Uterine fibroids are very common and affect 70% of women by the age of 50. However, the symptoms they cause can vary greatly and some women with uterine fibroids do not require treatment at all. In this instance, watchful waiting is usually employed, which involves regular pelvic exams to monitor the tumor growth.
For women that experience heavy menstrual bleeding or significant abdominal pain, treatment is often needed to manage the symptoms. Depending on the individual factors of the woman’s situation, either pharmacological or surgical treatment may be most beneficial.
Factors to Consider
Initially, it is important to consider the presence of symptoms due to uterine fibroids. Many women with fibroids do not need treatment, as the symptoms do not make a big impact on their life.
Additionally, the type of symptoms is important because some treatments target specific ailments. Symptoms can be broadly classified into two groups of heavy menstrual flow and discomfort of the abdominal area.
They type of fibroids and the general health of the woman should also be considered. Her age may affect the treatment given, particularly if she is close to menopause.
Women who are currently pregnant or who are planning to become pregnant in the future should be given special consideration because uterine fibroids can have an impact on fertility and fetal growth, as well as impact the treatment decision. Additionally, some types of surgery should only be recommended if the woman is sure that she does not want to bear any children in the future, as they may render her infertile.
Medical treatment can be used to address the symptoms that result from the presence of uterine fibroids. Treatment options may include:
- Oral contraceptive pill (OCP) to regulate hormonal levels and control the growth of uterine fibroids. This is particularly helpful when heavy flow and spotting between periods poses an issue.
- Intrauterine devices (IUDs) inserted into the uterus also release hormones that reduce related symptoms of heavy bleeding and abdominal pain.
- Analgesic medication such as ibuprofen, naproxen and other NSAIDS can help to relieve abdominal pain and cramping.
- Iron supplements can manage symptoms of anemia, which is common in women who lose large volumes of menstrual blood.
- Hormone therapy injections administered over a short, distinct period, offer a solution to help shrink fibroid that cause problems.
Surgical removal of uterine fibroids is often indicated if they are causing the women to experience significant symptoms that impact on her daily life. There are several different types of surgery and the best procedure will depend on the unique situation of the woman.
- A hysteroscopy involves the removal of fibroids that are growing inside the uterus.
- Uterine artery embolization is a procedure that obstructs the blood supply to the uterine fibroid, which causes the cells to die and the tumor to shrink. As this does not affect the functionality of the uterus, it is a good option for women that plan to become pregnant in the future.
- Myomectomy involves the surgical removal of fibroids from the uterus and is another good option for women who may wish to become pregnant in the future.
- A hysterectomy involves the complete removal of the uterus. This is a good option for persistent fibroids that are likely to come back, as it eliminates the possibility of recurrence. However, it is not possible for women who would like to bear children in the future, as the uterus plays a central role in pregnancy.
An emerging treatment method involves the use of radiofrequency ablation to destroy fibroid tissue with minimal damage to surrounding uterine tissue. This is a non-invasive procedure that shrinks the fibroids and allows many women to make a full recovery within a few days.