Methods of treatment depend on the severity of symptoms, age, pregnancy status, desire for future pregnancies, general health, and characteristics of the fibroid(s). Treatment may consist of simply monitoring the fibroids, specifically their rate of growth, with periodic pelvic exams or ultrasound.
Nonsteroidal anti-inflammatory medications (like ibuprofen or naprosyn) may be recommended for lower abdominal cramping or pain with menses. Iron supplementation will help to prevent anemia in women with heavy periods. These methods are usually sufficient in pre-menopausal women.
Hormonal treatment, involving drugs such as injectable Depo Leuprolide, causes fibroids to shrink, but can also causes significant side effects. This method is sometimes used for short treatment periods before surgical procedures or when menopause is imminent.
The hormones produce an environment in the body that is very similar to that of menopause, with associated side effects like hot flashes, vaginal dryness, and loss of bone density.
The treatment lasts several months and during this time the reduction in estrogen concentration allows the fibroids to shrink. Fibroids will begin to enlarge as soon as treatment stops.
Hysteroscopic resection of fibroids (an outpatient surgical procedure) may be appropriate for women with fibroids largely growing within the uterine cavity. In this procedure, a small camera and instruments are inserted through the cervix into the uterus to remove the fibroid tumors.
Uterine artery embolization is a new procedure aimed to prevent the need for major surgery for uterine fibroids. Small catheters are placed through veins in the groins and advanced to the arteries that supply the uterus with blood.
Materials are then injected to block these arteries permanently. The decreased blood supply to the uterus may prevent further growth of the fibroids and may cause them to shrink. The long-term effects of this procedure are still unknown, and the safety of pregnancy after this procedure is questionable.
A myomectomy, which is a surgical procedure to remove just the fibroids, is frequently the chosen treatment for pre-menopausal women who want to bear more children, as it usually can preserve fertility.
Another advantage of a myomectomy is that it controls pain or excessive bleeding that some women with uterine fibroids experience. However, a myomectomy often cannot remove very small fibroids that may grow and cause symptoms again in the future.
A total hysterectomy, which involves removal of the uterus, is a curative option that is often chosen by older women.
