When Tiffany Miller first contacted Taraneh Shirazian, MD, director of NYU Langone’s Center for Fibroid Care, in August 2022, she was desperate for help. The pelvic pain, which started five years earlier and was getting progressively worse, was sharp and stabbing. “I was in so much pain, I couldn’t sleep,” Miller says.
After doing online research, Miller suspected she had uterine fibroids, noncancerous tumors of the uterus that can affect up to 70 percent women, with Black women affected more than any other racial or ethnic group. Miller, who lives in Washington, DC, made an appointment with a local gynecologist who ignored Miller’s suspicions about fibroids and instead advised her to see a gastroenterologist. Miller pushed back, insisting on a pelvic ultrasound exam to look for any abnormalities. “I had severe pain on my left side. I knew something had to be there,” she says.
The ultrasound exam revealed what Miller had suspected: She had several large uterine fibroids. Dissatisfied with the care from her gynecologist, Miller returned to the internet, where she found Dr. Shirazian, a minimally invasive gynecologic surgeon who specializes in fibroid care.
“Please help me,” Miller wrote to Dr. Shirazian. It was an all-too-common request.
“The minute I met Dr. Shirazian online, I just trusted her.”
“I see many patients with fibroids who have been dismissed by their providers. They know something is wrong, but they haven’t gotten the answers they want,” Dr. Shirazian says.
Searching for Answers and Relief
Miller’s pelvic pain began in 2018. At first, it came and went with her period, and she was able to manage it with over-the-counter pain relievers and taking time off from work. “It was almost expected that I would be out for a few days every month,” says Miller, a policy advisor for the federal government. Over time, the pain became constant and unbearable.
“Because fibroids are benign tumors, women are often told to just live with them,” Dr. Shirazian says. “People often underestimate how much fibroids can affect someone’s quality of life, including their ability to feel good about themselves and their bodies or their ability to form relationships because of the pain and other symptoms they can cause.”
Confirming a Diagnosis and Treatment Plan
Miller overnighted her pelvic ultrasound results, and within a day had a telehealth appointment scheduled with Dr. Shirazian. “The minute I met Dr. Shirazian online, I just trusted her,” Miller says. Dr. Shirazian promptly ordered a pelvic MRI, an imaging test that provides the most detail in terms of the number, size, and location of all fibroids. The test results told the story. “Tiffany’s uterus measured the size of roughly a five-month pregnancy,” Dr. Shirazian says.
To make an appointment with one of our fibroid specialists, visit the Center for Fibroid Care.
A fibroid on the left side of Miller’s pelvis measuring 11-by-9 centimeters—the size of a large grapefruit—was the largest of her eight fibroids, and it was pushing on her internal organs. The massive fibroid was also pedunculated, meaning that it had a stalk descending to the outside of the uterus, which can put pressure on nearby organs and cause sudden pain or pressure, especially with movement. Miller also had several other medium-sized fibroids, all of which were contributing to her discomfort.
Miller was experiencing pain, pressure, and constipation because her fibroids were located in the subserosa or muscle layers of the uterus, Dr. Shirazian says. “Fibroids can create pressure and pain because their thick tissue takes up space in the uterus.” Fibroids can cause constipation when their size and location in the uterus puts pressure on the bowels. Fibroids can also compress the bladder to reduce its ability to hold urine, causing urinary frequency.
Dr. Shirazian discussed treatment options with Miller. Although hysterectomy—surgical removal of the uterus—is one of several treatments for fibroids, it wasn’t an option for Miller, who would like to start a family someday. Because of the location of the fibroids, and the fact that Miller wanted to have children, Dr. Shirazian recommended an open myomectomy. During this fertility-sparing surgical procedure, the tumors are surgically removed through the abdomen through one small, 4- to 5-centimeter bikini-line incision, leaving the uterus intact.
“Finding a doctor that cared about making sure I could have kids later and someone who was really experienced with myomectomy was really important to me,” Miller says.
Two weeks after the initial consultation, Miller came to New York City for the surgery.
“After surgery, I felt immediate relief, and within two weeks, I was able to go back to work,” Miller says. “It fully changed my life and my perspective. I have not been in pain ever since. Everyone in the office said it was like I was a new person.”
Miller dropped several jeans and shirt sizes, too. “I had to buy new clothes,” she says.
Reducing the Risk of Rebound Fibroids
Miller continues to see Dr. Shirazian and her team at the Center for Fibroid Care regularly for follow-up care. Fibroids can grow back, with an average of five years to recurrence. To potentially reduce that likelihood, Miller is participating in the Life Program, a research study Dr. Shirazian is leading at NYU Langone designed to assess the effectiveness of lifestyle modification, including diet, exercise, and weight management, for preventing new fibroid growth.
Because fibroids are common and can greatly impact your quality of life yet are often disregarded, Miller encourages others who are affected by them to be proactive. “I want Black women, and women in general, to be aware that it’s important to advocate for yourself,” Miller says. “Seek out doctors like Dr. Shirazian, who will take your fibroid symptoms seriously.”
“Having fibroid surgery was a huge life changer,” Miller says. Today, Miller is an avid exerciser and hiker, and is planning to run the New York City Marathon, activities she couldn’t do until becoming fibroid-free. “My only regret was that I didn’t have fibroid surgery sooner,” Miller says. “It was literally the best decision I have ever made.”