The Different Schools of Thought on Fibroid Treatments
When it comes to treating this condition, doctors are divided.
Acupuncturist Dr. Hui Kang treats a patient at her Paoli clinic//Photo by Tessa Marie Images.
Fibroids are having a moment. Real Housewives’ Bethenny Frankel, Cynthia Bailey, Kenya Moore and Kandi Burruss had them, as did former Secretary of State Condoleezza Rice. Those women had surgery to remove their fibroids and, in late July, 36-year-old singer/songwriter Sara Bareilles followed suit. Bareilles shared her experiences on Instagram, documenting the process from her hospital bed.
The noncancerous tumors grow inside and outside the uterus. Some are tiny and harmless, while others can grow to be the size of a grapefruit. Celebrities speaking publicly about fibroids sheds light on a condition that is seldom discussed because of the graphic nature of its symptoms. Pelvic and abdominal pain, severe cramps, lower back pain, and extreme bloating are just a few. Some fibroids cause bleeding that’s so excessive it renders women anemic.
Dr. Jay Goldberg has treated fibroids for years. He founded the Jefferson Fibroid Center and is now director of the Philadelphia Fibroid Center at Einstein and vice chair of Einstein Healthcare Network’s OB-GYN department. He has an arsenal of treatments at his disposal, from oral contraceptives to an IUD that controls bleeding to Lupron, a medication that manufactures temporary menopause and shrinks fibroids. Two surgical procedures—myomectomy and uterine fibroid embolization—provide relief while leaving the uterus intact. “Depending on the number and size of the fibroids, a myomectomy can be more invasive than a C-section,” Goldberg says. “We go in through the abdomen to remove the fibroids.”
Most of Goldberg’s patients make a full recovery and are back to work within two weeks of surgery. Still, new fibroids can form and become problematic. Doctors can’t predict the chances of that happening because even they aren’t exactly sure why fibroids grow. “There is thought to be a genetic link and a family-history risk,” says Goldberg.
Dr. Hui Kang, an acupuncturist with offices in Paoli and Narberth, has a different take. Kang earned an MD in her native China and taught at the Beijing University of Chinese Medicine and McGill University in Canada. When she moved to the U.S., she became licensed and board certified in acupuncture and oriental medicine, with special certification in reproductive medicine. To Kang, fibroids and infertility have a common link: hormone imbalance. “Estrogen and progesterone are the main hormones involved, but an imbalance in other hormones—FSH, DHEA, cortisol—can cause problems in women,” Kang explains.
Goldberg dismisses that idea. “Women with and without fibroids have about the same levels of estrogen and progesterone, so there is no apparent imbalance,” he says. “An overall change in hormones—an increase or decrease linked to pregnancy or menopause—can affect fibroids, but there is no documentation of an imbalance.”
To Kang, the hormone imbalance seems both logical and obvious. Fibroid symptoms wax and wane over a woman’s menstrual cycle, she says, just as her hormones do. “The period doesn’t lie,” says Kang.
That story is different for every woman. To get a full picture of a woman’s hormonal health, Kang has patients fill out a lengthy questionnaire, measures pulse points, and conducts an applied kinesiology test to gauge response to different substances. Results differ by patient, but the overall problem is Qi (Chi) stagnation. Qi can be blocked by poor nutrition, insomnia, emotional stress, and other aspects of modern life. “When Qi flows, we are happy,” says Kang. “When Qi is blocked, bad things happen.”
Kang inserts fine needles into specific points on the body to unblock Qi. There are more than 400 points on the head, arms, legs, torso and back. They follow certain meridians that correspond to different organs. Kang’s goal is to increase or decrease the production of whichever hormones are out of balance.
Sessions last 45 minutes. Some patients need three months of treatment to find complete relief from fibroid symptoms, but most feel better within the first few sessions. Many have tried everything else without success. “Some people lie on the table with needles in them and tell me they doubt it will work, but they’re at the end of the road and don’t know what else to try,” says Kang.