How Are Fibroids Treated?
Your doctor will create a plan of treatment unique to your circumstances. Factors that will influence the plan are your age, the number of fibroids, their size, location, symptoms, and overall health. For women diagnosed with uterine fibroids that are not experiencing any symptoms, there is no treatment necessary.
Hormones and Other Medications To Shrink Fibroids
Most doctors try to use hormones and over-the-counter medications as the first line of treatment for fibroid symptoms. Non-steroidal over-the-counter anti-inflammatory pain relievers such as Naproxen, Motrin, or Ibuprofen can help alleviate mild pain and symptoms. Another option that can help control bleeding and pain, but won’t shrink or eliminate fibroids, is an intrauterine device (IUD) that releases the hormone progestin or oral contraceptives.
GnRH agonists can be used temporarily (less than 6 months) to retard the growth of fibroids. They only work while they are in your system and fibroids will return to their former growth patterns when the medication is stopped. May induce early menopause and other unfavorable side effects.
There have not been adequate findings recorded indicating if fibroids shrink as a result of using selective estrogen receptor modulators to target estrogen levels. Results on fibroid shrinkage or elimination are unknown at this time.
Natural Fibroid Reduction
Experts have not successfully determined a cause for fibroids but they do have data highlighting factors that help them grow. Many women endeavor to avoid certain foods and self-care products that can cause fibroids to grow.
- Choosing foods that can help balance estrogen levels and not increase them;
- Getting adequate rest;
- Avoiding self-care and beauty products containing estrogen-altering additives;
- Exercising and sustaining a healthy weight to avoid excess fat being converted to estrogen;
- Vitamin D and iron supplements are important to help keep estrogen within balanced levels.
Surgery to Eliminate Fibroids
There are different types of surgery that are used to remove fibroids from the uterus.
Myomectomy is performed by an OB/GYN under general anesthesia; a myomectomy removes fibroids one at a time using one of several available myomectomy techniques. Often leaves the uterus compromised and weak, requiring a C-section if the patient ever gets pregnant after. Future fertility can be affected due to uterine scarring.
Myomectomy techniques include:
Open myomectomy – the most invasive myomectomy technique where fibroids are accessed through a “bikini cut” incision in the lower abdomen. Recovery is 4-6 weeks.
Laparoscopic myomectomy – fibroids are accessed and removed through small abdominal incisions using a special scope that contains a tiny camera and an instrument used to remove the fibroids. A 2-D image is projected on a screen for the surgeon to view the surgical site. Recovery time is about 4 weeks.
Hysteroscopic myomectomy – can only be used to remove submucosal fibroids. The surgical tools are inserted through the vagina and cervix without incisions. A light or tiny camera is sometimes used along with a special loop-like tool that uses electricity to remove the fibroid. Recovery time is typically a few days.
Robotic-assisted myomectomy is a more high-tech approach to a laparoscopic myomectomy using robotic arms controlled by the surgeon who is sitting at a terminal viewing the surgical site in 3-D. Robotic arms mimicking the surgeon’s movements can be more precise and move in ways the human hands can not. Recovery is about 4 weeks.
It is important to note that myomectomy surgery typically can not address all types of fibroids or fibroids that are too numerous. Any fibroids that remain after surgery will continue to grow, and new ones may also grow. Many women require another procedure to remove them within 5 years after their first myomectomy surgery.
Hysterectomy is the removal of the uterus by an OB/GYN through surgery. It is performed under general anesthesia and requires a hospital stay. A hysterectomy can remove the entire uterus or just a part of the uterus, cervix, ovaries, and fallopian tubes may also be removed. A hysterectomy removes a woman’s ability to become pregnant.
There are several different hysterectomy techniques:
Abdominal hysterectomy – the uterus and possibly other reproductive organs are removed through a C-section type incision in the abdomen. As the most invasive type of hysterectomy, this requires a hospital stay and 6-8 weeks recovery time.
Laparoscopic hysterectomy is performed using a laparoscope (a lighted instrument equipped with a camera) through very small abdominal incisions. The laparoscope fed through the belly button visually assists the surgeon in removing the uterus. Specialized instruments are inserted through a few other small abdominal incisions and the uterus is detached and removed. Recovery time is between 5 – 6 weeks.
Robotic-assisted laparoscopic hysterectomy – the technique and surgery steps are the same but robotic arms are holding the instruments instead of the surgeon.
Vaginal hysterectomy – the surgeon removes the uterus and possibly the cervix, fallopian tubes, and one or both ovaries through the vagina using the laparoscopic technique. Recovery time is about 4 – 6 weeks.
Nonsurgical Fibroid Treatment
Endometrial ablation is not a fibroid treatment but it is performed to alleviate heavy bleeding caused by fibroids. The procedure destroys the layer of the uterine lining that normally builds up and is shed during the menstrual cycle. There are several techniques used to perform uterine ablation including electrosurgery, cryoablation, free-flowing hot fluid, heated balloon, microwaves, and radiofrequency. After endometrial ablation, a woman cannot get pregnant.
Uterine Fibroid Embolization
Uterine Fibroid Embolization (UFE) is a technique that does not involve surgery or a hospital stay. This minimally invasive procedure performed by an Interventional Radiologist stops all fibroids from growing by cutting off their blood supply, which makes them shrink. UFE addresses every type of fibroid, no matter the size, location, or type.
The results of UFE have been clinically proven to be 90% effective in relieving fibroid symptoms. Recovery is typically less than 7 days. Most women report that their fibroid symptoms were eliminated within three months after the procedure. Many patients with previous fertility issues were able to conceive and have successful pregnancies after UFE.