Unless symptoms are severe, or fertility is an issue, treatment is not usually necessary for uterine fibroids. Regular examinations and monitoring of symptoms (also known as “watchful waiting”), is often all that is required. Should medical intervention be necessary, options for fibroid treatment range from pain management with NSAIDs to hysterectomies.
NSAIDs and Hormone Therapy Medication
Pain can often be managed effectively with non-steroidal anti-inflammatory drugs (NSAIDs). Prescription drugs are typically not necessary: effective pain management can be achieved using non-prescription NSAIDs, such as ibuprofen.
Oral contraceptives are occasionally used as a form of hormone therapy to help reduce menstrual bleeding, but have no effect on the growth rates. To reduce growth, more aggressive hormone therapy is required. Gonadotropin releasing hormone (GnRH) agonists reduce the overall level of estrogen in the body, resulting in a reduction in growth rate and shrinkage of the fibroid. Hormone therapy may be used prior to surgery to reduce tumor size.
Surgical Options for Fibroid Treatment
If medication proves inefficient, or if symptoms are severe enough, a number of surgical treatments are available. Surgery may affect fertility, so it is important for women who wish to have children to discuss possible complications with their doctors.
A myomectomy is the surgical removal of the leiomyoma. The procedure is most often used in younger women who wish to bear children. A hysteroscopic myomectomy uses a hollow tube called a hysteroscope to enter the uterus through the vagina and cervix. A laproscopic myomectomy enters the uterus through a small incision in the abdomen.
A hysterectomy is the surgical removal of the entire uterus. Hysterectomies are most often performed on older women who do not plan any further children, and whose primary symptom is excessive vaginal bleeding. A hysterectomy is major surgery, with a lengthy recovery period. Depression is a possible side effect. A woman’s sex life may be adversely affected by a hysterectomy, although often the operation improves sexual intercourse by removing painful fibroid symptoms.
Endometrial ablation destroys the uterine lining, preventing further menstrual bleeding. Women considering an endometrial ablation should be aware that the procedure results in infertility.
Uterine Artery Embolization (UAE)
A relatively new procedure, uterine artery embolization uses a catheter to deliver small particles into the fibroid’s blood vessels. The particles block the blood vessels, reducing blood flow to the tumor, causing it to shrink and reducing symptoms. Clinical trials studying the long-term effects of uterine artery embolization have yet to be completed.
Clinical Trials: Get Involved!
Clinical trials are necessary in order to develop new treatments and to better understand how leiomyomas develop. Investigations by the National Institutes of Child and Human Development, for instance, have indicated that the genetic propensity for fibroids is passed from father to daughter.
Women must be willing to participate in clinical trials if new options for fibroid treatment are to be found. Participation in clinical trials gives you access to experts in uterine fibroids, and to cutting-edge research in to how the disease can be prevented.