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Fibroid Treatment | Shrink Fibroids | Fibroid Surgery | Fibroids Research and Treatment Centre

Fibroids Treatment Options for Fibroid Disease

If an individual with fibroids experiences no fibroid symptoms, usually no fibroids treatment is needed. However, there may be an argument for fibroids treament in a young woman desiring fertility in the future – to minimize damage of the uterus as the fibroids continue to enlarge. If a decision is made to NOT treat fibroids that are without symptoms, then the woman should be monitored on a regular basis (perhaps annually) to assess the growth of the fibroids and review symptoms.

For women with symptoms requiring fibroids treatment there are several options, and the choice should be individualized to each woman based on a numbers of factors including the following:

• If the woman wishes to preserve fertility
• the size of the fibroids
• the number of the fibroids
• the location of the fibroids
• the woman’s age and proximity to the menopause
• the availability of a treatment modality

Fibroids Treatment: Medical Therapies

A number of drugs commonly used as contraceptives can help control symptoms of fibroids.
These include:

– The combined oral contraceptive pill: these DO NOT make fibroids grow and can help control heavy bleeding.

– Progesterone based medications eg Depo-Provera, given as an injection once every three months: many women stop menstruating altogether; of the Mirena intrauterine device, which gives excellent contraception and also reduces menstrual flow by thinning the lining of the womb. The Mirena does not work well if the fibroids have distorted or significantly enlarged the cavity of the uterus.

Other medications for fibroids treament include the following:

Over-the counter pain killers may be useful in women with painful menses. Iron supplements can also be obtained over the counter to alleviate anaemia.dandilion_clocklr

Fibroids Treatment: Tranexamic acid: these tablets are taken from the start of the period for up to four days. However, treatment should be stopped if symptoms have not improved within three months. The tablets work by helping the blood in the womb to clot, which reduces the amount of bleeding. Tranexamic acid tablets are not a form of contraception and will not affect chances of becoming pregnant once they are discontinued.

Fibroids Treatment: Anti-inflammatory medicines such as ibuprofen and mefanamic acid (ponstan) help to ease painful periods and are taken for a few days during menstruation. They work by reducing the body’s production of a hormone-like substance, called prostaglandin, which is linked to heavy periods. They are also painkillers but are not a form of contraceptive. Common side effects include indigestion and diarrhoea.

Fibroids Treatment: GnRH analogues (GnRHa) – gonadotropin releasing hormone analogues are given by injection, nasal spray, or implanted. They shut down the production of the hormone oestrogen, and create an artifial and entirely reversible menopause, and in this way cause fibroids to shrink. There are some gynaecologists who use GnRHa to shrink fibroids prior to surgery in the belief that they make the operation easier and reduce blood loss. Because of the artificial menopause they create these drugs have significant side-effects including hot flashes, depression, poor sleep, decreased sex drive, and joint pains.

However, most women tolerate GnRHa well, and the addition of “add-back HRT” (effectively treating the menopausal symptoms without affecting their role in shrinking the fibroids) means that the drug can be used with minimal difficulties. Most women do not get a period when taking a GnRHa. It also allows women with anemia to recover to a normal blood count. GnRHas can cause bone thinning, so their use is generally limited to six months or less. These drugs are very expensive, something that should be considered when they are to be used. GnRHa can cause significant shrinkage in fibroids, but once they are stopped the fibroids grow back quickly, often becoming bigger than they were prior to treatment. They are therefore not suitable as stand-alone fibroids treatment, except perhaps in the woman who is already undergoing a natural menopause – but even then there are cheaper and effective alternatives!

Fibroids Treatment: Mifepristone, and other anti-hormonal drugs being developed, could provide symptom relief without bone-thinning side effects. These are promising treatments for fibroids, but none are yet available or formally approved.

Thus overall, medical therapies are rarely ever a permanent solution to the problems caused by fibroids, especially if they are large and/or numerous.

Fibroids Treatment: Surgical Therapies

Surgery is often the most appropriate method of fibroids treatment that are symptomatic, and indeed until about 15 years ago hysterectomy and myomectomy were the only surgical options available. However, the range of options available are now wide, and they are briefly described below:

Fibroids Treatment: Hysterectomy: this involves surgery to remove the womb. A hysterectomy is not usually necessary unless the fibroids are very large or the symptoms, such as heavy menses, are severe. Hysterectomy offers complete cure of the fibroids, since there is no possibility of new fibroids re-forming. Research indicates that the majority of women who have the operation report an improved quality of life. However, women often have an earlier menopause following hysterectomy, with the attendant issues relating to this stage of a woman’s life.

Fibroids Treatment: Myomectomy involves surgery to remove the fibroids from the wall of the womb. A myomectomy is an alternative to having a hysterectomy, particularly for women wishing to have children. However, the procedure may not always be possible as it depends on individual circumstances, such as the size, number and position of the fibroids.

Fibroids Treatment: Endometrial ablation is removal of the womb lining. It is usually only carried out if the fibroids are near the inner surface of your womb. The affected womb lining is removed, which may be done in a number of ways, including using laser energy, a heated wire loop, microwave heating or hot fluid in a balloon. Endometrial ablation can be used as an alternative to a hysterectomy.

Fibroids Treatment: Uterine artery embolisation (UAE) is a new treatment used to block the blood supply to fibroids. This is done by injecting a chemical through a small tube (catheter) that has been guided by X-ray scans into a blood vessel in the groin. This is usually used in women with large fibroids, and has been known to shrink fibroids by up to 60%. As UAE is a new procedure it may not currently be available in some hospitals.

For more information on Fibroids Treatment using Uterine Artery Embolisation Click Here

Fibroids Treatment: Magnetic-resonance-guided percutaneous laser ablation: Another new fibroids treatment is magnetic-resonance-guided percutaneous laser ablation. In this procedure, a magnetic resonance imaging (MRI) scan (which uses a strong magnetic field and radio waves to produce detailed pictures of the inside of your body) is used to find your fibroids. Once the fibroids have been located, fine needles are inserted through your skin and guided into the fibroids. A fibre optic cable (a cable that can transmit beams of light) is threaded through the needles. Light is then targeted at the fibroids, and the heat from the light is used to shrink them. This method of fibroids treatment has largely been replaced by the similar treatment described below.

Fibroids Treatment: Magnetic-resonance-guided focused ultrasound surgery (MRgFUS): Magnetic-resonance-guided focused ultrasound surgery is a similar procedure to magnetic-resonance-guided percutaneous laser ablation. An MRI scan is used to locate the fibroids and sound waves are targeted at them. The sound waves produce pulses of energy to shrink the fibroids. The need for sophisticated MRI facilities severely limits the availability of MRgFUS: in the UK at present only two centers offer the treatment, while there are more centers in the United States. In addition, much research is required on this treatment before its true benefits can be appreciated.

If You Are Looking for Fibroids Treatment

For an NHS appointment please ask your GP to refer you to the
Myoma Clinic, St George’s Hospital.

If seeking a private consultation please ring 020 8947 9877.

St George’s Fibroids Clinic London | Parkside Hospital Fibroids Clinic Wimbledon
Princess Grace Hospital Fibroids Clinic | St Anthony’s Hospital Fibroids Clinic

Links

  • Women's Health – Women’s Health Clinic Website, Dedicated to Gynecological Disorders. Information on a wide range of women’s health disorders & symptoms women may experience.

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