When Is Treatment for Fibroids Necessary?

Uterine-Fibroid-Treatment-Image (1)Uterine fibroids are benign growths in the uterus that generally occur in 20% of women over 30 years of age, and are usually completely harmless.  Fibroids growing prior to that age are rare, and almost never occur in women who are not yet at menstruating age.

Symptoms of Uterine Fibroids

The most common symptom in women with fibroids is a heavy menstrual period.  Most women do not experience more than that, and usually it is not enough to warrant treatment, unless there is extremely heavy bleeding.  Heavy bleeding is not, in itself, an indication of fibroids, so a woman must get a routine pelvic examination from her doctor to determine if fibroids are present.  

Other symptoms of fibroids may include pressure or pain in the lower abdominal region, abdominal and uterine enlargement, anemia if bleeding is excessive, susceptibility to urinary tract infections (if a fibroid presses against the bladder), constipation (if a fibroid presses against the rectum), and pain during sexual intercourse.

When is Treatment Necessary?

As they are non-cancerous, most fibroids will not need to be treated at all in a woman’s lifetime. However, there are occasions where a fibroid can grow in a certain area, or to a large enough size, where it can cause discomfort, and she may need to seek treatment. The decision to treat a fibroid depends on the age of the woman, size of the fibroids, and severity of symptoms. 

If any of the symptoms are severe enough to interrupt daily life during or between menstrual periods, a woman’s doctor may decide on a course of treatment based on the symptoms she is experiencing, as well as factors involving age andpotential future childbirth.

Treatment Options

Contraceptives – medications, usually taken orally, that work to reduce the amount ofbleeding and regulate the woman’s cycle. Contraceptives do not shrink or reduce the fibroids in any way.Intrauterinedevices (IUDs) may also be used for the same purposes, andare easily applied during routine office visits.

GnRH Agonists – another classification of medications a doctor may prescribe that is a bolder approach, but it is only recommended for specific types of cases, and should be a precursor to surgery.They block the production of estrogen in order to temporarily reduce the fibroids’sizeand reduce symptoms long enough to make surgery safe.These include Lupron.

If treatment by medication is not sufficient in reducing the symptoms of fibroids, orthe symptoms meet the requirements, other treatment options include various surgeries.

Myomectomy -a surgical process that removes only the fibroids fromthe uterus. This is done in a variety of ways, including “open” surgery (laparotomy), or less invasive ones. Myomectomies are not always a permanent solution for fibroids, as fibroids may grow back over time.

Uterine Artery Embolization – uterine artery embolizationcuts off the blood flow to the fibroids themselves,which causes them to shrink. It is minimally invasive,but includesan overnightstay at the hospital andsome recovery time from associated pain.

Endometrial Ablation – a procedure that destroys the lining of the uterus. It may, or may not, be effective in treating women with fibroids. Additionally, this procedure is not recommended for those who want children.

Hysterectomy – incertain cases, one of many types of hysterectomies may be used as a permanent solution to fibroids. The woman and doctor must discuss hysterectomy options in depth in order to determine the best course of action, as hysterectomies are not reversible, and will prevent the woman from ever becoming pregnant.

Laparoscopic Radiofrequency Volumetric Thermal Ablation – The newly cleared Acessa System from Acessa Health provides a new method of treatment for uterine fibroids that uses a minimally invasive procedure that preserves the uterus but significantly reduces or eliminates the recurrence of fibroids.

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Treatment Options for Uterine Fibroids

<pFibroid-Treatment-Options>Uterine fibroids are extremely variable from woman to woman. In some women they cause pain and heavy bleeding, others are asymptomatic. They can develop on the inside or outside of the uterus. Fibroids sometime interfere with pregnancy, grow slowly and are not cancerous. For some women, the best plan is to simply “watchful waiting”. If they do cause you pain and excessive menstrual bleeding you may want to consider one of these treatment options for uterine fibroids:

Drug regimen

With this method the medications target hormones that control your ovulation cycle, such as estrogen and progesterone. The drugs can alleviate pain in the pelvis and heavy blood flow during your period. However they will not make the fibroids go away, only make them smaller. A few of the medications that are available are birth control pills, androgens and intrauterine devices (IUD).

Hysterectomy

This is a major abdominal surgery. The entire uterus is removed from the body, thus ending the patient’s bout with fibroids and their complications. With a hysterectomy there may be the option to leave the ovaries in place. If the ovaries need to be removed you may need to be put on hormone replacement therapy in the future. There are potential risks and complications to hysterectomy, and frequently women will encounter these many years after the procedure.

Myomectomy

Myomectomies are surgical procedures. If you choose one ofthose treatmentoptions for uterine fibroids the growths will be fly removed from your uterus. The benefit of a myomectomy is that the uterus is left in place. A down fall is that some women may re-grow fibroids after the myomectomy.

With the myomectomy there are variations available for the different sizes and locations of growths. For large or deep fibroids your provider may choose to do an abdominal myomectomy, which is an open abdominal surgery. Laparoscopic myomectomies are used for several small fibroids. With the laparoscopic procedure a small incision is made in the abdomen and a slender tool is inserted into the body. The physician will conduct hysteroscopy, the surgery is completed by inserting a small scope through the vagina and cervix. This method also utilizes a small camera.

Endometrial ablation

With this option, energy is used to destroy the lining of the uterus. When the lining is destroyed it either ends or reduces menstruation. If you are not planning to have more children, this may be a treatment option. However, there is no guarantee that endometrial ablation will treat fibroids. Additionally, many fibroids are located where this treatment option will not be effective. .

Make sure to consider all of your treatment options for uterinefibroids. Do not be afraid to bring up possible solutions to explore with your doctor. There are many ways to address the issue and there is sure to be one that will help you live a life without pain or excessive bleeding.

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