1. The Wait and See Approach
If you are like most women with uterine fibroids, you will probably never have any symptoms or require any treatment. In most cases, doctors will simply note the presence of the fibroids in your medical files and monitor their size in future pelvic examinations. Because fibroids do not become malignant, leaving them alone doesn't pose a threat to your health. Should your fibroids grow to the point where you are experiencing symptoms or they interfere with your fertility, then your doctor will likely discuss treatment options with you.
2. Shrink Them With Medications
Gonadotropin-releasing hormone (GnRH) agonists are among the medications used to treat uterine fibroids. These drugs cause estrogen and progesterone levels to fall in the body and stop menstruation. Your doctor may prescribe these drugs if your uterine fibroids are causing heavy bleeding and anemia. They may also help to shrink the fibroids. Alternatively, your doctor may prescribe a synthetic androgen like danazol, which is a testosterone-like hormone. This medication also shrinks fibroids, stops menstruation and helps with anemia, though it has some unfortunate side effects, like unwanted hair growth, as well.
3. Surgical Removal
If you have abnormally large uterine fibroids and/or several fibroids that are causing you uncomfortable symptoms, they may need to be surgically removed. There are various options you can choose from for the surgical removal of fibroids. A myomectomy is a common surgical procedure for fibroids in which the fibroids are cut out of the body. A myomectomy can be done through an abdominal incision, abdominal laparoscopy or hysteroscopy. Abdominal laparoscopy and hysteroscopy are the least invasive options, but open abdominal surgery may be required for very large or very deep fibroids. In some cases, a myomectomy may be performed without actually removing the fibroids. Myolysis is a technique that destroys the fibroids using an electrical current, and cryomyolysis is a technique that uses liquid nitrogen to freeze fibroids. These procedures get rid of fibroids without taking them out of the body.
4. Alternative Surgical Options
Besides surgical removal, there are a couple of other procedures you may be able to choose from to treat your uterine fibroids. One option is an FDA-approved procedure called focused-ultrasound surgery (FUS). In this procedure, the doctor uses an MRI scanner to locate fibroids. A device that emits high-frequency, high-energy sound waves is then used to ablate the fibroids. Another option is uterine artery embolization, in which the blood supply to the fibroids is cut off. Both of these procedures do not require incisions and have an easy recovery.
5. Hysterectomy, a Permanent Treatment
While other treatment options have good success rates and will likely reduce or eliminate your symptoms, they all have a risk of recurrent fibroids. The only permanent treatment for uterine fibroids at the moment is hysterectomy, which is removal of the uterus. A hysterectomy eliminates your ability to bear children and will trigger menopause if the ovaries are removed as well. Hysterectomy procedures also carry a significant risk of surgical complications and are usually last resort treatments for uterine fibroids.
