A New Bill Could Keep Women Out of the ER, and the OR

by Kerrie Rushton

Top image: Senator Angela Alsobrooks (D-MD.) and Academy Award-winning actress, producer, and author Lupita Nyong’o who received a uterine fibroid diagnosis at the age of 31.

On July 27, I headed to the ER about 24 hours before a scheduled hysterectomy. The bleeding associated with the uterine fibroids that necessitated my surgery had become overwhelming. I was certain I would need a blood transfusion — my third in as many months — before the operation.

Uterine fibroids are not uncommon. Ultrasound evidence indicates more than 80% of African American women and approximately 70% of white women will develop them by age 50.

But, as in my case, they often are undetected for months. That is why U.S. Sen. Angela Alsobrooks (D-MD) and Sen. Cynthia Lummis (R-WY) are fighting to increase access to routine screenings. Their bill, Uterine Fibroid Intervention and Gynecological Health and Treatment Act (U-FIGHT Act), would authorize the U.S. Department of Health and Human Services (HHS) to award grants to increase early detection of and intervention, education and awareness programs, and research.

The U-FIGHT Act would provide resources for that type of education — education that could not only improve women’s lives, but reduce the need for later, much costlier interventions like the ones I needed.

Their work could keep millions of women from ever facing a hysterectomy.

It is unclear what causes fibroids, and there is no way to prevent them. The good news? In about 99% of cases, they are not cancerous. Perhaps because they are common, benign, and in some cases they can be managed without surgery, women and their physicians may not act with urgency when faced with symptoms.

I did not. When I first visited my gynecologist in January with concerns about a heavier and longer menstrual cycle, we both assumed perimenopause. (I was 47.) The provider performed a pelvic exam, but I was not offered an ultrasound or MRI to check for a fibroid — and I did not demand one. I was instructed to resume birth control to help regulate my cycles.

“From chronic pain to emergency room visits, women’s medical concerns are often dismissed at higher rates than those of men,” NPR reported in 2023. “One study shows that middle-aged women with chest pain were twice as likely to be diagnosed with a mental illness than their male counterparts.”

For Black women, pain is dismissed at even higher rates, according to a 2019 study published in the American Journal of Emergency Medicine.

“I am proud to reach across the aisle and partner with Senator Alsobrooks to ensure women in Wyoming and across the country suffering from uterine fibroids no longer suffer in silence. Our bipartisan legislation will expand access to screenings and intervention, providing hope to the millions of women who endure this painful condition.” –Sen. Cynthia Lummis (R-WY)

Women with fibroids are often told to just wait and see. “The message women get is if you can hang on until menopause, the fibroids will get better,” Dr. Elisa Jorgensen, gynecologic surgeon at Massachusetts General Hospital, told Harvard Women’s Health Watch in 2024. (Fibroids rely on estrogen to grow. The thought is that, with the natural falloff in estrogen with menopause, fibroid symptoms will lessen even if fibroids do not go away.)

Other women never seek care. Sen. Alsobrooks explained, many women do not know what fibroids are or the havoc they can cause. Research supports this claim. A 2016 study published in the Journal of Women’s Health concluded many women with symptomatic fibroids “live with this condition chronically without seeking care.” The study advised, “There is a need for patient-centered and community-based education to improve women’s knowledge of fibroids and symptoms and to promote treatment options.”

The U-FIGHT Act would provide resources for that type of education — education that could not only improve women’s lives, but reduce the need for later, much costlier interventions like the ones I needed.

Ultrasound evidence indicates more than 80% of African American women and approximately 70% of white women will develop them by age 50.

After a week of excruciating leg pain and some minor shortness of breath, I headed to the ER on Easter Sunday. Bloodwork showed I was severely anemic (hence, the first blood transfusion), and an ultrasound identified two fibroids that were likely the cause of my severe bleeding. The pain and shortness of breath were not from the fibroid. I also had deep vein thrombosis and two pulmonary emboli — blood clots — in my lungs. The clots may have been caused by the birth control, by the fibroid pressing on an artery, or something else entirely.

Like 40-60% of women with uterine fibroids, I would need a hysterectomy.

My blood clots needed to resolve before I could have surgery, a process that could take a few months to a year or more. In the meantime, my hematologist tried to manage the fibroid-induced anemia through iron infusions.

Anywhere from one-third to three-quarters of women with fibroids developed anemia, according to a 2024 cohort study published in Cureus. For me, iron infusions worked for about two months, but in June, I headed back to the ER, where I was given a second blood transfusion. The hematologist estimated I had lost about a third of my blood over the previous week. In the two days before my eventual surgery on July 28, he estimated I lost 25% percent of my blood in less than 48 hours.

The U-FIGHT Act could keep women from ever having to head to the ER or OR. Routine pelvic exams can help detect fibroids, but this method is not always accurate. (As I mentioned, I had an exam the day I was given the birth control prescription. By the time my fibroid was discovered, less than four months later, the fibroid was nearly the size of my uterus.) The U-FIGHT Act authorizes the Secretary of Health and Human Services to:

• Conduct or support research on the early detection or intervention of uterine fibroids.
• Formulate evidence-based or evidence-informed strategies to increase early detection in health care settings.
• Increase early detection and intervention for uterine fibroids, with funds supporting screening procedures, patient navigation services, program implementation, and patient access to health care settings.
• Develop and implement public awareness and education campaigns for the early detection and intervention of uterine fibroids.
• Support research on disparities in pain control and management in uterine fibroid surgical treatment and Asherman’s Syndrome, intrauterine adhesions, and other intrauterine conditions.

Built into the bill is accountability. The U-FIGHT Act also requires the submission of a report to Congress and the public detailing findings and developments. The bill has been introduced in the House by Representative Shontel Brown (D-OH), who is working hard to find a Republican co-sponsor.

“For too long, uterine fibroids have plagued women,” said Sen. Alsobrooks. “We need to invest in research, raise public awareness, and develop programs for early treatment. No woman should have to suffer in silence.”