Fibroids are the most common tumors in women and about 99% of them are benign (non-cancerous). Although uterine fibroids are so common, the good news is that most of them are usually not a problem for women who have them. For other women, dealing with the different symptoms of uterine fibroids can be a challenge. They may experience pain, pelvic pressure, heavy bleeding, infertility, pregnancy complications, constipation, etc. For women with these tumors, here are the different options available to you when considering fibroid treatment.
Treatment of fibroids
1. Ignoring fibroid tumors
Many women choose this option with varying degrees of success. Choosing to ignore fibroids and their symptoms is a fearful approach that is not the healthiest. Hoping they will go away is not the best solution. They can go away, but they can also get worse.
2. Watch and wait
Although you don’t treat fibroids, you don’t ignore them with this approach either. Since most uterine fibroids don’t cause any problems, your gynecologist may recommend this approach, which is fine.
With this approach, your gynecologist will monitor the tumors up to four times a year. This option also requires you to do your own monitoring by recording your symptoms (if any) and noting any changes you notice. You should also monitor your menstrual cycles and note any changes you notice, as well as any lifestyle changes that may affect your symptoms (if any). Keeping a diary or journal can be beneficial and eye-opening.
3. Drug Treatment
Conventional treatment of fibroids may begin with drug therapy. I can do alone this or in combination with surgery.
It may simply involve the use of over-the-counter pain relievers to relieve the pain caused by fibroids.
Drug therapy also involves the use of birth control pills to control hormones and prevent fibroids from growing in size, as well as to relieve other symptoms of fibroids such as heavy bleeding, cramping.
Using birth control pills (low estrogen pills) can be effective, but there is also a risk that the pills may cause the tumors to increase in size.
The other aspect of drug therapy is the use of hormone therapy to treat uterine fibroids. These are drugs that are used to prevent a dominant estrogen state in your body. Although the causes of fibroids are unknown, estrogen, as well as the activity of other hormones such as progesterone, may play an important role in the growth of fibroids.
Hormone therapy, which uses drugs that suppress the growth of estrogen or progesterone, attempts to create an environment that mimics menopause, which is characterized by low levels of hormones, particularly estrogen and progesterone. I think fibroids to shrink or die during menopause, and this is what hormone therapy seeks to do.
We usually gave hormone therapy by injection over 1 to 3 months. While the fibroids may shrink during the treatment period and other fibroid-related symptoms may improve, such as heavy bleeding, once treatment is stopped, estrogen and progesterone return to normal levels, causing the fibroid tumors and various uterine fibroid symptoms you had before treatment to return.
This therapy is usually recommended if the fibroids are affecting fertility and the small window of opportunity offered by hormone therapy can increase the chances of conception.
However, because fibroids and symptoms tend to be worsened by increased hormonal activity during pregnancy, it is not always wise to choose hormone therapy to increase fertility. In fact, some fibroids have the ability to significantly increase in size during pregnancy, leading to complications and increasing the risk of miscarriage.
4. Surgical Treatment
There are several types of surgical procedures to treat fibroids, and many more are being researched and developed daily.
The most common surgical procedures to treat fibroids are as follows;
a. Myomectomy, which removes fibroid tumors while leaving the uterus intact. If you want to conceive and the fibroids are bothering you, an abdominal myomectomy may be the solution for you, as the fibroids are removed, including those that impact fertility, while leaving the uterus intact so you can get pregnant.
There are other types of myomectomies besides abdominal myomectomy, such as hysteroscopic (vaginal) resection or laparoscopic myomectomy. Because the latter do not restore the uterus as close to the original uterus as abdominal myomectomy does, they are not recommended for people who wish to become pregnant after surgery.
Because the uterus remains intact after a myomectomy, there is always a risk that fibroids will return in the future.
b. Hysterectomy, which is the most common surgical procedure performed on women, with fibroids being the most common reason for a hysterectomy each year.
A total hysterectomy involves removing the uterus and cervix while leaving the ovaries and fallopian tubes intact. Without the uterus, fibroids cannot develop. It is therefore a more permanent solution for fibroids than myomectomy.
However, without a uterus, there is no chance of pregnancy after surgery, and sometimes, a hysterectomy can trigger early menopause besides many other side effects.
Other types of hysterectomy include total abdominal hysterectomy (the uterus, cervix, ovaries and fallopian tubes are all removed) and supra cervical hysterectomy, which removes only the upper part of the uterus while the cervix, ovaries and fallopian tubes remain intact.
5. Image-guided therapy
In this fibroid treatment option, probes and images are used to help reduce fibroids or disintegrate them without removing them. The most common type of image-guided therapy is uterine artery embolization (UAE), also known as uterine fibroid embolization (UFE).
In UFE, x-rays are used to image the fibroids, and then a probe is inserted into the thigh to reach the main blood supply of the fibroids and cut off or reduce the blood supply to the tumors by depositing small round particles (microspheres) in the uterine artery.
Fibroids grow when they have a large blood supply. So by cutting off or reducing this blood supply, the tumors will usually shrink or die.
This is an outpatient procedure that is not performed by a gynecologist. Therefore, when you discuss treatment options with your gynecologist, he or she may not mention it. If this is the case, bring it up.
Other image-guided therapies include myolysis (which uses heat to kill fibroid tumors and blood supply through probes inserted into the abdomen) and cryomyolysis which uses extreme cold to do the same.
Because these various therapies keep the uterus intact, there is always a risk of fibroid tumors returning in the future.
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6. Alternative therapies
More and more women with fibroids are turning to alternative methods of fibroid treatment, as many of them not only treat the symptoms, but can also provide a more permanent solution to the fibroid problem.
In fact, before considering surgery, it is important to try other treatment methods first, including alternative therapy, as you may find that these work better without the potential risks and side effects of surgery. Many of them are even able to permanently cure fibroids, unlike most conventional treatment methods.
The various alternative treatment methods include:
Major dietary and lifestyle changes
Acupuncture
Herbal medicine (Chinese or Western)
Ayurveda
Homeopathy, etc.
