Fibroid Survey

Privacy Disclosure

This is an anonymous survey. Although I do ask that you provide your email address, this is purely for technical reasons in tracking respondents. The email address you provide will NEVER be disclosed, shared or used publicly in any way. This survey should take 3 minutes or less to complete (depending on how much you choose to write into the "comments" fields).

Email address:
Age:
Education:
How many years have you known about your fibroids?
Current symptoms (check all that apply):	none excessive bleeding on AND off menstrual cycle (hemorrhagia) excessive bleeding during menstrual cycle only (menorrhagia) pelvic pain bloating extreme cramping weight gain edema (water retention) chronic fatigue migraines/frequent headaches anemia depression other If "other" is checked, please describe here
How many physicians have you consulted about your uterine fibroids?
Which of the following treatment options have physicians recommended to you for treatment of your uterine fibroids? (check all that apply):	ignore it ("watchful waiting") D & C birth control pills hysterectomy myomectomy myolysis cryomyolysis endometrial ablation uterine artery embolization hormones (Lupron) alternative natural methods other If "alternative natural methods" is checked, please describe here If "other" is checked, please describe here
Which options have you chosen to follow? (check all that apply):	ignore it ("watchful waiting") D & C birth control pills hysterectomy myomectomy myolysis cryomyolysis endometrial ablation uterine artery embolization hormones (Lupron) alternative natural methods other If "alternative natural methods" is checked, please describe here If "other" is checked, please describe here
Are you happy with the outcome of your treatment choice(s)?	YES NO
Why or why not?
Have you ever been diagnosed with any of the following? (choose all that apply):	adenomyosis endometriosis ovarian cysts hyperplasia dysplasia none of the above
Have you ever had a hysteroscopy?	NO YES If "YES", please describe why here
Have you ever had a laparoscopy?	NO YES If "YES", please describe why here
Is sexual function and/or orgasm something you are concerned about when it comes to choosing a treatment option for your uterine fibroids?	YES NO
Sexual feelings/orgasm for you is experienced (choose all that apply):	in the clitoris in the vagina in the uterus in the g-spot through or with uterine contractions prefer not to answer this question other If "other", please describe here:
Is maintaining your ability to have children of concern to you in regard to your uterine fibroids and your treatment options?	YES NO
Do you intend to (or want to) become pregnant at any time in the future?	YES NO
Please write in 1 question that you would LOVE to hear your doctor ask you:
Are there any additional questions that you would like to see on future surveys on this website?
Do you have any additional comments on this survey?