The Best Way to Treat Uterine Fibroids

Uterine fibroids are non-cancerous growths near or in the uterus. They are common and often don't cause symptoms or require any treatment. However, they may cause pain, pressure and excessive bleeding. When uterine fibroids cause these symptoms, treatment is necessary.

Medications to Treat Fibroids

• Medications for fibroid treatment are prescribed primarily to relieve symptoms. No medication eradicates uterine fibroids. One type of medication is gonadotropin-releasing hormone agonist, or Gn-RH agonist. These work to drop estrogen and progesterone levels, causing your periods to stop and usually shrinking fibroids.

  Another medication that can relieve fibroid problems is progestin-releasing intrauterine devices (IUD). This birth control device works to relieve the heavy bleeding and pain associated with fibroids, but it won't shrink the tumors.

  Androgens, or male hormones, can shrink fibroids and relieve symptoms. However, the side effects can be problematic and include deepening of the voice, weight gain, depression and unwanted hair growth.

  Oral contraceptives can help with bleeding, but they don't effect the size of the fibroids.

Non-Surgical Procedures for Fibroids

• One non-surgical option is myolysis where an electric current or laser destroys the tumors and blood vessels that feed them. Cryomylolysis is similar, except it uses liquid nitrogen to freeze the fibroids. These are newer procedures, so long-term effectiveness and side effects are still unknown.

  Endometrial ablation uses some one of various types of energy to destroy the uterine lining, end periods or reduce menstrual flow. It will not destroy any fibroids beyond the uterine lining.

  Uterine artery embolization targets arteries that feed the uterus by injecting small particles into them and cutting off the blood supply and shrinking the fibroids.

  Focused ultrasound surgery is non-invasive and uses high-energy soundwaves to destroy fibroids. However, it is a new procedure and the long-term results are unknown.

Surgical Options

• Myomectomy is surgery to remove the fibroids. It preserves a woman's ability to bear children, but the fibroids may return eventually. It can be done as an abdominal myometomy, which is typically used for very large or multiple fibroids. Laparoscopic myomectomy is done with small incisions in your abdomen using a slender instrument. Hysteroscopic myomectomy is done through a scope inserted through the vagina and cervix into the uterus.

  In the case of serious symptoms and when a woman does not want children, a hysterectomy can be done to remove the uterus. Rarely, the ovaries are removed as well. This procedure brings on menopause. This often is a last resort when the symptoms are greatly impacting the woman's quality of life and she has no interest in bearing children.