Beyond the physical: a qualitative assessment of the emotional burden of symptomatic uterine fibroids on women’s mental health

Abstract

To qualitatively assess the emotional impact of symptomatic uterine fibroids. Qualitative semi-structured interviews and demographic surveys. Forty-eight women with symptomatic uterine fibroids were recruited from an urban academic medical center and community-based organizations. Subjects completed in-depth, one-on-one interviews, a demographic survey and a health literacy assessment. Interviews were recorded and transcribed verbatim. Data was analyzed using a grounded theory approach and uploaded to NVivo version 10 for thematic coding. Three coders identified major themes and subthemes. A total of 29 hours of interviews were conducted yielding 1,108 transcribed pages. The κ amongst coders was 0.94. The mean age of subjects was 42.8 ± 7.4 (mean ± SD). 62.5% self-identified as African-American, 20.8% as Caucasian, 10.4% as Hispanic and 6.3% as Asian. 70.9% of the participants had at least a 4-year college degree. 58.4% of the women had a total annual household income of less than $75,000. The majority of the participants demonstrated a significant emotional response to their fibroids ranging from general worry and concern to fear, anxiety, sadness and depression. Over half of the women felt disempowered or helpless and believed that they had no control over their fibroids, specifically with regard to the inability to manage and predict heavy periods. Many women also possessed a negative self-image and cited concern over appearing pregnant, overweight, and less attractive, which led to difficulties becoming intimate with a partner. Several women felt that they lacked substantial support to help them deal with these issues with only two women mentioning that they received support from a mental health professional. There is a significant psychological burden among women suffering from symptomatic fibroids. Despite the impact of fibroids on women’s lives, many women feel that they lack support to help them deal with these issues and very few seek help from a mental health professional. There is an opportunity and a need for the mental health community to address the concerns in this population. Leveraging the unique expertise and role of the mental health professional may lead to improved psychological health and quality of life in patients living with this chronic condition.