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Fibroids Health Centre
Treatment |
Most fibroids cause no symptoms, do not interfere with pregnancy, and do not need to be treated.
If your fibroids cause mild symptoms, they may require no treatment either. Your doctor should simply keep an eye on them to see if they are growing.
Fibroids require treatment when they are extremely large, making it impossible to get pregnant, or causing symptoms which substantially reduce your quality of life. Which treatment is right for you will depend on the size and location of your fibroid(s), your age and how close you are to menopause, and whether or not you would like to get pregnant.
Treatment options include:
Surgery
There are three main procedures used to surgically remove fibroids: myomectomy, hysterectomy and uterine fibroid embolization. To learn more about these procedures, click on the links below.
Drugs
Drugs are often used to reduce the size of fibroids. Drugs may also be recommended before surgery to make the surgery less difficult.
GnRH agonists
Gonadotropin-releasing hormone (GnRH) agonists are used to shrink fibroids. These drugs reduce estrogen and progesterone levels, reducing the blood flow to the fibroids, and making them smaller. Women who use these drugs will have their periods stop and will temporarily experience other symptoms of menopause, such as hot flashes, vaginal dryness and headaches.
These drugs can also cause substantial bone loss (see our Osteoporosis section). Because estrogen levels drop dramatically, the bone loss can be severe. GnRH agonists can make surgery safer and easier but, to avoid osteoporosis, they should not be used for more than three to six months.
Lupron is the most commonly used drug in this class. It is given by monthly injection in your doctor's office. After you stop taking the drug, your period will return to normal in one to three months. If you do not have one of the other treatments described in this section, the fibroids will also return to their original size within a few months.
Androgens
Androgens are often referred to as male hormones. Synthetic androgens can slow or stop the growth of fibroids and relieve the symptoms. Drugs such as danazol can reduce the size of the fibroids and the uterus, and stop menstruation and anemia. However, the side effects make many women reluctant to take them. Potential side effects include weight gain, depression, anxiety, oily skin and hair, deepening of the voice, headaches, fatigue, hair loss, growth of facial and body hair, blood clots and liver problems.
Birth control hormones
Birth control hormones (in the form of birth control pills, a skin patch or a vaginal ring) can help control heavy menstrual bleeding. However, they do not shrink fibroids.
Medicated IUD
Putting a medicated intra-uterine device (IUD) into the uterus can decrease a woman’s blood flow and reduce the size of her fibroids. This new treatment is one way of avoiding surgery. Medicated IUDs are not suitable for women whose uteruses are greater than 12-week size.
High-Intensity Focused Ultrasound
High-intensity focused ultrasound is a new, non-invasive outpatient procedure, which uses MRI to locate fibroids and then directs high-intensity ultrasound energy to destroy the fibroids. This procedure was approved as a treatment for uterine fibroids in the US in 2004; however, it is not yet available in Canada.
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