Treatment options for uterine fibroids

Fibroids do not have a single best way of dealing with as several treatment options are available. PHOTO | FOTOSEARCH

What you need to know:

  • Medication for uterine fibroids are meant to target hormones that influence menstruation, treat symptoms like pelvic pressure and heavy menstrual bleeding. They do not get rid of fibroids although it may shrink them.

Fibroids do not have a single best way of dealing with as several treatment options are available. With doctor’s advice, the following treatments can be recommended.

WATCHFUL WAITING

Most women with uterine fibroids have no visible symptoms or signs of the disease except for mild annoying signs that one can tolerate.

If this applies to you, then watchful waiting is the best option.  Therefore, if there are no symptoms and a woman is not bothered by fibroids, they are usually left to stay.

When a woman reaches menopause, hormonal changes which include reduction of reproductive hormones causes them to shrink on their own.

If fibroids are symptomatic, then there are treatment approaches which may include hormonal treatment, non-hormonal treatment, use of medication that induces menopause, or surgery.

MEDICATION

Medication for uterine fibroids are meant to target hormones that influence menstruation, treat symptoms like pelvic pressure and heavy menstrual bleeding. They do not get rid of fibroids although it may shrink them. These common medications include;

 Gonadotropin –releasing hormones agonists (Gn-RH): these medications include Synarel, Lupron and others and treat fibroids by inducing medical menopause and also improves anemia. 

 Progestin-releasing intrauterine device (IUD): this can relieve heavy bleeding resulting from fibroids. The progestin releasing IUD provides relief on symptoms only and has no shrinking effect on the fibroids; neither does it make them disappear.

Besides, there are other medications that your doctor may recommend including oral contraceptives to help regulate bleeding but do not shrink the fibroids. Non hormonal drugs like non-steroidal anti-inflammatory drugs (NSAIDs) also relief pain associated with fibroids but do not reduce bleeding resulting from the fibroids.

Non-invasive procedure

MRI-guided focused ultrasound surgery (FUS) entail a non-invasive treatment option for uterine fibroids which preserves the uterus needs no incision and is carried out in an outpatient basis.

MRI-guided FUS can also be performed when the patient is inside an MRI scanner fitted with high power ultra sound transducer for treatment. The images produced provide your doctor with the exact position of the fibroids. Once located, the ultra sound transducer emits sound waves into the fibroid to heat and damage small sections of fibroid tissue.

MINIMALLY INVASIVE PROCEDURES

 Some procedures can be done to destroy uterine fibroids without necessarily removing them through surgery. They entail:

 Myolysis: In this procedure, an electric current or laser damages the fibroids and contracts the blood vessels feeding them. Cryomylysis is a similar procedure which freezes the fibroids.

Uterine artery embolisation: This entails introduction of small particles of embolic agents into the arteries feeding the uterus, blocking the flow of blood to fibroids leading them to shrink and finally die. However, here in Kenya, this procedure is available in limited hospitals.

Laparoscopy: In this procedure the surgeon gets rid of the fibroids leaving the uterus intact. This involves inserting thin instruments through a small cut on the abdomen to remove fibroids in the uterus.

Hysteroscopic myomectomy: This option is undertaken when the fibroids are inside the uterus. The surgeon removes the fibroids using instruments inserted through the vagina into the uterus.

Abdominal myomectomy: This is a traditional method which involves abdominal surgical procedures to get rid of multiple fibroids or fibroids that are deeply rooted. This method is preferred for women who desire to have children thereafter.

Hysterectomy: This is a surgical procedure that involves the removal of the entire uterus. Being a major surgery, it is the only permanent solution to fibroids so far.

Ovaries may also be removed bringing about menopause. However, hormonal replacement therapy may be required if the ovaries are removed which makes most women choose to retain them.