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Thousands of Women Turn to ER for Uterine Fibroid Relief. Maybe They Shouldn’t.

Photo by Adhy Savala on Unsplash

Women are heading to an unexpected place to receive treatment for uterine fibroids—the emergency room. Some symptoms of uterine fibroids, including heavy menstrual bleeding that won’t stop, pelvic pressure and difficulty emptying the bladder, would send any woman into a panic and heading to the nearest emergency room.

In spite of that, the ER is not the best course of treatment, as fibroids are a chronic condition, and care is costly, according to researchers from Michigan Medicine (University of Michigan).

Fibroids are benign muscular tumors that grow on the uterine wall and are known to cause a variety of worrying symptoms. An estimated 26 million women between the ages of 15 and 50 have uterine fibroids, according to the National Institute of Health. A woman of any race can develop fibroids, but Black women are disproportionately impacted.

The researchers evaluated more than 487 million emergency visits by women between the ages of 18 and 55 over an 11-year period for their study. Thousands of women visited the ER for uterine fibroids, and the number of visitations more than doubled from 28,732 to 65,685 during the study period. Hospital admission rates fell 13%, and only 1 in 10 fibroid-related ER visits resulted in hospital admittance, signifying that most cases can be managed in a non-emergency setting.

"Fibroids are often a chronic disease, so we have opportunities to treat this through established care with a trusted health provider,” Erica E. Marsh, MD, chief of the division of reproductive endocrinology and infertility at the Center for Reproductive Medicine at Michigan Medicine Von Voigtlander Women's Hospital, said in a statement. “Yet we’ve seen a big increase in women using the emergency room for fibroid care.”

Emergency room physicians typically require the patient to receive immediate imaging, to get to the root cause of the pelvic pain and continuous menstrual bleeding, leading to skyrocketing costs. The average cost for a fibroid-related ER visit was $6,000, and researchers believe many of these patients, especially those who are uninsured or low-income, would have fared better in an outpatient imaging facility.

More research should be conducted to determine why women look to the emergency department for a chronic condition like fibroids. And more importantly, resolving barriers to fibroid care should be a priority as women who are uninsured are less likely to be admitted to the hospital even if they have a serious condition like uncontrolled bleeding.

"Ultimately, we want to ensure patient centered and equitable care for all individuals with this chronic condition," Marsh said.

The study was published in Obstetrics & Gynecology.

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