Progesterone IUDs as a Fibroid Treatment

The progesterone intrauterine device (IUD), while not specifically used to treat uterine fibroids, does help reduce the heavy bleeding often caused by fibroids. Not all women with fibroids experience symptoms, but some report discomfort during sex, lower back pain, frequent urination, painful periods or menstrual bleeding that is so heavy it causes anemia.

Fibroids Defined

• Uterine fibroids are benign growths in the muscle tissue of the uterus. They can range in size from very small to 6 inches wide and can grow inside or outside the uterus. Doctors don't know what causes fibroids, but the U.S. Department of Health and Human Services estimates that as many as 80 percent of women will have developed fibroids by the time they're 50.

IUD Defined

• An IUD is a small, plastic, T-shaped device, used for birth control, which is inserted into a woman's uterus by her gynecologist. There are two types available in the United States---hormonal and copper. The hormonal IUD can remain in place for 5 years; the copper IUD for 10. They work by creating an environment within the uterus that is hostile to egg and sperm.

  The hormonal IUD releases a small amount of progestin, the synthetic form of the hormone progesterone. Along with thickening the cervical mucus, which makes it difficult for sperm to swim up into the cervix, progestin also thins the lining of the uterus. The decrease in uterine thickness keeps a woman's fertilized egg from implanting and makes her periods lighter.

Effectiveness

• Its effect on the uterine lining makes the hormonal IUD a solution for the heavy menstrual bleeding that can accompany fibroids. According to William H. Parker, M.D., a clinical professor of Obstetrics and Gynecology at UCLA School of Medicine, "One study showed that by 3 months, 85 percent of women [who had hormonal IUDs inserted] returned to normal bleeding, and heavy bleeding and anemia were cured in virtually all women at the end of one year."

Considerations

• Women with very large fibroids may not be able to use the hormonal IUD because the fibroids may make insertion impossible. Also, because the IUD must be inserted and removed by a doctor, women who hope to become pregnant may want to choose a treatment option that is not a contraceptive---such as surgical removal of the fibroids---or choose a more flexible form of contraception, such as a diaphragm and condom.

Paradox

• The progesterone that can be so effective at lessening the heavy bleeding associated with uterine fibroids is now thought to contribute to fibroid growth. The Center for Uterine Fibroids reports that studies have shown synthetic progesterone---like the progestin in some IUDs---increases fibroid size. Parker reports that fibroids shrink and heavy bleeding stops in most women who are treated with progesterone-blocking drugs.