There are many different methods of treatment available for uterine fibroid tumors. Treatment options depend primarily upon whether or not you plan to bear more children. If you plan to bear children, you will want to choose a treatment method that does not in any way impair your chances of becoming pregnant or carrying a child to term. Be sure to consult with your doctor over which of the many treatment options available is best for you. If you would like to learn more about women's health and the symptoms, read How To Learn About Uterine Fibroid Tumors.
- Hysterectomy. This is the removal of the entire uterus. Approximately one-third of hysterectomies performed annually in the United States are a result of these tumors. While once standard treatment, many women now choose less invasive options. Of course, once a woman has had a hysterectomy, she can no longer bear children.
- Myomectomy. This treatment requires the surgical removal of the tumor only (not also the uterus). Myomectomies can be performed either through abdominal or laparoscopic surgery, depending on the location and type of the tumor. Myomectomy.net provides a good overview of the differences among procedures.
- Uterine Fibroid Embolization. Embolization originated as a procedure to reduce bleeding during uterine surgery. Today it is used to shrink uterine fibroids. These tumors depend upon their access to a blood supply to grow. Embolization blocks the blood supply, making the fibroid shrink. A radiologist performs this treatment using a tiny catheter threaded through a small cut in your groin area to an artery to your uterus. Once the catheter is in place, the radiologist injects plastic or gelatin sponge particles which move through the catheter into the artery that sends blood to the fibroid. This stops the flow of blood, thus "starving" the tumor of its blood supply.
- Ultrasound. In an ultrasound procedure, magnetic resonance imaging (MRI) is first used to locate and determine the parameters of the tumor. Then an ultrasound beam uses high-frequency sound waves to heat and destroy it. This procedure requires repeated targeting and heating of the tissue over a period of several hours; a temperature gauge tracks changes in temperature of the tissue during the procedure. Not all tumors can be treated in this way, for example if the fibroid is close to a sensitive organ such as the bowel or bladder or is outside of the image area. No more than two treatments should be performed in a two-week period. Ultrasound is intended for women who have completed childbearing or do not plan to become pregnant.
- Medications. Medications such as Lupron and Synarel are used on a temporary basis to shrink tumors before surgery or menopause. These two work by preventing the ovaries from creating estrogen and progesterone. The tumor require estrogen and progesterone to grow, and without these hormones, they shrink in size. Lupron must be taken by injection and Synarel is given via a nasal spray (because they would be destroyed in the digestive system if taken orally). The menstrual period stops upon taking these medications, but resumes once treatment is stopped; therapy generally lasts several months. Possible side effects should be discussed with your doctor; long-term use is not allowed by the FDA due to the potential for a loss of bone density (osteoporosis).
- Progesterone-Blocking Therapy. Because progesterone contributes to the growth of fibroids, progesterone-blocking drugs are another alternative. These drugs stop heavy bleeding and shrink fibroids in most women. However, they may cause endometrial hyperplasia (overgrowth of the endometrium, the mucous membrane lining of the uterus) which may lead to pre-cancer of the uterine lining.
- Pirfenidone. This is a new drug currently under investigation that may add to the range of treatment possibilities available.
- Endometrial Ablation. This treatment uses either electrical energy or hot water (hydrothermal ablation) to destroy lining cells. Because the lining of the uterus is damaged and/or destroyed, women who want to have children should consider other options.
- Alternative Treatments. Books such as Natural Treatments of Fibroid Tumors and Endometriosis by Susan M. Lark, Healing Fibroids: A Doctor's Guide to a Natural Cure by Allan Warshowsky, and Fibroid Tumors Healed Naturally: A Personal Journey Shared With Specific How-To's by Faye Hardaway are good starting points in your research on alternative treatments.
The variety of treatment options can be overwhelming; consult with your doctor over which procedure is best for you. And remember that if your doctor does not perform one of these procedures, consider getting a second opinion from a doctor who does.