problems. In the 17th century, hysteria emerged as an explanation for the various symptoms and diseases in women. Derived from the ancient Greek hysteria, hysteria, which means uterus, was originally derived from the reproductive organs, which have been the cause of many women’s diseases since the Hippocratic era.

In the 19th century, especially when the cause of the disease could not be identified immediately, female hysteria moved “to the center of the stage” and “became a clear topic in numerous medical texts,” said the British medical historian Roy. Porter writes in “Hysteria Beyond Freud”. .. As the cultural critic Elaine Showalter has shown in her influential story The Female Malady, prominent doctors and psychiatrists at the time were aware of the perception of women who create symptoms of hysteria for attention and empathy. Connected to trends.

Prejudices against the body, mind and life of women cast a long shadow over modern clinical and biomedical knowledge. Graves’ disease, an autoimmune thyroid disease that affects 70-80% of women more than men, was first described in 1835 as “female nervousness” and in 1956 as an autoimmune causal link. Was called psychosomatic after the discovery. Graves’ disease, an autoimmune neuromuscular disease first mentioned in 1877, was misdiagnosed as mentally ill and rejected as a psychosomatic disease in the 20th century. Multiple sclerosis has been known to be more common in women since the 1940s, but this prevalence has long been obscured by the assumption that female neuropathy and movement disorders are neuropathy or hysteria. Was there.

In 1955, Johns Hopkins’ chronic disease expert found that over the past decade, several women who were eventually diagnosed with lupus after a doctor misdiagnosed chronic physical pain had been treated with electroshock therapy, insulin. He revealed that he had tolerated unnecessary psychiatric and surgical procedures such as coma and hysterectomy. As a symptomatism of emotional instability. Ulcerative colitis is a chronic bowel disease that affects women’s reproductive and sexual functions in ways that are not well understood and that have historically been attributed to psychological distress. The recommended treatment for female patients in the 1950s was prefrontal lobotomy.

“”
It was only a generation ago that a groundbreaking study from 2001 created widespread awareness of the “gender pain gap”.

Until the late 20th century, clinical studies and biomedical research relied heavily on male subjects and male laboratory animal models. US law of 1993 required the appropriate involvement of women and minority members in projects funded by the National Institutes of Health. This led, for example, to the first large-scale study on the preventive effects of aspirin on cardiovascular disease in women. In previous exams only men were enrolled.

A widespread awareness of the “gender pain gap” arose only a generation ago as a result of a groundbreaking study from 2001 entitled “Girls Who Cry Pain: Prejudice against Women in the Treatment of Pain”. Using clinical data and social research collected since the 1970s, authors Diane Hoffman and Anita Talzian, medical ethics and law scholars at the University of Maryland, found that women were more comforting than stated they were more likely to be prescribed antidepressants. They considered this inequality to be “unreliable because it is more emotionally based on the pain of women”.

Recently, a Swedish team analyzed gender and pain studies published in the US, UK and Europe since 2001, and pain in women is more often “psychological” than men. It’s not taken very seriously. “

A 2019 and 2020 report by two related teams based in Toronto analyzed studies on the treatment of heart disease and depression and found that women had fewer referrals and procedures than men. Women also tended to declare poor communication with doctors. The report can change the dynamics by developing specific “patient-centered” treatment regimens in treating women, including training doctors to “listen actively” and “question”. It has been suggested that few practical studies have been found to initiate such practices.

One of the bright spots is that the number of women doctors is increasing. Women themselves report better diagnosis and treatment results when they are treated by a doctor. According to a 2018 report by the National Academy of Sciences, female patients are more likely to survive a heart attack if their doctor is a woman. Men still outnumber active U.S. doctors, but in 2019 women made up 36.6% of the field, 8 points more than in 2007.

Share your thoughts

Have you or your family and friends found that women are more likely to dismiss health problems than men? Join the conversation below.

Last year, the Covid-19 pandemic demonstrated the importance of integrating gender differences into medical research. Studies have shown that women, especially women over 55, are more likely to experience long-term post-viral symptoms such as shortness of breath, malaise, and brain fog. Women also seem to have more side effects after vaccination, including life-threatening ones, but the extent and severity of possible risks are not yet understood.

Today researchers have realized that the exact reason for the gender differences in the incidence of my disease, SLE, was prevalent in women over a century ago, but it remains largely a mystery. More research is urgently needed to understand how and why far more women are affected by complex chronic and immunological diseases, but women also experience their own pain and illness experiences. Must be valued more as an accurate reporter. Many of the answers lie in the female body, which has been written by the female body for centuries.

Copyright © 2020 DowJones & Company, Inc. All rights reserved. 87990cbe856818d5eddac44c7b1cdeb8

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Women’s Health

Medicine’s Failure With Women in Pain

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I became a sick woman 10 years ago. In October 2010, the cause of the strange pain that had haunted me for years was finally uncovered and I was diagnosed with systemic lupus erythematosus (SLE), a chronic autoimmune disease that is the most common form of lupus. Ninety percent of the estimated 3.5 million people who have it are women. Like many other autoimmune and chronic diseases that disproportionately affect women – including multiple sclerosis, Graves’ disease, myasthenia gravis, rheumatoid arthritis, and endometriosis – SLE is incurable and its cause is not fully understood.

In the years since my diagnosis, as I learned to live with my mysterious, unpredictable disease, I looked for answers through my medical history. Unwell women, like so many Russian nesting dolls, emerged from the annals of medicine. Their medical histories often followed similar patterns: childhood illnesses, years of pain and mysterious symptoms, and repeated misdiagnosis. These women were part of my story. But the observations of their disorders and symptoms in clinical trials told only a fraction of their stories. Notes on their cases gave clues about their bodies but said nothing about what it meant to live in them.

I tried to imagine what it felt like to be a sick woman struggling with an illness that defied medical understanding at these different points in history. I felt a close relationship; we shared the same basic biology. What has changed over time is not the female body, but medicine ‘s understanding of it.

The author, who suffers from the most common form of lupus, was photographed at her home on June 8th.


Photo:

Dylan Thomas for the Wall Street Journal

Specters of doubt and discrimination have haunted medical treatises on women’s health since ancient Greece. The authors of the Hippocratic Corpus, the fundamental treatise on Western medical practice, spoke of the “inexperience and ignorance” of women about their bodies and their diseases. In the 17th century, hysteria emerged as an explanation for a variety of symptoms and illnesses in women. Derived from the ancient Greek word hystera, which means uterus, it was originally believed that hysteria originated from the reproductive organs, which have been considered the source of many female diseases since the Hippocratic era.

In the 19th century, female hysteria “took center stage” and “became the explicit topic of numerous medical texts”, especially when the cause of an illness was not immediately apparent, wrote the British medical historian Roy Porter in “Hysteria Beyond Freud”. . “As the cultural critic Elaine Showalter has shown in her influential story“ The Female Malady ”, well-known doctors and psychiatrists of the time linked hysteria with the perceived tendency of women to fabricate symptoms for attention and sympathy.

Prejudices about the body, mind and life of women have cast a long shadow over modern clinical and biomedical knowledge. Graves’ disease, an autoimmune thyroid disease that affects 70-80% more women than men, had “female nervousness” in its earliest descriptions in 1835 and was even labeled psychosomatic, even after its autoimmune causality was discovered in 1956. Many women with myasthenia gravis, an autoimmune neuromuscular disease first mentioned in 1877, were diagnosed as mentally ill and dismissed as hypochondriac until the 20th century. Multiple sclerosis has been known to be more common in women since the 1940s, but this prevalence has long been obscured by the assumption that the neurological and motor disorders in women are nervous or hysterical.

In 1955, chronic disease specialists at Johns Hopkins revealed that over the past decade, several women who were eventually diagnosed with lupus had undergone unnecessary psychiatric and surgical procedures – including electroshock therapy, insulin coma, and hysterectomy – after doctors misdiagnosed their chronic physical pain diagnosed as a symptom of emotional instability. Ulcerative colitis, a chronic bowel disease that affects the reproductive and sexual functions of women in poorly understood ways, has historically been considered to be caused by psychological distress. The recommended treatment for patients in the 1950s was prefrontal lobotomy.


As a result of a groundbreaking study in 2001, the gender pain gap was widely recognized only a generation ago.

Until almost the end of the 20th century, clinical studies and biomedical research relied disproportionately on male subjects and male laboratory animal models. US law of 1993 required the appropriate involvement of women and minority members in projects funded by the National Institutes of Health. This led, for example, to the first large-scale research on the preventive effects of aspirin on cardiovascular disease in women; previous studies had only men enrolled.

As a result of the groundbreaking 2001 study, “The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain,” the gender pain gap was generally recognized only a generation ago. Authors Diane Hoffmann and Anita Tarzian, academics in medical ethics and health law at the University of Maryland, showed, based on clinical data and sociological research collected since the 1970s, that women were more likely to be prescribed sedatives and antidepressants than referred to diagnostic tests Chronic Pain Self-Assessment. They attributed this inequality to the fact that female pain is “more emotional and therefore less believable”.

Recently, a Swedish team analyzed research on gender and pain published in the US, UK and Europe since 2001 and concluded that women are still more “psychologized” and “taken less seriously” than men’s pain .

Reports from 2019 and 2020 from two related teams based in Toronto analyzed studies on the treatment of heart disease and depression and found that women received fewer referrals and procedures than men. Women were also more likely to describe poor communication with their doctors. The reports suggested that the development of specific “patient-centered” treatment regimens in treating women, including training clinicians in “active listening” and “asking questions”, may change the dynamics, but there has been little practical research into introducing them Practices.

One ray of hope is the increasing number of female doctors. Women themselves report better outcomes in diagnosis and treatment when they are cared for by female doctors, and female patients are more likely to survive a heart attack if their doctors are female, according to a 2018 report by the National Academy of Sciences. Although the number of men among active US doctors is still higher than that of women, women made up 36.6% of the field in 2019, an 8 percentage point increase from 2007.

SHARE YOUR THOUGHTS

Have you, family or friends seen that health problems are too easily dismissed by women compared to men? Join the conversation below.

Last year, the Covid-19 pandemic demonstrated the importance of integrating gender differences into medical research. Studies show that women, especially over 55, are more likely to experience persistent post-viral symptoms such as shortness of breath, fatigue, and brain fog. Women also seem to experience more side effects after vaccination, including some that are life-threatening, but the extent and severity of possible risks are not yet understood.

Today, the exact reasons for the gender inequality in the incidence of my disease, SLE, are still largely mysterious, although researchers recognized its prevalence in women more than a century ago. More research is urgently needed to understand how and why confusing chronic and immune-mediated diseases and conditions affect women in far greater numbers, but women also need to be valued more as accurate reporters of their own experiences of pain and illness. Many of the answers lie in the bodies of women and in the stories their bodies have been writing for centuries.

Copyright © 2020 Dow Jones & Company, Inc. All rights reserved. 87990cbe856818d5eddac44c7b1cdeb8

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