Dr. Kevin Windom answered:
There are numerous treatments for uterine fibroids. When I see a patient in the office who comes to see me with symptoms of pelvic pressure, pelvic pain, heavier menstrual cycles, or other symptoms from fibroids, we have a long discussion and we perform a pelvic exam and then an ultrasound to diagnose the significance of her fibroids. The most common complaint of patients with fibroids is heavy menstrual cycles, and because of this, the easiest treatment to try initially is oral contraception. Oral contraceptive pills will help decrease the amount of menstrual flow, and this might be all the patient needs to help remedy her problems with fibroids.
If the patient fails oral contraception, other treatments for fibroids would be to consider a myomectomy, which is a surgical procedure in which the fibroid is removed. A myomectomy can be performed both laparoscopically or with an abdominal incision. Also, myomectomies can be performed with a hysteroscopic resection in which a telescope is placed into the cervix and the uterus, and the fibroid is cut out of the inner lining of the uterus.
Some patients who have large fibroids can be treated with medical therapy such as Lupron (leuprolide). This medication will put patients in temporary menopause, and it decreases the estrogen levels and will help shrink the fibroids. In my practice I only use this medication if I want to decrease the size of the fibroid prior to some type of surgical intervention.
There is a very good interventional radiology procedure called a uterine artery embolization in which small beads are injected through the groin and into the blood vessels that are supplying the uterus, and the hope is this will cut off the blood supply to the uterine fibroids and help decrease the fibroids size and help these fibroids deteriorate. In certain cases this is a very good treatment and alleviates the need for a hysterectomy.
The last remedy for uterine fibroids if all other treatments have not worked is a hysterectomy.There are numerous treatments for uterine fibroids. When I see a patient in the office who comes to see me with symptoms of pelvic pressure, pelvic pain, heavier menstrual cycles, or other symptoms from fibroids, we have a long discussion and we... More
Dr. John Lipman answered:
Yes ! In fact hysterectomy is largely unnecessary in the treatment of uterine fibroids which are benign, non-cancerous tumors. There is a significant value for women if they can keep their uterus which is underappreciated by some healthcare providers. The uterus is important for a woman psychologically, sexually, and is important for her bone and cardiovascular health.
There are a number of medicines that can be tried to relieve the symptoms of fibroids (exs. non-steroidal anti-inflammatory medications, oral contraceptive pills) which can help but in many cases are short-term fixes.
A non-surgical procedure called Uterine Fibroid Embolization (UFE) can effectively treat all of the fibroids in the uterus. The procedure is performed by Interventional Radiologists which are physicians specifically trained in less invasive, non-surgical treatments using image (ex. x-ray) guidance. The procedure is often performed as an outpatient and is safer, less invasive, and less recovery time than surgery and allows a woman to keep her uterus.
A newer non-surgical procedure to treat a few fibroids in the uterus is called MRI-guided focused ultrasound (MRgFUS). It can treat up to 3 fibroids and performed as an outpatient. The three limiting factors for MRgFUS are that most insurances don't cover this procedure, only a handful of centers in the country have this equipment, and the physician time necessary to perform this procedure is high (often 3-4 hours).Yes ! In fact hysterectomy is largely unnecessary in the treatment of uterine fibroids which are benign, non-cancerous tumors. There is a significant value for women if they can keep their uterus which is underappreciated by some healthcare... More