Fibroids are the most common tumor that affect women and about 99 percent of them are benign (non cancerous). Although uterine fibroids are so common, the good thing is that most of them usually pose no problems for the women that have them. For other women, dealing with the various symptoms of uterine fibroids can be a challenge. They may suffer from pain, pelvic pressure, heavy bleeding, infertility, pregnancy complications, constipation, etc. For women with these tumors, here are the different options available to you when considering treatment for fibroids.
Treatment for Fibroids
1. Ignore the fibroid tumors
Many women choose this option with varying degrees of success. Choosing this option to ignore fibroids and any symptoms is a fearful approach which is not the healthiest approach to have. Hoping that they go away is not the best way to go. They may go away but they may also become much worse.
2. Watch and wait
Although you are not treating the fibroid tumors, you are also not ignoring them either with this approach. As most uterine fibroids do not cause any problems, this may be the approach that your gynecologist recommends which is fine.
With this approach, your gynecologist will monitor the tumors up to four times annually. This option also requires that you do your own monitoring by keeping good records of your symptoms (if any) and noting any changes you notice. You also need to monitor your menstrual cycles and record any changes you notice as well as any lifestyle changes that may impact your symptoms (if any). Keeping a diary or journal can actually be beneficial and eye opening for you.
3. Drug therapy
Conventional treatment for fibroids can start with drug therapy. This can either be done alone or with surgery.
This can start as simply as using pain medication available over the counter to relieve some of the pain from fibroid tumors.
Drug therapy also commonly involves the use of birth control pills in order to control hormones and prevent fibroids from increasing in size as well as to help with other symptoms of fibroids such as heavy bleeding, cramps, etc.
Using birth control pills (low estrogen pills) may work but there is also the chance that the pills may cause the tumors to grow larger.
The other aspect of drug therapy is the use of hormone therapy to treat uterine fibroids. These are drugs that are used to prevent an estrogen dominant state from existing in your body. While the causes of fibroid tumors remain unknown, it is thought that estrogen as well as the activity of other hormones such as progesterone may play an important role in fibroid growth.
Hormone therapy using drugs that suppress estrogen or progesterone growth try to create an environment that mimics menopause which is characterized by low levels of hormones especially estrogen and progesterone. Fibroids are believed to shrink or die during menopause so this is what hormone therapy seeks to do.
Hormone therapy is usually administered through an injection over a period of 1 to 3 months. While the fibroids may shrink during the treatment period and other fibroids related symptoms may lessen such as heavy bleeding, once the treatment stops, estrogen and progesterone will return to normal levels and with that so will the fibroid tumors as well as the various symptoms of uterine fibroids you had been dealing with prior to the treatment.
This therapy is usually recommended if fibroids are affecting fertility and the small window of opportunity provided by hormone therapy may increase chances of conception.
However, since fibroids and symptoms tend to be worsened by the increased hormone activity during pregnancy, choosing hormone therapy in order to increase fertility many not be wise. This is due to some fibroids having the ability to increase greatly in size during pregnancy and causing pregnancy complications as well as increasing the risk of miscarriage.
4. Surgical treatment
There are various types of surgical procedures available as a treatment for fibroids and many more are being researched and developed every day.
The most common surgical procedures for fibroids include;
a. Myomectomy which seeks to remove fibroid tumors while leaving the uterus intact. If you wish to conceive and fibroids are interfering, an abdominal myomectomy may be the answer for you as the fibroids are removed including those impacting fertility while leaving the uterus intact to allow you to get pregnant.
There are other types of myomectomies that can be performed besides the abdominal myomectomy such as the hysteroscopic resection (vaginal) or the laparoscopic myomectomy. Since these do not restore the uterus as close as possible to the original as the abdominal myomectomy does, they are usually not recommended for those who wish to get pregnant after the surgery.
Since the uterus remains intact after a myomectomy, there is always a chance that the fibroids will return in the future.
b. Hysterectomy which is the most common surgical procedure performed in women with fibroids being the most common reason for a hysterectomy each year.
The total hysterectomy removes the uterus along with the cervix while leaving your ovaries and fallopian tubes intact. Without a uterus, fibroids cannot grow so this is a more permanent solution for fibroids than a myomectomy.
On the other hand, without a uterus, there will be no chance of pregnancy after the surgery and in some cases, a hysterectomy may trigger early menopause in addition to many other side effects.
The other types of hysterectomy include the total abdominal hysterectomy (uterus, cervix, ovaries and fallopian tubes are all removed) and well as the supracervical hysterectomy which removes only the top part of the uterus while the cervix, ovaries and fallopian tubes remain intact.
5. Image guided therapy
With this treatment for fibroids option, probes and pictures are used to help shrink fibroids or cause them to disintegrate without actually removing them. The most common type of image guided therapy is the uterine artery embolization (UAE) which is also known as uterine fibroid embolization (UFE).
With the UAE, x-rays are used to get the image of the fibroids and then a probe is inserted into the thigh to get at the main blood supply of the fibroids to cut off or reduce this blood supply to the tumors by depositing small round particles (microspheres) into the uterine artery.
Fibroids are believed to thrive when there is a robust blood supply so by cutting off or reducing this blood supply, the tumors will usually shrink or die.
This is an outpatient procedure and is not performed by a gynecologist. Therefore, when talking about treatment options with your gynecologist, he or she may not mention this treatment option. If so, you need to bring it up.
Other image guided therapies include the myolysis (uses heat to kill the fibroid tumors as well as blood supply using probes inserted into the abdomen) and the cryomyolysis which uses extreme cold to do the same.
Since these various therapies keep the uterus intact, there is always a chance of the future return of fibroid tumors.
6. Alternative therapies
More and more women with fibroids are turning to alternative treatment for fibroids methods as many of them not only treat the symptoms but may also provide a more permanent solution for the problem of fibroids.
In fact, before considering surgery, it is important to try other treatment methods first including alternative therapy as you may find that these work better without the potential risks and side effects of surgery. Many of them are even able to cure fibroids permanently unlike most conventional treatment methods.
The various alternative treatment methods include;
- Making important diet and lifestyle changes
- Herbalism (Chinese or Western)
- Homeopathy, etc