Uterine fibroids don’t always need treatment – in fact, in many cases, they shrink and go away over time. But if a woman and her healthcare provider decide that it’s in her best interest to treat the condition, there are a few different ways to go about this.
Depending on the woman’s symptoms, fibroids get treated in a few different ways.
Watchful waiting
In a lot of cases, the fibroids aren’t causing any symptoms. In these situations, the best treatment is most likely going to be waiting to see if any symptoms appear. If no symptoms appear, it’s likely that there won’t be any course of treatment.
Medication
Certain medications can help slow the growth of fibroids. Some block estrogen and progesterone production, others relieve heavy bleeding, and other medications supplement iron that might be lost through bleeding. Medication is a noninvasive form of treatment that your healthcare provider may prescribe or recommend, based on your symptoms and risk factors. It is usually most helpful for women who have predominantly bleeding or menstrual symptoms, and is typically less effective for women who have bulk symptoms like pelvic pain, constipation, or bladder control problems.
MRI-guided focused ultrasound surgery (FUS)
For this procedure, a woman lies on a bed inside an MRI scanner. The scanner pinpoints where the fibroids are located, and uses sound waves to break down fibroid tissue. This procedure is generally reserved for women who have finished having children, although it has recently begun to be offered to women who are planning on getting pregnant, and it isn’t normally recommended for women who have abdominal scarring, more than five fibroids, or fibriods that are located in the bowel or bladder wall.
Uterine artery embolization
This is a slightly more invasive procedure that can help reduce the size of fibroids and decrease their symptoms. The patient is lightly sedated, and then the specialist makes an incision in her leg and inserts a catheter into the uterine artery. Small particles are inserted into the catheter, blocking the blood supply to the fibroids and making them shrink. Women who undergo this procedure have usually tried medication for their fibroids, or have symptoms like pelvic pain, constipation, or low blood count. This procedure is considered safe for women who want to get pregnant in the future, but it’s more commonly performed on women who aren’t planning on getting pregnant again. Women who have larger uteri or multiple fibroids are generally advised not to undergo this procedure for their fibroids.
Myomectomy
This is the preferred procedure for women who plan on getting pregnant in the future. For this procedure, the surgeon makes an incision in the abdomen and removes fibroids from the uterus. There are two different kinds of incisions; what’s used depends on the size of the fibroids and of the woman’s uterus. Myomectomy takes some recovery time, and the woman might have to stay in the hospital for a few days, and restrict activity outside of the hospital for a few weeks, depending on her circumstances.
Myolysis
For this procedure, the surgeon makes a small incision in the abdomen. He or she then focuses a high frequency electric current on blood vessels that run to the fibroid. The vessels shrink, cutting off blood flow to the fibroid. Myolysis is minimally invasive, and recovery takes about a week at most. There are some risks associated with the procedure, however, including the possibility of a uterine rupture during pregnancy due to a weakened uterine wall from the procedure, so women should be counseled on and consider all the risks before they reach a decision.
Endometrial ablation
This minor surgery is best for women who experience very heavy bleeding during their period. It is reserved for women who have completed childbearing, and who don’t plan on getting pregnant in the future, because most women can’t get pregnant after the surgery. To perform endometrial ablation, a doctor uses heat, electrical currents, or a laser to break down and permanently remove the lining of the uterus (endometrium). Complications are rare, and recovery is generally fast, meaning that women almost always go home the same day.
Hysterectomy
A hysterectomy is the most invasive of all the above procedures. In it, the entire uterus is removed. Hysterectomies are common and low-risk, and they are the only way to permanently treat fibroids. But they render a woman unable to have children in the future, so women need to be sure of their choice to have a hysterectomy.
As you can see, there are a lot of different ways used to treat fibroids, and they range in terms of invasiveness. The way that a woman will be treated for uterine fibroids really depends on certain aspects of her health and her condition; for the most part, though, a provider will work with their patient to make sure that she is making the best decision for her health.
Sources
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Mayo Clinic Staff. “Uterine fibroids: treatment.” MayoClinic. Mayo Foundation for Medical Education and Research, Jul 6 2016. Web.
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Mayo Clinic Staff. “Focused ultrasound surgery for uterine fibroids.” MayoClinic. Mayo Foundation for Medical Education and Research, Apr 30 2016. Web.
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“Uterine artery embolization.” MedlinePlus. National Institutes of Health, Nov 16 2014. Web.
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William H Parker. “Abdominal Myomectomy.” FibroidSecondOpinion. William H Parker MD, Jan 22 2010. Web.
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“Endometrial Ablation.” WomansClinicPA. Woman’s Clinic, 2016. Web.
