How One Center is Revolutionizing Fibroid Care

This NYU Langone center is changing the narrative around fibroid care for women.

Heavy periods, pelvic pressure, bloating and pain–many people simply endure these common fibroid symptoms as part of their monthly menstrual period. Uterine fibroids are noncancerous tumors of the uterus that can affect up to 70% of women.

“Because fibroids are so common and recur so frequently, it’s a major condition that women suffer with for most of their reproductive years,” says Taraneh Shirazian, MD, board-certified gynecologist and director of the Center for Fibroid Care at NYU Langone Health. “And yet, it doesn't get prioritized in the way that it should.”

That’s why, at NYU Langone’s Center for Fibroid Care, a multidisciplinary team of experts is working to change this. By informing patients of the different options available to them, hosting educational events and developing individual treatment plans that focus on each patient’s distinct life goals, the center is showing women that they don’t have to live with their symptoms and can have an improved quality of life.

Board-certified gynecologist Dr. Taraneh Shirazian is the director of the Center for Fibroid Care at NYU Langone Health.

Personalized Care

Before patients even come into the Center for Fibroid Care, they receive an online packet that outlines all the options available, a standard quality-of-life survey and a life goals questionnaire developed by Dr. Shirazian. Then, a tele-visit is scheduled with a nurse practitioner to make sure the team has an understanding of who the patient is, what their goals are and what they’re struggling with.

“It helps us understand the nature of the disease, how aggressive your individual presentation of fibroids is and helps us know where to start in treatment recommendations,” Dr. Shirazian says. “We really want to get a sense of our patients before they ever come in to see us.”

This level of attentiveness to each patient, coupled with the center’s multidisciplinary approach, allows the doctors to devise a personalized plan that aligns with the patient's condition, lifestyle and goals. For patient Jennifer Medina, the center’s approach was vastly different from the five other doctors she had visited about her fibroid symptoms.

“I had been struggling with heavy periods, a lot of cramping and pain since I was about 15 years old,” Medina says. “It got progressively worse over the years, and with every physician that I spoke to, I got basically the same response: ‘Everyone has a different level of pain thresholds. Maybe yours is a little bit lower.’ Dr. Shirazian was the first doctor to ask me how I was feeling and how my experiences were with other doctors. She walked me through what some of the options were, starting with the most minimally invasive treatment. Then she explained her recommendation, which wasn't the surgery, but something in between called transvaginal ablation. Since then, the care has just been very intentional.”

Array of Options

Traditionally, the treatments for fibroids have been hysterectomy, a surgery that removes the whole uterus; or myomectomy, a surgery that removes one or multiple fibroids. Both of these procedures are extremely invasive and require a prolonged recovery period. The Center for Fibroid Care offers every treatment out there, ranging from holistic management—where a nutritionist helps guide patients through fibroid-friendly diets—to various levels of procedures and surgery.

“We're really interested in creating a one-stop shop for these patients,” says Elizabeth Morris, MD, a vascular and interventional radiologist at NYU Langone. “We want the experience to be seamless, convenient and efficient. We want patients to come in, get their needs identified, their symptoms addressed, get their imaging and see the right doctors all in one place.”

With a variety of specialists working together, the Center for Fibroid Care’s innovative multidisciplinary approach gives patients access to a wider variety of choices than other offices. A therapy Dr. Morris performs is an image-guided minimally invasive procedure called uterine fibroid embolization, which requires only a pinhole incision into the artery of the left wrist.

Dr. Elizabeth Morris performs an image-guided minimally invasive procedure called uterine fibroid embolization.

“Fibroids are benign tumors, so they're not cancer, but they pull away the blood supply from adjacent structures,” Dr. Morris says. “So we take advantage of that. We inject small beads into the arteries that supply the fibroids. And those small beads are sized in such a way to block the blood flow to the fibroids, and it basically starves them of what they need to thrive, and they become inactivated and shrink in place.”

Another option that requires no incision at all is transcervical radiofrequency ablation, the procedure that helped Jennifer, Dr. Shirazian’s patient. This relatively new vaginal procedure uses an ultrasound device to target individual fibroids and deliver radiofrequency to shrink them. With the help of the Center for Fibroid Care, more individuals are learning about these different routes that they can take when it comes to alleviating their symptoms and addressing their fibroids based on the size, number and location.

“With minimally invasive treatments, patients aren’t sitting around the hospital. They're able to walk around, they're able to go home and do their normal daily activities and they're also able to go back to work to provide for their families,” says Michelle Bennett, MD, minimally invasive gynecologic surgeon at NYU Langone practices in the Brooklyn neighborhoods of Cobble Hill and Midwood. “Patients don’t need to only go to Manhattan for high-quality care. We’re committed to bringing state-of-the-art treatments closer to where our patients live and work,” Dr. Bennett says.

Dr. Michelle Bennett is a minimally invasive gynecologic surgeon at NYU Langone, practicing in the Brooklyn neighborhoods of Cobble Hill and Midwood.

Research and Awareness

At the center, patient care extends beyond just the procedure or treatment—every patient is continuously monitored for years. “We create a home for patients that have fibroids, meaning women can follow with us throughout their reproductive lives,” Dr. Shirazian says. “We don't just offer treatment and then the patients leave us. We continue to follow them because we know that fibroids are recurrent. Being able to both offer treatment now and then follow the patient for years to come is very important in being able to continuously monitor this condition.”

Not only does this long-term care benefit the patient, but it also informs research that the center is doing to help improve and expand fibroid care. All of the specialists at the Center for Fibroid Care are passionate about spreading awareness of the different treatment options available and finding new ways to alleviate symptoms for patients.

“I think we're creating a group of physicians who are really keen on pushing forward fibroid care and advancing this specialty,” Dr. Morris says. “Because of the multidisciplinary efforts at NYU Langone’s Center for Fibroid Care and the way that we collaborate, we can work together to review outcomes and look for any sort of predisposing factors that might impact patients' symptoms or their recovery from these various procedures.”

Along with contributing to the knowledge base around fibroids, the center also hosts events to educate women on their options and create a supportive community of women who are going through the same thing.

“I attended an event last fall where they brought together women who have had the same procedure and those who are considering options,” Medina says. “We talked about our experiences and answered their questions. They got to see someone who was in their position say that they felt a difference since the procedure.”

Patient Jennifer Medina felt a significant change in her quality of life after getting treated at the Center for Fibroid Care.

Success Stories

According to Dr. Shirazian, the Center for Fibroid Care is outcome-focused, and its doctors thrive on the success stories of their patients. For Medina, who had spent most of her adult life struggling with severe symptoms, the treatment was life-changing.

“I feel like a different person—I don't have to take off work once a month, and I don't have to plan my life around my cycle,” she says. “I lost weight. I didn’t feel bloated or sluggish anymore. I didn’t need iron supplements anymore. My lifestyle is just different now. When you feel awful and have a lot of pain and a lot of pressure eating at you, to have that minimized by more than half has been incredible.”

For other patients, finding the right fibroid treatment is the difference between infertility and having children. Dr. Shirazian remembers one patient who had been trying for years to get pregnant with no luck.

“Whoever she had seen before me told her that she couldn't get pregnant because of her age, not the fibroids,” Dr. Shirazian says. “Then, when I saw her she had so many large fibroids, so I focused on reducing the fibroid burden because these are inflammatory tumors in the uterus. So, we removed all the fibroids, and she got pregnant literally three months later, spontaneously without reproductive technology at the age of 39.”

It’s stories like these that make the team at the Center for Fibroid Care even more driven to get the word out about fibroid treatment options and continue making fibroid care more accessible and widely recognized.

Learn more about the Center for Fibroid Care: https://nyulangone.org/care-services/center-for-fibroid-care.