Fibroids are benign, or non-cancerous, growths which occur inside the womb. They are common and in many cases cause no symptoms. Sometimes, though, fibroids can give rise to symptoms such as heavy menstrual bleeding and abdominal discomfort or lead to fertility problems. Different types of uterine fibroids treatment may then be carried out. The range of options comprises: medication to shrink the fibroids, surgical removal, cutting off the blood supply to the growths, and destruction of fibroids using guided ultrasound.
Often, fibroids are small and the main symptom is increased menstrual bleeding. In such cases, the type of uterine fibroids treatment used may only involve those medications commonly taken for heavy periods. These might include anti-inflammatories to relieve cramps and possibly contraceptives in order to create lighter, less painful menstrual cycles.
Synthetic hormones are sometimes used to shrink uterine fibroids, as they are sensitive to the levels of certain hormones in the body, including estrogen. What is called a gonadotrophin-releasing hormone, or GnRH, analog is used to lower the level of estrogen. Since fibroids are associated with high amounts of estrogen, a lower level causes them to shrink. Unfortunately, low estrogen also gives rise to menopausal symptoms such as hot flushes and an increased risk of osteoporosis, or loss of bone density, so this kind of uterine fibroids treatment is typically prescribed for less than six months and may be used prior to fibroid surgery.
There are a number of surgical fibroid treatment methods. A myomectomy involves using keyhole surgery to remove fibroids while leaving the womb, or uterus, intact. It is particularly useful for women intending to become pregnant. Although fibroids are removed, there is a possibility that new ones may appear or any remaining small fibroids might grow back. A hysterectomy removes the entire uterus, and is the uterine fibroids treatment of choice if fibroids must be permanently removed and future childbearing is not an issue.
Uterine artery embolization is a procedure where a thin tube is inserted through a leg artery and guided, using X-rays, into the arteries supplying the uterus. Once there, tiny grains of plastic are injected into the tube. These block the uterine arteries carrying blood to the fibroids, and the fibroids then shrink over a number of months. As this is a relatively new operation, its long-term effects are unknown, so it is not recommended for women who plan to have children later.
For some women, ultrasound can be used to dissolve fibroids. Using magnetic resonance imaging, or MRI, to see that they are positioned correctly, needles are inserted through the skin and into the middle of a fibroid. Focused ultrasound energy is passed through the needles and the fibroid tissue is heated and destroyed. Sometimes the procedure is carried out using laser energy instead of ultrasound, and the newer ultrasound techniques do not use needles at all. These operations are best performed where there are a few large fibroids and, as long-term effects are not yet fully known, they should not be used on women who want to become pregnant in the future.
