Uterine Fibroids Treatment

Uterine fibroids are very common and affect up to 70% of women by the time they reach 50 years of age. However, the symptoms caused by uterine fibroids 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 tumor growth.

For women who experience heavy menstrual bleeding or significant abdominal pain, treatment is often needed to manage their symptoms. Depending on the individual factors of the woman’s situation, either pharmacological or surgical treatment may be most beneficial.

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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 will target specific ailments. Symptoms can be broadly classified into two groups of heavy menstrual flow and discomfort of the abdominal area.

The type of fibroids and the general health of the woman should also be considered. The woman's age may also 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, as uterine fibroids can have an impact on fertility and fetal growth, as well as impact their 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.

Uterine Fibroid Treatment Video – Brigham and Women’s Hospital

Pharmaceutical options

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 the occurrence of related symptoms of heavy bleeding and abdominal pain.
  • Analgesic medications such as ibuprofen, naproxen, and other nonsteroidal anti-inflammatory drugs (NSAIDs) can help to relieve abdominal pain and cramping.
  • Iron supplements can manage symptoms of anemia, which are 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 fibroids that causes problems.

Surgical options

Surgical removal of uterine fibroids is often indicated if they are causing the woman to experience significant symptoms that impact her daily life. There are several different types of surgery that are available; thus, 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 who plan to become pregnant in the future.
  • Myomectomy involves the surgical removal of fibroids from the uterus. This procedure 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.

References

Further Reading

Last Updated: Apr 27, 2021

Yolanda Smith

Written by

Yolanda Smith

Yolanda graduated with a Bachelor of Pharmacy at the University of South Australia and has experience working in both Australia and Italy. She is passionate about how medicine, diet and lifestyle affect our health and enjoys helping people understand this. In her spare time she loves to explore the world and learn about new cultures and languages.

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