Fibroid Treatment Options: Alternatives to Hysterectomy
For the many women who experience no symptoms, fibroid treatment is not necessary. For others whose symptoms are mild to moderate, over-the-counter pain relievers, exercise and/or changes in diet may be the only uterine fibroid treatments needed. Some women who do not have severe symptoms may delay fibroid treatment until after menopause, when symptoms sometimes become less severe or disappear spontaneously.
The following treatments are alternatives to hysterectomy.
This surgical procedure was developed to meet the need for uterine fibroid treatments that preserved the uterus and a woman’s childbearing potential. The procedure, in which only the fibroid tumor or tumors are surgically removed, became the preferred fibroid treatment for women desiring to keep their fertility.
Like hysterectomy, however, standard myomectomy requires general anesthesia and a long recovery time. On average, the procedure results in more blood loss than hysterectomy or other uterine fibroid treatments. Laparoscopic myomectomy, which is less invasive, is sometimes possible and has a much shorter recovery time.
GnRH agonists are drugs that block estrogen production, starving uterine fibroids of estrogen and causing them to shrink. Lupron is the drug most commonly used, often in combination with other uterine fibroid treatments. Lupron may be used to shrink fibroid tumors, making fibroid treatment with surgery easier to perform. But shrinkage is temporary and the drug also is associated with menopause-like symptoms such as hot flashes, mood swings, insomnia, sexual dysfunction, and premature bone mineral loss.
Endometrial Ablation and Resection
In this outpatient procedure, a gynecologist places a scope through the cervix into the uterine cavity to burn and scrape the lining of the uterus. The procedure also is used to burn and cut out uterine fibroid tumors that can be reached through the scope. The removal of the lining (endometrial ablation) stops bleeding, but not all uterine fibroid tumors can be removed with this technique. Like hysterectomy, this fibroid treatment causes permanent infertility. A heated balloon may also be used.
Myolysis or Cryomyolysis
These are uterine fibroid treatments in which uterine fibroids are burned or frozen via laparoscopic surgery.
Focused Ultrasound Therapy
MR-guided, focused ultrasound obliterates tumors by focusing high-intensity ultrasound beams on the growths, raising the temperature enough to destroy them. The treatment is guided by magnetic resonance (MR) images. The MR scanner allows the Interventional Radiologist to see where the fibroid is and what has been treated and to monitor temperature changes inside the body. Only a small spot is treated at a time and the process is repeated, usually about 50 times per session, until the fibroid is destroyed. The technology is limited to symptomatic women not interested in childbearing who have only a few fibroids. Large fibroids and multiple smaller fibroids are difficult to treat. One caution is that, because this is a new technology, the long-term effects are not yet clear.
Uterine Fibroid Embolization (UFE)
This is a new, non-surgical uterine fibroid treatment. It is safer than uterine fibroid treatments that require surgery, and a highly effective alternative for some women who strongly desire to avoid hysterectomy, or are likely to experience difficulty with myomectomy. Although it is relatively new compared to uterine fibroid treatments such as hysterectomy and myomectomy, more than 200,000 women have been treated with UFE.
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