Uterine fibroids develop when smooth muscle cells of the uterus grow out of control and form noncancerous tumors. Uterine fibroids also go by the names of myomata and uterine leiomyomata. Whatever they are called, they are quite common--the Mayo Clinic says that three out of four women will have fibroids at some point. Most women never know they have fibroids because they do not cause any symptoms, but for some women, the pain and heavy bleeding caused by fibroids prompt them to seek treatment.
Medicines
Drugs that mimic the ovary-stimulating hormone GnRH, and drugs that antagonize GnRH's action both can treat fibroids by lowering estrogen levels. These drugs halt menstrual cycles and relieve pain and bleeding from fibroids. They do not eliminate fibroids, but they do make them shrink. Oral androgens or a progestin-releasing intrauterine device can also shrink fibroids.
Myomectomy
In myomectomy, a surgeon removes the muscle layer of the uterus where fibroids arise. The rest of the uterus remains intact so that women can carry a pregnancy after this procedure. The procedure removes fibroids, but they recur in up to 44 percent of patients, according to "Primary Care for Women." There are several ways the surgeon can reach the fibroids to do a myomectomy--through an abdominal incision, by inserting an instrument called a hysteroscope or through a laparoscopic procedure.
Uterine Artery Embolization
In uterine artery embolization, the doctor injects particles called embolizing agents into the blood vessels that supply the uterus. The agents cut off blood flow to the uterus, causing the fibroids to shrink. While the procedure is effective and allows faster recovery than surgery, it can cause infertility if the blood supply to the ovaries is affected. "Primary Care for Women" says that up to 20 percent of women need narcotics after embolization because of severe pain.
Myolysis
While myolysis seems to be equally as effective at shrinking fibroids as uterine artery embolization, according to "Primary Care for Women," its safety is not yet established. In this procedure, the doctor inserts a laser, electric current or special instrument into the fibroids to destroy them.
Endometrial Ablation
This procedure uses a special instrument that provides heat, microwave energy or electric current to burn off the inner lining of the uterus. Fibroids on the inner lining are destroyed, but others can remain. This procedure may be best for women whose fibroids cause heavy bleeding.
Hysterectomy
As the Mayo Clinic points out, hysterectomy, the surgical removal of the uterus, is the only known permanent cure for fibroids. However, hysterectomy is a major surgery, and it removes the woman's ability to carry a pregnancy.
References
- Mayo Clinic: Uterine Fibroids
- "Primary Care for Women"; Phyllis Leppert and Jeffrey Peipert; 2004
