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Uterine fibroids treatment

Uterine fibroids (myomas) are benign growths of the muscle inside the uterus. According to surveys, about 25% of reproductive age women have uterine fibroids. Most popular age for fibroids is 30-50. In most cases after menopause fibroids shrink. Uterine fibroids are not cancerous but could cause several unpleasant symptoms including heavy and painful menstrual bleeding, irregular uterine bleeding, pelvic pain and infertility. Many women even don’t know that they have fibroids because most uterine fibroids don’t cause any disturbing symptoms or problems.

Nobody knows the exact cause of uterine fibroids but it was proved that the growth of fibroids depends from estrogen levels – actually estrogens can trigger the growth of myomas.

Uterine fibroids

There are few types of uterine fibroids:

  • Submucous fibroids (developed in the uterine cavity),
  • Intramural fibroids (growing on the wall of uterus),
  • Subserous fibroids (appeared on the outside of uterus),
  • Pedunculated fibroids (fibroids growing on the stalk).

Small fibroids that don’t cause any symptoms and fibroids which appeared close to menopausal period most often don’t require any treatment. At the same time, fibroids with moderate and severe symptoms should be treated immediately. Method of uterine fibroids treatment is selected depending on the type of fibroids, location and size. Treatment includes surgical and medical options.

Uterine fibroids treatment – myomectomy

Myomectomy is the surgical procedure when only fibroids are removed while leaving the uterus intact. In these cases women keep their reproduction functions and can have children after operation. Most often myomectomy can be recommended in cases of pedunculated fibroids. Myomectomy does not give quarantines that in future no more new fibroids could appear.

Uterine fibroids treatment – hysterectomy

Hysterectomy means removal of the uterus with all existing fibroids. Hysterectomy can be considered as the most aggressive method of treatment and should be recommended only in cases when other methods are not possible or not effective as well as in cases of finished reproductive functions (no more pregnancies are planned).
In most cases hysterectomy is recommended in cases of fast growing multiple or large fibroids with severe uterine bleeding.

Uterine fibroids treatment – medication

Conservative medication therapy can also be the option for some women with uterine fibroids. Since fibroids are dependent on estrogen for their growth, medical treatment that lower estrogen levels can be effective and can shrink fibroids. Several treatments can be effective and can reduce heavy uterine bleeding and painful periods triggered by fibroids. Medications cannot prevent the growth of benign tumors but can postpone surgical interferences. What are options of medications?

Some experts recommend birth control pills or other hormonal contraceptives which are able to reduce levels of estrogen and stop ovulation. This method can be effective in cases of heavy and painful bleeding.

Gonadotropin-releasing hormone (GnRH) agonists are able to stop regular menstrual cycles and shrink fibroids. Sometimes GnRH agonists can be used before surgical procedures to reduce the risk of bleeding. This method of treatment can be recommended only during 3-6 month (no longer) because of multiple side effects in almost 90% cases.

Hormonal intrauterine devices (mainly progestin releasing IUDs) can be used in cases of fibroids which appeared outside of uterus. This method can reduce heavy and painful bleeding but doesn’t treat fibroids themselves.

Uterine fibroids treatment – hysteroscopy

Hysteroscopy can be used in cases of submucous (intra-uteral) fibroids which appear in the cavity of uterus. With special equipments (lazer or electrical) doctor can remove fibroids without any problems. Hysteroscopy needs special qualification and can be performed as the outpatient procedure.

Uterine fibroids treatment – endometrial ablation

Endometrial ablation is a procedure which destroys the lining of the uterus. This method can be effective only in cases of small tumors (less than 3 centimeters). There are several ways to perform endometrial ablation.

Uterine fibroids treatment – uterine artery embolization

Uterine artery embolization (UAE) is the procedure when tiny particles are injected into the blood vessels that lead to the uterus. These particles cut off the blood flow to the fibroid and trigger shrinking. Uterine artery embolization needs special qualification and can be performed as the outpatient procedure.

Focused ultrasound surgery

Uterine fibroids treatment – focused ultrasound surgery

Magnetic resonance imaging-guided focused ultrasound surgery (FUS) is a noninvasive procedure that preserves the uterus. FUS is performed inside the MRI scanner equipped with a high-energy ultrasound transducer for treatment. MRI scanner provides the precise location of targeted fibroids and ultrasound transducer focuses sound waves into the fibroid to heat and destroy fibroid tissue. This method is safe and effective.

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