Treatment options for Uterine Fibroids
Fibroids are non cancerous (benign) tumours that can be as small as a pea nut or as large as an orange. Depending on the place where they grow and how they grow, they are classified into different types. Typically as long as these fibroids don’t show any symptoms, you are good. However, in some cases, they start showing symptoms including heavy discharge during periods, severe pain in lower abdomen, frequent urination, pain when having sex etc.
Home remedies options to treat fibroids
Simple answer is NO. You can’t treat fibroids at home. As the estrogen levels come down in your body (typically during menopause), some fibroids shrink and go away. When you are not able to bear the pain, all you can do (after taking your urologist or urogynecologist’s advice) is apply hot pack while lying down on your back. If over the counter pain killers are available, you can take them for temporary pain relief. Administration of pain killers should be only in emergency period. You must see your gynaecologist if they are bothering you.
Treatment options after diagnosing fibroids
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Hormone (Replacement) Therapy:
In some cases, your doctor will advise you to stop birth control pill or he/she may put you off the HRT (Hormone replacement therapy) if you are undergoing one. Depending on the diagnosis, the treatment may be quite opposite. Birth control pills may be advised to control bleeding. Excessive bleeding from fibroids results in severe anaemia.
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GnRH Agonists:
Gonadotropin Releasing Hormone is responsible for releasing Follicle Stimulating Hormone (FSH) and Lutenizing Hormone (LH) from the pituitary gland (in the brain). They regulate the reproductive parts in the body. The ‘agonist’ is an agent that acts ‘against’ the hormone. This results in shrinkage of fibroid tumours. However, long term administration of GnRH has shown that the patient can develop osteoporosis. (A condition when bones become fragile). In order to counteract this side effect, your gynaecologist may also put you on progestin hormone. Drawback of this treatment is, once you stop taking these agonist and progestin hormones, fibroids will most likely return.
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Selective Estrogen Receptor Modulators:
Also called SERMs. Not much research is available on this therapy but the medicines administered works by lowering the estrogen levels but not cause the symptoms of menopause. This ‘selectively’ works on shrinking the fibroids.
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IUDs – Intra Uterine Devices:
These are similar to birth controlling IUDs (like copper T) that are placed inside the body. But, these devices release hormone progestin which helps in controlling bleeding and cramps. They don’t actually shrink the fibroids.
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Fibroid Embolization:
An inpatient procedure done by injecting PVA – PolyVinyl Alcohol into the arteries that send blood to fibroids. PVA, once in your blood, cuts off the blood supply to the fibroids. As a result, they shrink. Side effects may include nausea, vomiting etc. You need to be under observation of the gynaecologist in hospital for a few days.
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Endometrial Ablation:
This process is targeted towards destroying the Endometrium, the lining of the uterus. This is done to reduce the menstrual flow and in some cases, the menstrual flow may stop completely. There is no incision made to perform this procedure. Special tools or microwave energy is used to achieve the purpose.
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Myomectomy:
A surgery performed to remove fibroids. Conventional method involves an incision to be made in the abdominal area or latest technology uses a laparoscope to perform this operation. This is opted when the patient wants to get pregnant. However, you must choose your gynaecologist for this procedure after a thorough research. If the gynaecologist is not experienced in using laparoscope, it may result in scarring which can lead to infertility. It is vital that you pick a highly experienced urologist or urogynecologist to perform this procedure.
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Hysterectomy:
Vaginal or incision based or laparoscopic hysterectomy, this procedure is taken as a ‘last resort’ in women who do not want to get pregnant. In this surgery, the total uterus is removed. There are other types of hysterectomy where other parts like cervix, fallopian tubes etc are removed but that depends on where the fibroids are growing.
Do fiboirds come back after myomectomy procedure?
Possible. It depends on how many firboirds are present, their size and how many your doctor was able to remove. Fibroids do come back in women who undergo myomectomy. Instead of a laparoscope, an ultrasound procedure is also available that can pinpoint the location of fibroid and can shrink or destroy it with focused energy.
