Uterine Fibroids Treatment
Uterine fibroids treatment is only necessary when the fibroids cause symptoms.
Only 20% to 50% of women with fibroids develop symptoms requiring treatment of some kind.
There
are options available to shrink fibroids or excise them from the
uterus. No single best treatment works for all women. The optimal
treatment for you will depend on your symptoms, the type of fibroids,
other medical conditions, desire for pregnancy and your general
health.Treatment will also be different for women who are require
treatment during pregnancy.
The available fibroid treatments are discussed below, including the medications, surgeries and natural treatments.
Uterine Fibroids Treatment Options
Watchful waiting
The most common treatment option is
to do nothing! Since most women will not have symptoms, or have
pregnancy issues related to fibroids and experience a reduction in the
size of the tumor after menopause, watchful waiting is a viable option
in many cases.
However, if symptoms or some other complication develops, specific treatments will have to be given.
Medications
I
have noticed some women actually have very high expectations from
medications that “treat” fibroids, higher than what these medications
actually can do. Current medications available can effectively shrink
fibroids to some degree to obtain good improvements in symptoms. These
drugs do not cure fibroids nor do they completely remove it from your
uterus like surgery does!
These medications are hormones that are
involved in regulating your menstrual cycle and so may have additional
benefit like treating irregular or heavy bleeding.
They include
- Gonadotropin-releasing hormone (GnRH) agonists
Examples of GnRH include Lupron,Synarel, others. They reduce the levels
of estrogen and progesterone and so stop menstruation and shrink the
fibroids. They may be used before surgery to reduce the size of the
tumors and facilitate remove. Since they act against estrogen, they may
cause hot flashes as a side effect. - Progestin-releasing intrauterine device (IUD) These can be used to treat the heavy bleeding and pain caused by fibroids and do not reduce the fibroid size.
- Androgens.
Danazol, is a drug similar to the male hormone testosterone that can
also be used as a uterine fibroids treatment. Though it can stop
menstruation like the GnRH above, it has many side effects such as
weight gain, abnormal hair growth, depression, and male-type voice. As a
result,it is not often used or even wanted by women for obvious
reasons! - Other medications.
Other medications can be used to control the symptoms of fibroids
including oral contraceptive pills to control irregular bleeding and Nonsteroidal anti-inflammatory drugs (NSAIDs) to control pain.
Surgery
Surgery is a mainstay of the uterine fibroids
treatment options available. Major surgery may either remove the
individual fibroids(myomectomy) or the entire uterus( hysterectomy).
- Myomectomy
This is the removal of the fibroids( also called myomas). This is often
the procedure of choice for women who want to conceive in the future.
All the fibroids are removed while the uterus is left in place. There
is a risk of recurrence of the fibroids in the future.It may be
done through the belly wall( abdominal myomectomy), vaginal( using a
hysteroscope pass through the vagina) or by endoscopy( tiny holes
through your belly wall). - Hysterectomy
This is removal of the whole uterus. Fibroids are the primary reason
for hysterectomy in the U. It will result in abrupt cessation of menses
after the procedure. If the ovaries are also removed, premature
menopause will also occur.
Focused ultrasound surgery
This is a new technique that is still under research but has proved safe and effective.
It
is non-invasive, meaning no incisions will be made on you like during
surgery. It uses MRI radiology technique to identify the fibroids and
then destroy them using high energy ultrasound waves. Multiple cessions
may be required.
Other Uterine Fibroids treatment options
There are several other minimally invasive methods that are being used to treat fibroids. Minimally invasive
means they will not usually involve cuts into our body or blood
vessels. Most of these techniques are new and have not been extensively
studied to determine their full efficacy and safety.
They include
- Myolysis In this procedure, an electric current or laser is used to destroy the fibroids.
- Endometrial ablation
This treatment is used to treat bleeding and fibroids that are
submucosal, meaning those that are below your endometrium. It uses
either heat, hot water, microwave or electric current to destroy the
endometrum and fibroids associated with it. - Uterine artery embolization
This is based on the premise that fibroids also need food to thrive. If
the food supply is cut off , they will die! Embolization means the
arteries that take blood to the fibroids are identified and selectively
blocked. This causes the fibroids to shrink. The procedure is done by an
interventional radiologist.
Natural treatments
There
are many natural treatment options available and being promoted
especially online as effective uterine fibroids treatment.
Unfortunately, these options have not been tested by medical research
and their efficacy and safety are not certain.
So What Is Good For Me?
The options available above are there for you to choose from.
Normally, your doctor will discuss each procedure with you, pointing out
its efficacy, side effects and alternatives in order to guide you
through to make the best option for your situation.
As stated above, treatment will depend on
Treatment depends on several things, including:
- Your age
- General health
- Severity of symptoms
- Type of fibroids
- Whether you are pregnant
- If you want children in the future
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