There’s Nothing Normal About Uterine Fibroids


As told to Shannon Shelton Miller

July is Fibroid Awareness Month.

For too long, I was told my painful period cramps and heavy bleeding were normal. As a teenager, I was put on iron supplements, which should have been a sign I was bleeding too much. But growing up in Mississippi in the 1980s and 1990s, no one was thinking, “Let’s figure out why a healthy young woman who’s active in marching band and cheerleading has to have iron supplements,” or “Why do we need to put this young woman on birth control to help her regulate her period?”

I would eventually learn that I wasn’t alone. More than half of Black women develop fibroids by the time they’re 35, and more Black women get fibroids than white women. We’re also more likely to get fibroids earlier in life, just as I did, and our pain often goes overlooked by the healthcare establishment.

I wouldn’t learn I had fibroids until I gave birth to my twins in 2006. My husband and I also like to say we have 17-year-old twins, Elijah and Evelyn, and Ella, our surprise baby. She was made possible by my second attempt to get rid of my fibroids — a myomectomy. I had the procedure in 2013, and I got pregnant with Ella the next year. It’s a miracle that she’s here.

Gabbie with her husband, twins Elijah and Evelyn, and Ella, 2022 (Photo/Patricia Kelly)Gabbie with her husband, twins Elijah and Evelyn, and Ella, 2022 (Photo/Patricia Kelly)

My fibroids could have been overlooked during my first pregnancy because I had two babies. I was told it was normal to have heavier periods after birth, even though I thought I was bleeding too much and had more cramps. When I finally received a diagnosis of uterine fibroids, I was just told to take iron pills, which made me constipated and were taxing on my digestive system. The other option I was offered was birth control pills, which I also didn’t want because hormonal fluctuations affect my voice and vocal cords. As a professional jazz artist, I knew that wouldn’t work for my life.

Gabbie performing, 2015 (Photo/George Kelly, Jr.)Gabbie performing, 2015 (Photo/George Kelly, Jr.)

I was able to manage my fibroids at first when I had an artist’s residency for three months in Singapore. The doctors there offered recommendations for dietary changes and a more holistic approach that helped. When I returned to the States, the tumors eventually became too much. That’s when I had the myomectomy.

Whenthe fibroids came back a third time, I asked myself, “Am I just a hospitable environment for tumors? Can we even explore that to find out?” Being a musician and having a husband who’s also a creative — he’s an audio engineer and works in ministry — we don’t have a lot of money. The only thing available to us at that time was public healthcare, so my providers weren’t trying to get to the bottom of anything. It was just, “Here’s what we think will fix it. Have a great day.”

My quality of life continued to decline. I was bleeding so much I needed transfusions. I had to take time off work because I was lightheaded, and I knew I would ruin chairs and carpets. Nobody should have to stay home for a week just because they’re having their period.

And let’s not even talk about sex. I would have to take ibuprofen before sex with my husband because orgasms would lead to uterine contractions that were so painful. I couldn’t enjoy a healthy sex life without fearing the pain I knew was inevitable.

After 30 years, the best the medical system could offer me was a hysterectomy. I said yes because honestly, I just didn’t want to die. I felt I was dying every month. The anemia caused heart palpitations, and I couldn’t even go up stairs. I sometimes had to go to the emergency room to get a blood transfusion or IV fluid. I had a whole routine to keep myself alive while having my period, including going to rehydration clinics and taking liquid iron. And I couldn’t book shows when I was having my period because I didn’t know if I’d be able to continue my performance.

I knew I had to do something to save myself. At age 45, on Nov. 17, 2023, I had a hysterectomy. I wanted to be able to live.

Hysterectomy selfie, November 18, 2023. Hysterectomy selfie, November 18, 2023.

I’m grateful for the support I found along the way. MusiCares, a foundation that provides health and wellness support for artists, gave me a grant that paid my rent for two months until I could get back on my feet after surgery. I also found The White Dress Project, a national advocacy and support group for women with fibroids. I read all the messages on their social media page about women living with fibroids and recovering from fibroid surgery. The women there made great recommendations about resources you can use while you’re recovering.

My sister-in-law, Patricia, is a primary care physician and has been a blessing as my medical advocate. I tell every woman to look for a healthcare provider who can be in your corner, including through telehealth. I’m also thankful to the foundation at Grady Hospital in Atlanta, which helped pay for my hysterectomy. I wouldn’t be alive without them.

Uterine fibroids shouldn’t be dismissed as just a “women’s issue.” I have two daughters, and I want more to be done to make sure they and other women have a better quality of life if they develop fibroids. There needs to be more dedicated research, studies, clinics — anything we can muster to help women find the answers they need, and give them the care and support they deserve.

Resources

The White Dress Project

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Our Real Women, Real Stories are the authentic experiences of real-life women. The views, opinions and experiences shared in these stories are not endorsed by HealthyWomen and do not necessarily reflect the official policy or position of HealthyWomen.

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Period Products Not Being Tested with Real Blood



In 2020, a period product company used red liquid to show how absorbent their sanitary pads are in a TV commercial. It was the first time a mainstream company in the U.S. swapped the typical blue liquid for red to represent period blood.

After the advertisement aired, some people took to social media to applaud the realistic representation.

But that’s all it was. A representation.

In reality, manufacturers test the absorbency of period products using saline — a mix of water and salt — and not actual blood.

This fact was recently noted in a 2023 study where four female researchers at Oregon Health and Science University (OHSU) used human blood to test the accuracy of absorption in period products — for the first time ever.

Read: What’s Normal When It Comes to Menstrual Bleeding? >>

As you might imagine, the study received a lot of attention. If you didn’t know this mind- boggling nugget about period products before now, it can be a lot to process. Although the lack of industry testing with actual blood may be shocking to some people, Bethany Samuelson Bannow, M.D., co-author of the study and an associate professor of medicine at OHSU, wasn’t fazed. “I’m never super surprised when things haven’t been done in women’s health,” she said.

Heavy menstrual bleeding and health concerns

The study also raised eyebrows regarding the results. Researchers found that a majority of the existing absorbency labels on period products that had been tested with saline indicated that they could hold more compared to what researchers found during testing. This mismatch is because blood and saline have different physical properties and are absorbed at different rates. What that means is that using the estimates on the label for most period products will result in an underestimate of the blood loss the menstruator is experiencing.

These findings are especially concerning considering that heavy menstrual bleeding is typically diagnosed based on a person’s experience with their period products. “The important thing to note is the distinction between medically diagnostic tools and products used for other purposes. So if I’m going to check someone for thyroid disease, I’m going to send them to a lab and do a test that was specifically created for that purpose. But when we are diagnosing heavy periods, we are really dependent on reports of what patients are using,” Samuelson Bannow said.

Read: I Thought My Heavy Bleeding Was Normal — Until It Almost Killed Me >>

And if people think their products hold less blood than they actually do, that could mean people with heavy menstrual bleeding are going undiagnosed. This is a serious problem because heavy bleeding can lead to anemia, or a lack of iron, which can cause fatigue, headaches and weakness among other issues. Heavy bleeding can also be a symptom of other serious health concerns such as endometriosis, fibroids and some gynecologic cancers.

Read: Comic: Annie Has Anemia >>

To diagnose heavy menstrual bleeding, healthcare providers (HCPs) also use the pictorial blood loss assessment chart (PBAC) so people can tell their HCPs how saturated their pads or tampons are. But, once again, this is flawed if providers are assuming that a “full” pad or tampon holds more than it does. (The PBAC doesn’t include newer period products like menstrual cups. And menstrual cups are commonly used among people who have heavy periods, Samuelson Bannow said.)

“I hope [the research] helps make people aware of the varied ability of these products and I hope that changes how [healthcare providers] look at history taking,” Samuelson Bannow said.

Heavy menstrual bleeding and mental health

Heavy periods can bleed into all aspects of life and have a negative affect on mental health too. “Bleeding heavily can cause women stress — worrying about bleeding through products and onto clothes, the cost of buying products [and] just the weariness that heavy bleeding can cause,” said Heather Bartos, M.D., an OB-GYN and member of HealthyWomen’s Women’s Health Advisory Council. “Heavy bleeding can also affect a woman’s sex life.”

If you think you may have heavy menstrual bleeding, it’s important to talk to your HCP about your symptoms. “A simple ultrasound and labs can usually diagnose the issue, and there are many options to control the bleeding — not just contraceptives — but also newer treatments,” Bartos said.

It’s still tough to think that an essential product that all menstruators will use at some point in their life has been developed without using the very thing it was made for. Periods are natural. And people who menstruate deserve products and healthcare options that reflect this normal — however complicated — part of life.

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Facts About Free Bleeding – HealthyWomen



Whoever said you can’t wear white after Labor Day didn’t have periods. For some of us, you can’t wear white — ever. At least not comfortably without feeling like Carrie at the prom.

That time of the month usually calls for a look only Morticia Addams could love: solid black pants to disguise any leaks and long, over-the-butt dark shirts for added protection. And don’t forget the trusted sweater to cinch around your waist if things get too heavy when you’re out just trying to live your life.

We’ve all had clothing maimed in the name of menstruation. But, for some people, flowing through clothes is intentional. It’s called free bleeding — and it’s been around forever. In ancient times, period blood was deemed powerful and magical. (And really, depending on your definition of magic, who’s to say it’s not?)

More recently, the “free bleed” trend has made the rounds on social media and ramped up interest in the pros of going with the flow (sorry, we couldn’t resist!).

If you’re curious, here’s more about the basics behind free bleeding.

What is free bleeding?

Free bleeding is just like it sounds. It’s when you have your period, but you don’t use period products like tampons, menstrual cups or pads to collect, block or absorb the blood. You just let the blood go wherever it goes.

Some people wear regular underwear and clothing during this time. Other people wear period underwear or period-proof clothing. While these products are technically period products, you’re not going out of your way to stop the bleeding, so you’re still considered to be free bleeding by the free bleeding community.

Read: 5 Women’s Health and Beauty Products Made by Women >>

Unrelated, free bleeding isn’t always a choice. Sometimes, it can be the result of period poverty, or the lack of access to period products because of financial burden. Free bleeding when you can’t afford period products isn’t the same as intentional free bleeding for personal reasons. It’s a serious societal problem that has been linked to mental health conditions including depression and anxiety, and it affects the health and well-being of people across the world — especially people of color.

Read: The Complex Crisis of Period Poverty >>

Why are people free bleeding?

There are a few reasons why people voluntarily ditch their period products.

To be natural. Periods are a normal bodily function, and some people feel that using period products disrupts the natural flow of things.

To normalize menstruation. For some people, period products send a message that menstrual cycles are shameful or should be hidden. No products, less shame.

To protest against the “tampon tax.” In some states, menstrual products are priced as luxury goods, which means there’s an added tax for anyone who wants to buy them. Although some states have stopped the tax in recent years, as of today, 20 states still have the “tampon tax.”

To raise awareness for period poverty. Too many people don’t have access to period products and ditching them can be an effort to draw attention to the issue and support people who don’t have access and can’t afford them.

Read: My Struggle with Period Poverty Motivated Me to Help Other Women >>

To help the planet. More than eight million metric tons of plastic waste go into the ocean each year. Most disposable period products are made with plastic (pads are typically 90% plastic and most tampon applicators are made from non-recyclable plastic) and add to environmental waste.

Is free bleeding healthy?

Free bleeding is generally safe. There’s no scientific evidence of health benefits to free bleeding, but it can be beneficial to some people. For example, if you’re not buying period products, you’re going to save some cash (although period-proof clothing also costs money, too). If you’re giving up tampons, you’re also reducing the risk of getting toxic shock syndrome (TSS), a rare but potentially deadly infection from bacteria that can come from leaving tampons in for too long.

Is free bleeding sanitary?

As you might imagine, free bleeding can be messy. And if you’re out in the world free flowing, period blood can leak onto surfaces. And period blood, like all other blood, has the ability to carry blood-borne viruses. These can include:

Read: What You Need to Know About Viral Hepatitis A, B and C >>

Blood-borne viruses are transmitted when the blood or fluids enter the body of another person. So, while it may not be technically impossible, it is extremely rare for someone to get infected via period blood on a chair.

But if you’re free bleeding, it’s worth thinking about the people who may come in contact with your blood.

Which leads us to free bleeding in the real world. It’s your choice to go where you want, when you want, but it may be a good idea to pack extra clothes or period underwear to minimize the chances of leaving blood behind.

Free bleeding may not be for everyone, but we can all respect doing what each of us feels is right for our own bodies.

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