Fibroids Treatment

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Fibroids Treatment Options

Watchful waiting

Many women with uterine fibroids experience no signs or symptoms. If that's the case, watchful waiting (expectant management) is the best option. Fibroids aren't cancerous. They rarely interfere with pregnancy. They usually grow slowly - or not at all - and tend to shrink after menopause when levels of reproductive hormones drop.

Medications

There are medications used for uterine fibroids that target hormones that regulate your menstrual cycle, treating symptoms such as heavy menstrual bleeding and pelvic pressure. They don't eliminate fibroids, but may shrink them. Medications include:

Gonadotropin-releasing hormone agonists (DepoLupron), progestin-releasing intrauterine device (Mirena IUD), oral contraceptives or progestins can help control menstrual bleeding, and prevent the fibroid from getting larger. Nonsteroidal anti-inflammatory drugs (NSAIDs), which are not hormonal medications, may be effective in relieving pain related to fibroids, but they don't reduce bleeding caused by fibroids. Danazol, a synthetic drug similar to testosterone, is rarely used to treat fibroids. Unpleasant side effects, such as weight gain, dysphoria (feeling depressed, anxious or uneasy), acne, headaches, unwanted hair growth and a deeper voice, make most women reluctant to take this drug.

Minimally invasive procedures for fibroids

Certain procedures can destroy uterine fibroids without actually removing them through surgery. They include:

1.StopFlo/Endometrial ablation

This treatment, usually performed by a hysteroscopic specialist with a designed instrument inserted into your uterus, uses energy to obliterate the lining of your uterus, either ending menstruation or reducing menstrual flow. Endometrial ablation is effective in stopping abnormal bleeding, but doesn't affect fibroids. Can be accompanied by hysteroscopic submucosal myomectomy which can remove the fibroid(s) from within the uterine cavity. This procedure is best performed by physicians very experienced in this technique.

2.Uterine fibroid embolization

Small particles (embolic agents) injected into the arteries supplying the uterus cut off blood flow to fibroids, causing them to shrink. This technique, performed by an interventional radiologist, is proving effective in shrinking fibroids and relieving the symptoms they can cause. Advantages over surgery include no incision and a shorter recovery time. UFE is effective in stopping bleeding from fibroids but doesn’t treat bleeding from the endometrial lining. Progressive physicians will offer this in conjunction with endometrial ablation specifically to avoid hysterectomy. A retrospective cohort study showed that UAE has much fewer serious adverse effects than and similar rates of satisfaction. For those that have been treated with ablation/UAE, 96% would recommend the duo treatment to a friend compared to 70% of those treated with hysterectomy.

3.Hysterectomy

This operation — the entire removal of the uterus — remains the only proven permanent solution for uterine fibroids. But hysterectomy is major surgery and ends the ability to bear children.

4.Myomectomy

In this surgical procedure, the surgeon, usually an infertility specialist, removes the fibroids, leaving the uterus in place. Typically reserved for those that want or need to preserve childbearing or have infertility issues associated with the fibroids. With myomectomy, there's a risk of fibroid recurrence and significant blood loss.

5.Focused ultrasound surgery

MRI-guided focused ultrasound surgery (FUS) is a noninvasive treatment option for uterine fibroids that preserves your uterus. This procedure is performed while you're inside of a specially crafted MRI scanner that allows doctors to visualize your anatomy, and then locate and destroy (ablate) fibroids inside your uterus without making an incision. Focused high-frequency, high-energy sound waves are used to target and destroy the fibroids. One or two treatment sessions are done in an on- and off-again fashion, sometimes spanning several hours.

Because it's a newer technology, researchers are learning more about the long-term safety and effectiveness of FUS. Research continues, but so far data collected show that FUS for uterine fibroids is safe and very effective. Since it is new and expensive it may not be covered by certain insurance plans.