RH Survey COVID-19

Tell Us About Your Experience With Uterine Fibroids
Uterine fibroids (UF) are noncancerous growths of the uterus that most often develop during a woman’s childbearing years. They are also called fibromyomas, leiomyomas or myomas. Most American women will develop fibroids at some point in their lives, but many women have no symptoms. Real Health wants to know about your experience with uterine fibroids.
1) Have you ever experienced any of the following symptoms? (Check all that apply.)

Lower back painPain in the abdomen (cramps)Heavy menstruationAnemiaPainful periodsReproductive problemsPainful sexVaginal bleeding when not menstruatingUrinating frequently or problems urinatingNone of the above
2) Has anyone in your family ever been diagnosed with uterine fibroids?

YesNo
3) Have you ever been diagnosed with uterine fibroids?

YesNo (Skip to question 10.)
4) How much have uterine fibroids affected your quality of life?

A lotSomewhatNot very muchNot at all
5) Have you ever taken medication to treat uterine fibroids?

YesNo
6) Have you ever had any of the following procedures to treat uterine fibroids? (Check all that apply.)

Magnetic resonance–guided focused ultrasound surgery (MRgFUS)Fibroid embolizationEndometrial ablationMyomectomyHysterectomyNone of the above
7) Did your doctor discuss available UF treatment options with you?

YesNo
8) Did your doctor discuss possible side effects of UF treatment with you?

YesNo
9) Have you ever had a recurrence of uterine fibroids after treatment?

YesNo
10) What year were you born?
11) What is your gender?

MaleFemaleTransgenderOther
12) What is your sexual orientation?

StraightGay/LesbianBisexualOther
13) What is your ethnicity? (Check all that apply.)

American Indian or Alaska NativeArab or Middle EasternAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or other Pacific IslanderWhiteOther
14) What is your current level of education?

Some high schoolHigh school graduateSome collegeBachelor’s degree or higher
15) What is your household income?

Under $15,000$15,000 - $34,999$35,000 - $49,999$50,000 - $74,999$75,000 - $99,999$100,000 and over
16) What is your zip code?
Enter the message as it's shown*
Should be Empty:

Tell Us About Your Experience With Uterine Fibroids