Uterine Fibroids Treatment
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|What Is The Treatment For Fibroids?
If you receive a fibroids diagnosis, treatment can range from no treatment at all to the surgical removal of the womb (hysterectomy). A woman with no fibroid symptoms or minor symptoms may only need to visit a doctor occasionally to check if the fibroids have grown or if symptoms have worsened. Once uterine fibroids start, they are likely to continue growing until menopause after which they usually start to naturally disappear. Unless disabling symptoms occur, such as severe pelvic pain or distended bloated stomach, treatment is usually unnecessary. Nonsteroidal anti-inflammatory painkillers (NSAIDs) such as ibuprofen (brand names Advil, Nuprin, Motrin) can help relieve pain associated with fibroids but cannot halt heavy bleeding.
Women with pressure symptoms caused by large fibroids pressing on organs, muscles or nerves will not benefit from any medicine or drug currently on the market. However there are some drugs in development phase which show promise, not only at tackling fibroid symptoms, but the fibroids themselves. Meantime, medications are limited to treating excessive bleeding caused by fibroids. Studies are still not conclusive, but there are indications that contraceptive pills may help prevent heavy periods (menorrhagia) during a menstrual cycle. An IUD device such as Mirena may be suggested as an alternative to women who have already had children. The Mirena IUD releases a type of progestin called levonorgestrel. This thins the lining of the uterus to decrease menstrual blood flow and cramping. An IUD can be inserted during a routine doctor's appointment. Meantime severe bleeding will need to be treated with an iron supplement or injection to prevent anemia.
Treatment of fibroids with hormone therapy (such as GnRH agonists like Lupron or Synarel) can shrink the size of the fibroids but it is not considered a long-term option. As soon as the therapy stops, the fibroids grow back. The therapy is expensive, and side effects are similar to induced menopause symptoms (hot flashes, insomnia and depression). Hormone therapy is usually only recommended where fibroids are larger than 10 to 12 cms and size reduction will make a myomectomy procedure easier.
A hysterectomy is the complete surgical removal of the uterus (womb). This is a major surgery yet it is the only way to ensure that fibroids do not return. It remains an option for women who are over 35 years and no longer wish to have children. Fibroids account for nearly 50 percent of all hysterectomies performed in the United States today. Unless a woman is near menopause, a hysterectomy procedure for fibroids will probably not involve the removal of her ovaries. In fact the closer a woman is to menopause; the less likely she will be offered this surgical procedure as fibroids often resolve themselves naturally after menopause. Traditionally fibroids which were over 4 inches in diameter were treated with a hysterectomy. Today however women have more treatment options than they did even a decade ago.
This is an alternative to women who wish to retain their childbearing ability. It is a surgical procedure which removes the fibroids but leaves the uterus intact. Drug therapies are usually recommended prior to surgery to reduce fibroids before removal. A myomectomy can be performed in several ways depending on the size, location and amount of fibroids. Myomectomy is performed about 40,000 times a year in America. Types of myomectomy include:
Abdominal Myomectomy: An incision is made to the abdomen (bikini cut). The fibroids are physically removed from the wall of the uterus after which the lining and abdomen skin is stitched back together. This procedure involves about 2 days in hospital and 6 weeks of recovery at home.
Laparoscopic Myomectomy: Tiny incisions are made near the lower abdomen, belly button, below the bikini line and near each hip. A laparoscope is inserted and a surgical instrument called a tissue morcellator is used to cut up and remove the fibroids. Women spend one night in hospital for this procedure and recovery takes up to 4 weeks at home. The da Vinci surgery method may be used to perform this surgery.
Hysteroscopic Myomectomy: Only women with submucosal fibroids are eligible for this procedure. Fibroids are removed using a hysteroscope which is inserted through the vagina and into the uterus. Targeted electric currents vaporize the fibroids, leaving the uterus intact. This is an out patient procedure and recovery is up to one week at home.
A myomectomy is a very effective way of removing fibroids, but fibroids usually grow again in 25 percent of cases. The younger the woman is and the more fibroids she has before a myomectomy, the more chance she has of fibroids returning. Women nearing menopause are the least likely category to have a recurrence (see can fibroids grow back?). As such, it is one of the valuable alternatives to hysterectomy.
Uterine Artery Embolization (UAE)
Uterine artery embolization is a new procedure which reduces fibroids by obstructing their blood supply. Performed by a radiologist, small particles of plastic are injected into the uterine arteries to cut off blood supply. Originally embolization was intended for preventing bleeding after delivery and childbirth but has since been trialed for treating fibroids. The procedure is minimally invasive and just as successful in young women as postmenopause women. Generally considered safe, it takes less than an hour and no general anesthesia is required. The main side effect is cramping which usually disappears after a few hours. More studies need to be carried out to verify safety and the possibility of fibroids returning.
See also natural therapies for reducing fibroids: Fibroids Diet Plan.
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