When we talk to our patients at Atlanta Fibroid Center about fibroid treatment options, we strive to provide a comprehensive overview of each option so that each woman can make the best decision for her. If she is asymptomatic, our general recommendation is to leave fibroids untreated. Meanwhile, women who suffer from unpleasant fibroid symptoms, especially from heavy menstrual bleeding, often ask if the use of IUDs can help control it. Before answering this question, let’s clarify what an IUD stands for.
IUDs and Fibroids: What Is an IUD?
An IUD or an Intrauterine Device is a birth control method. An IUD is T-shaped, about 3 to 4 cm long, and flexible enough to be placed by a doctor inside the uterus to prevent pregnancy. There are two types of IUDs: non-hormonal (copper-releasing) and hormonal (progestin-releasing).
The non-hormonal IUD involves copper as the active agent that creates an environment where it is impossible for sperm to meet an egg. Copper IUD can stay in the uterus for up to 10 years and can be removed at any time with no consequences.
The hormonal type of IUD works by releasing a small amount of progestin, a synthetic analog of progesterone hormone that is produced naturally in the body and maintains the menstrual cycle, pregnancy, and other body processes. Progestin in an IUD affects the uterus lining making it thinner, so that fertilized eggs cannot get attached to it. Additionally, the cervix becomes thicker preventing sperm physically from entering the uterus. This type of IUD is effective for 3 to 7 years, with the possibility of reversing at any moment.
How Do IUDs Affect Fibroids?
Both copper and progestin IUDs cause changes in vaginal bleeding, but in different ways. Women who opted for copper IUDs mention increased and prolonged period bleeding. Women with progestin IUDs commonly experience less heavy and less painful menstrual cycles.
The hormonal progestin-releasing IUD is the one that is often prescribed by health providers as the first-line fibroid treatment that are responsible for heavy menstrual periods.
Uterine fibroids are very sensitive to the levels of female sex hormones, estrogen and progesterone. Their imbalance greatly affects the development of fibroid tumors. When the amount of progesterone in the body isn’t sufficient, the level of estrogen elevates stimulating the growth of fibroids. The hormonal IUD is supposed to correlate estrogen since progestin in the IUD acts similar to its natural analog.
Therefore, in addition to thinning the uterus lining and thereby reducing the amount of menstrual bleeding, the progestin in IUDs balances out the level of estrogen. Progestin may limit the effect of estrogen on fibroids and sometimes (rarely) inhibit the growth of fibroids.
Can IUDs Relieve Pain from Fibroids?
If a woman has high levels of estrogen, progestin therapy may contribute to stopping the growth of fibroids and hence, the painful fibroid symptoms. However, it’s important to understand that a progestin-releasing IUD is a temporary solution as it doesn’t treat the fibroids.
Besides, hormonal IUDs are normally ineffective for women with large or multiple fibroids. IUDs are not an option for women with submucosal fibroids that grow inside the uterus as they can provoke the expelling of the device. Finally, as any hormonal therapy, progestin IUDs can cause unwanted side effects when used long term.
Women with fibroids should consider these 3 factors before opting for a hormonal IUD:
- Presence of large or multiple fibroids;
- Presence of fibroids within the uterus cavity;
- Side effect of hormonal therapy.
Hormonal IUDs mask bleeding as a symptom temporarily, but ultimately, the fibroid problem is not being addressed. Therefore, it’s critical to consider a permanent solution for fibroids while receiving the first-line treatment.
UFE Means Treating Fibroids Permanently
If you are a woman with symptomatic fibroids, it’s important to know about the non-surgical treatment option called Uterine Fibroid Embolization (UFE) that permanently treats all of the fibroids regardless of their size or number. It is a minimally invasive procedure without the risks traditionally associated with surgical fibroid treatments, such as hysterectomy and myomectomy. The procedure is done 35-40 minutes in outpatient settings. Women normally can resume their usual activities in 3-4 days after the procedure and will completely recuperate within a week.
If you would like to learn more about uterine fibroids, symptoms, and uterine fibroid embolization (UFE), contact Dr. John Lipman, one of the leading fibroid experts in the USA, by calling 770-214-4600, or make an appointment on ATLii.com.