The impact of uterine leiomyomas: a national survey of affected women


      We sought to characterize the impact of uterine leiomyomas (fibroids) in a racially diverse sample of women in the United States.

      Study Design

      A total of 968 women (573 white, 268 African American, 127 other races) aged 29-59 years with self-reported symptomatic uterine leiomyomas participated in a national survey. We assessed diagnosis, information seeking, attitudes about fertility, impact on work, and treatment preferences. Frequencies and percentages were summarized. The χ2 test was used to compare age groups.


      Women waited an average of 3.6 years before seeking treatment for leiomyomas, and 41% saw ≥2 health care providers for diagnosis. Almost a third of employed respondents (28%) reported missing work due to leiomyoma symptoms, and 24% believed that their symptoms prevented them from reaching their career potential. Women expressed desire for treatments that do not involve invasive surgery (79%), preserve the uterus (51%), and preserve fertility (43% of women aged <40 years).


      Uterine leiomyomas cause significant morbidity. When considering treatment, women are most concerned about surgical options, especially women aged <40 years who want to preserve fertility.

      Key words

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        • Baird D.D.
        • Dunson D.B.
        • Hill M.C.
        • Cousins D.
        • Schectman J.M.
        High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence.
        Am J Obstet Gynecol. 2003; 188: 100-107
        • Laughlin S.K.
        • Stewart E.A.
        Uterine leiomyomas: individualizing the approach to a heterogeneous condition.
        Obstet Gynecol. 2011; 117: 396-403
        • Carlson K.J.
        • Nichols D.H.
        • Schiff I.
        Indications for hysterectomy.
        N Engl J Med. 1993; 328: 856-860
        • Walker C.L.
        • Stewart E.A.
        Uterine fibroids: the elephant in the room.
        Science. 2005; 308: 1589-1592
        • Marshall L.M.
        • Spiegelman D.
        • Barbieri R.L.
        • et al.
        Variation in the incidence of uterine leiomyoma among premenopausal women by age and race.
        Obstet Gynecol. 1997; 90: 967-973
        • Zimmermann A.
        • Bernuit D.
        • Gerlinger C.
        • Schaefers M.
        • Geppert K.
        Prevalence, symptoms and management of uterine fibroids: an international Internet-based survey of 21,746 women.
        BMC Womens Health. 2012; 12: 6
        • Spies J.B.
        • Coyne K.
        • Guaou Guaou N.
        • Boyle D.
        • Skyrnarz-Murphy K.
        • Gonzalves S.M.
        The UFS-QOL, a new disease-specific symptom and health-related quality of life questionnaire for leiomyomata.
        Obstet Gynecol. 2002; 99: 290-300
        • Schonlau M.
        • Zapert K.
        • Simon L.P.
        • et al.
        A comparison between responses from a propensity-weighted web survey and an identical RDD survey.
        Soc Sci Comput Rev. 2004; 22: 128-138
        • Terhanian G.
        • Bremer J.
        • Smith R.
        • Thomas R.
        Correcting data from online surveys for the effects of nonrandom selection and nonrandom assignment.
        Harris Interactive. 2000; (Available at:) (Accessed July 31, 2013)
      1. Rothman KJ, Greenland S, Lash TL. Modern epidemiology. Philadelphia, PA: Lippincott, Williams, and Wilkins; 2008.

        • Deddens J.A.
        • Petersen M.R.
        Approaches for estimating prevalence ratios.
        Occup Environ Med. 2008; 65:481: 501-506
        • Zou G.
        A modified Poisson regression approach to prospective studies with binary data.
        Am J Epidemiol. 2004; 159: 702-706
        • Cardozo E.R.
        • Clark A.D.
        • Banks N.K.
        • Henne M.B.
        • Stegmann B.J.
        • Segars J.H.
        The estimated annual cost of uterine leiomyomata in the United States.
        Am J Obstet Gynecol. 2012; 206: 211.e1-211.e9
        • Peddada S.D.
        • Laughlin S.K.
        • Miner K.
        • et al.
        Growth of uterine leiomyomata among premenopausal black and white women.
        Proc Natl Acad Sci U S A. 2008; 105: 19887-19892
        • Lee D.W.
        • Ozminkowski R.J.
        • Carls G.S.
        • Wang S.
        • Gibson T.B.
        • Stewart E.A.
        The direct and indirect cost burden of clinically significant and symptomatic uterine fibroids.
        J Occup Environ Med. 2007; 49: 493-506
        • Hartmann K.E.
        • Birnbaum H.
        • Ben-Hamadi R.
        • et al.
        Annual costs associated with diagnosis of uterine leiomyomata.
        Obstet Gynecol. 2006; 108: 930-937
        • Flynn M.
        • Jamison M.
        • Datta S.
        • Myers E.
        Health care resource use for uterine fibroid tumors in the United States.
        Am J Obstet Gynecol. 2006; 195: 955-964
        • Lee D.W.
        • Gibson T.B.
        • Carls G.S.
        • Ozminkowski R.J.
        • Wang S.
        • Stewart E.A.
        Uterine fibroid treatment patterns in a population of insured women.
        Fertil Steril. 2009; 91: 566-574
        • Wechter M.E.
        • Stewart E.A.
        • Myers E.R.
        • Kho R.M.
        • Wu J.M.
        Leiomyoma-related hospitalization and surgery: prevalence and predicted growth based on population trends.
        Am J Obstet Gynecol. 2011; 205: 492.e1-492.e5
        • Rocca W.A.
        • Grossardt B.R.
        • Shuster L.T.
        • Stewart E.A.
        Hysterectomy, oophorectomy, estrogen, and the risk of dementia.
        Neurodegener Dis. 2012; 10: 175-178
        • American College of Obstetricians and Gynecologists
        ACOG practice bulletin: alternatives to hysterectomy in the management of leiomyomas.
        Obstet Gynecol. 2008; 112: 387-400
        • Wise L.A.
        • Palmer J.R.
        • Harlow B.L.
        • et al.
        Reproductive factors, hormonal contraception, and risk of uterine leiomyomata in African-American women: a prospective study.
        Am J Epidemiol. 2004; 159: 113-123
        • Wise L.A.
        • Palmer J.R.
        • Stewart E.A.
        • Rosenberg L.
        Age-specific incidence rates for self-reported uterine leiomyomata in the black women's health study.
        Obstet Gynecol. 2005; 105: 563-568
        • Heiervang E.
        • Goodman R.
        Advantages and limitations of web-based surveys: evidence from a child mental health survey.
        Soc Psychiatry Psychiatr Epidemiol. 2011; 46: 69-76
        • van Gelder M.M.
        • Bretveld R.W.
        • Roeleveld N.
        Web-based questionnaires: the future in epidemiology?.
        Am J Epidemiol. 2010; 172: 1292-1298
        • Kaplan R.M.
        Shared medical decision making: a new tool for preventive medicine.
        Am J Prev Med. 2004; 26: 81-83