Common Women's Health Problems

Common health problems specific to women can include issues with the uterus and ovaries, and problems related to menopause. Clinical trials are researching potential new treatments for these conditions that may help symptoms and improve quality of life for women.

In this guide, we'll cover the symptoms, causes, and treatment options for:

• Uterine fibroids
• Endometriosis
• Polycystic ovarian syndrome
• Hot flashes

Uterine fibroids

Uterine fibroids are non-cancerous growths in the uterus that range in size from being undetectable to the human eye, to the size of a grapefruit. They do not develop into cancer or raise your risk of uterine cancer.

Researchers aren't sure what causes fibroids to grow, but they may be stimulated by hormones. They may grow larger during your menstrual cycle, or when taking birth control pills, or during pregnancy. Fibroids often shrink or disappear with menopause.

Most women with uterine fibroids don't experience symptoms. For those that do, symptoms can include:

• Pelvic pain that doesn't go away
• Menstrual periods lasting more than a week
• Frequent urination or difficulty emptying the bladder
• Back or leg pain
• Constipation

When to see a doctor about uterine fibroids:

• You're experiencing pelvic pain that won't go away
• You're having difficulty emptying your bladder
• You can't control your urine flow
• You experience very heavy and painful periods

See a doctor right away if:

• You experience uncontrollable bleeding, or sudden sharp pelvic pain

What are the treatments for uterine fibroids?

As many women with uterine fibroids do not experience signs or symptoms, most often, doctors recommend simply keeping an eye on fibroids and symptoms.

For severe uterine fibroids, treatments may involve hormones to regulate your menstrual cycle. These treatments typically shrink fibroids, but may not eliminate them all together.

Hormonal treatments can include:

• Gonadotropin-releasing hormone (Gn-RH) agonists. These medications treat fibroids by blocking the production of estrogen and progesterone. Because the treatment puts you into a temporary postmenopausal state, many women experience significant hot flashes while on them. This treatment is typically used for no more than three to six months, often before a planned fibroids surgery, as it can cause bone loss.
• Progestin-releasing intrauterine device (IUD). This device can relieve the heavy bleeding associated with fibroids, but doesn't shrink fibroids or make them disappear.
• Tranexamic acid (Lysteda). This treatment can be taken during your menstrual period to ease heavy bleeding days.

Focused ultrasound surgery (FUS) for uterine fibroids

One non-invasive surgical option for treating uterine fibroids is MRI-guided ultrasound surgery.

This treatment option preserves your uterus and requires no incision. It's performed while you're inside an MRI scanner to give your doctor the precise location of your fibroids. Then, the ultrasound transducer focuses sound waves into the fibroid to destroy them with heat.

Because FUS is a newer therapy, researchers are still learning more about its long-term safety and effectiveness.

Clinical trials for uterine fibroids

Clinical trials are researching potential new treatment options for uterine fibroids. If you're interested, answer a few questions to find trials near you for which you may qualify.

Endometriosis

Endometriosis is a disorder in which tissue that usually lines the inside of the uterus grows outside your uterus.

During a menstrual cycle, the uterus sheds the lining of the uterus. With endometriosis, that still happens, but the displaced tissue can't leave the body. Surrounding tissue can then become irritated and develop scar tissue and adhesions that can cause pelvis tissues and organs to stick to each other.

Endometriosis symptoms

The main symptom of endometriosis is pelvic pain that often corresponds with your menstrual pain. The pain is typically more severe than the feeling of typical menstrual cramps. Pain may also increase over time in endometriosis.

Other signs and symptoms of endometriosis can include:

• Pain during or after sex.
• Pain with bowel movements or urination, especially during your menstrual period.
• Excessively heavy periods, or bleeding between periods.
• Difficulty becoming pregnant. Endometriosis brings with it an increased risk of infertility.

If you experience these symptoms, talk with your doctor. They may ask the following questions to help you get the right diagnosis:

• How often do you experience the symptoms you describe?
• Are your symptoms worse around your menstrual cycle?
• Does anything help your symptoms?
• Does anything make your symptoms worse?
• How long have you had these symptoms?

Endometriosis treatment

Treatment for endometriosis typically involves medication or surgery. In general, doctors recommend starting with non-surgical options first.

Most doctors recommend starting treatment with an over-the-counter pain reliever. For patients who are not trying to get pregnant, hormone therapy may be prescribed.

For patients with endometriosis who wish to become pregnant, conservative surgery may be an option. In conversative endometriosis surgery, a doctor will remove endometriosis implants while preserving your uterus and ovaries. This approach may also help severe pain from endometriosis.

Clinical trials are researching potential new options for reducing pain in endometriosis while preserving fertility. If you're interested in taking part, start your search below:

Polycystic ovarian syndrome

Polycystic ovarian syndrome (PCOS) is a common hormonal disorder, affecting women of reproductive age.

Symptoms include infrequent or prolonged periods, with excessive bleeding. The disorder can also involve excessive levels of the male hormone androgen, which may result in physical signs such as excess facial or body hair, severe acne, or male-pattern baldness.

In PCOS, the ovaries may develop small collections of follicles, and fail to release eggs regularly. PCOS can make it more difficult to get pregnant.

What causes PCOS?

Researchers aren’t sure of the exact cause of PCOS. Signs and symptoms typically develop at the same time as the first menstrual period during puberty, but can also appear after substantial weight gain. PCOS signs and symptoms tend to be more severe if you’re obese.

Factors that may play a role in PCOS include:

Excess insulin. If cells become resistant to insulin, the hormone produced in the pancreas that allows cells to use sugar, then blood sugar levels can rise and your body may produce more insulin. Excess insulin, in turn, can increase androgen production, which is connected with PCOS and difficulties with ovulation.

Genetics. Certain genes may be linked to PCOS, and you’re more likely to develop it if your mother or grandmother had PCOS.

Excess androgen. In PCOS, the ovaries produce abnormally high levels of the male hormone androgen, which can lead to excessive hair growth and acne.

When to see a doctor for PCOS

If you have an irregular period or difficulty becoming pregnant, talk to your doctor. Your primary care physician may refer you to a gynecologist, an endocrinologist (a specialist in hormone disorders), or a reproductive endocrinologist (an infertility specialist).

Before your appointment, it can be helpful to keep track of your menstrual cycles along with symptoms you’ve experienced, and other lifestyle factors, such as diet, exercise, and external stressors.

Questions your doctor may ask during your appointment include:

• How often do your symptoms occur?
• How severe are your symptoms?
• Have you recently gained weight?
• When was your last period?
• Are you trying to become pregnant, or do you hope to become pregnant in the future?

PCOS treatment options

To help regulate your menstrual cycle, doctors may prescribe a combination of birth control pills, a skin patch, or vaginal ring, which decrease androgen and regulate estrogen. For people with PCOS, hormone regulation can help lower the risk of endometrial cancer and reduce abnormal bleeding, hair growth, and acne.

Progestin therapy can also help regulate periods and reduce your endometrial cancer risk, but it does not prevent pregnancy or reduce androgen levels.

For patients who are trying to become pregnant, doctors may prescribe the following to stimulate the ovaries and help you ovulate:

• Clomiphene (Clomid): An oral anti-estrogen medication taken during the first part of your menstrual cycle.
• Letrozole (Femara): A breast cancer treatment that can work to stimulate the ovaries.
• Metformin (Glucophage, Fortmet, others): An oral medication for type 2 diabetes that helps improve insulin resistance and lower insulin levels. It may be added on with clomiphene if you don’t become pregnant.
• Gonadotrophins: Hormone medications that are given by injection.

Clinical trials are researching potential new treatment options for PCOS. If you’re interested in getting involved, start your search here:

Hot flashes in menopause

Around 80% of women experience hot flashes as part of menopause, but their frequency and duration can vary widely. Some women have hot flashes for only a short period of time, while others can experience them for 11 years or more. On average, women get hot flashes for around 7 years.

Chances are, you'll know it when you experience a hot flash – a sudden feeling of heat, which can be accompanied by a red, flushed face and sweating.

Hot flashes are typically unavoidable, but triggers include:

• Stress
• Caffeine
• Alcohol
• Spicy foods
• Tight clothing
• Heat
• Cigarette smoke

Hot flash treatment options

Treatment options for hot flashes include several home remedies, such as staying cool, reducing stress, and exercising daily. Plant estrogens found in soy products may have some weak estrogen-like effects that can help hot flashes.

For those with particularly bothersome hot flashes, talk with your doctor about hormone replacement therapy, or HRT. Typically taken for five years or less, HRT prevents hot flashes for many women and can help other symptoms of menopause, including vaginal dryness and mood disorders, as well. When you stop taking HRT, hot flashes may return. Some short-term HRT can also increase your risk of developing blood clots, breast and endometrial cancers, and gallbladder inflammation.

Besides HRT, other treatment options that can help provide relief for hot flashes include:

• Brisdelle, a paroxetine formula specifically for hot flashes
• Duavee, a conjugated estrogens/bazedoxifene formula designed to treat hot flashesLow-dose depression drugs, such as fluoxetine (Prozac, Rapiflux), paroxetine (Paxil, Pexeva), or venlafaxine (Effexor)
• Clonidine, a blood pressure medication
• Gabapentin, an anti-seizure drug

Treatments in development for hot flashes aim to alleviate symptoms as effectively as estrogen, without an increased breast cancer risk.

If you're interested in searching for clinical trials for hot flashes in menopause, find clinical trials you may qualify for by starting your search below: