To Treat or Not to Treat - That is the Question

Admittedly up to this point we've talked about bad stuff - what puts you at risk, what can go wrong? Today we'll start looking at what can be done about fibroids. For most women the answer is: nothing. The majority of women have no symptoms from their fibroids and really don't need to do anything about them.  Doctors often call this "expectant management" or "watchful waiting," meaning we'll wait and see if anything happens. With fibroids this means getting a yearly gynecological exam and telling your doctor if anything changes. For those women who do have symptoms from fibroids or have concerns about getting pregnant because of the location of their fibroids there are options. Today we're going to look at the non-surgical methods.

Hormones - Hormones in a variety of forms have been shown to help with fibroid symptoms, especially heavy bleeding. They do not seem to decrease the size of fibroids. The hormones like estrogen and progesterone can be given in a lot of different ways. The most common is oral contraceptives or birth control pills but there are also IUDs, implants and injections. There are also drugs that affect the level of hormones in your body. One type of these know as gonadotropin-releasing hormone agonists (quite the mouthful!) has been shown to be the most effective at decreased the size of fibroids. Sadly, this drug is not recommended for long term use and is usually only given before surgery.

NSAIDs - Non-steroidal anti-inflammatory drugs are a fancy name for medicines we all have in our cabinet - ibuprofen, Motrin, Aleve. Since pain is one of the most common symptoms of fibroids, these drugs can be very helpful in their management.

Uterine artery embolization (UAE) - UAE is one of the newer treatments for fibroids. While it is a procedure, it's not a surgery - in fact a radiologist does it! The goal of UAE is to stop the blood flow to the fibroids. This is done by injecting little plastic particles into the arteries that send blood to the uterus. 

This procedure is very successful at shrinking the fibroids (up to 65%) and up to 85% of women report less symptoms. 

References:

http://www.upmc.com/HospitalsFacilities/Hospitals/Magee/SpecialtyServicesWomen/FibroidTreatmentCenter/Pages/TreatmentOptions.aspx

http://www.rifibroids.com/