Medications
If your fibroids are causing heavy, painful periods, regular doses of nonsteroidal anti-inflammatory drugs (NSAIDs) may bring relief. They reduce discomfort and curb the activity of prostaglandins, chemicals that stimulate uterine contractions. Good choices include ibuprofen (Nurofen) and naproxen (Naprogesic). If you're truly plagued by heavy periods, oral contraceptives (Nordette, Microgynon, Brevinor) may help control the bleeding.
Because of the direct link between oestrogen and fibroids, drugs that block this hormone can reduce bleeding and shrink fibroid growth. Gonadotropin-releasing hormone (GnRH) agonists accomplish this by releasing reproductive hormones, which signal ovaries to stop producing oestrogen. The drugs come in a variety of forms, including leuprolide injections (Lucrin Depot), nafarelin acetate nasal spray (Synarel), and goserelin acetate implants (Zoladex). These medications are generally prescribed only for shortterm use, usually to shrink fibroids by about 50 percent before
surgery. The downside: GnRH agonists can cause unpleasant side effects that mimic menopausal symptoms (hot flushes, vaginal dryness, irritability) and, if taken for more than six months, can increase osteoporosis risk (strong bones need oestrogen). And fibroids usually grow back once the drug treatment ends.
PROMISING DEVELOPMENTS
If you've been told that the only surgery to cure fibroids is a hysterectomy (see below), it's time to become acquainted with other possibilities, especially because hysterectomy acquainted with other possibilities, especially because hysterectomy means you'll no longer be able to bear children. Although fibroids remain a top reason for a hysterectomy, other options do exist. But only hysterectomy offers a certain cure. Fibroids may eventually return following other procedures.
HYSTERECTOMY: IS IT RIGHT FOR YOU?
Until recently, hysterectomy was an almost automatic solution for fibroid problems--surgically removing the uterus guarantees and end to fibroids. Today the operation is contraversial, with many questioning its medical necessity when other options don't affect fertility. Still fibroid treatment accounts for more than 7000 of the hysterectomies performed on Australian and New Zealand women each year.
Additional reasons for a hysterectomy include cancer of the endometrium, cervix or ovary; chronic pelvic pain; severe endometriosis, chronic vaginal bleeding; and a prolapsed uterus.
There are two types of hysterectomy that are usually used for fibroids. One is partial hysterectomy, which removes the uterus through an abdominal incision, but leaves the crevix, fallopian tubes and ovaries in place.
The other is total hysterectomy which removes the uterus and cervix, fallopian tubes, and ovaries, either by vaginal incision (if the fibroids are small) or by abdominal incision (if they're large). This procedure is often recommended for premenopasual women; removing the ovaries eliminates the possibility of ovarian cancer.
a hysterectomy requires a hosptial stay of several days. You can sometimes recover in just two weeks (particularly from a vaginal procedure, which is faster and less painful) or it may take up two months.
You'll need to discuss the pros and cons of each possible treatment with your doctor, and be sure to seek a second opinion if hysterectomy is presented as your best--or only--option.
If you hope for a future pregnancy, you might choose a myomectomy. This surgical procedure removes individual fibroids either through your cervix (hysteroscopic myomectomy), in which case no incision is needed, or through your abdomen (laproscopic myomectomy), and sometimes through both (abdominal myomectomy). All require general aneathesia. Recovery from abdominal myomectomy takes up to six weeks, but you may bounce back from the hysteroscopic and laparoscopic procedures within two.
A newer, nonsurgical technique called uterine fibroid embolization (UFE), also called uterine artery embolization, works by stopping blood flow to fibroids so they wither away (see illustration previous). A specially
trained interventional radiologist makes a tiny cut in your groin, then inserts a catheter through an artery to the uterus. Next, the doctor injects tiny plastic (or gelatine) particles to block blood supply to the fibroids. General anaesthesia isn't necessary, although an overnight hospital stay is (many women suffer cramps, nausea and fever a few hours after the procedure). However, if you choose to undergo UFE, you should be able to resume your regular activities in about a week. Because its effect on fertility isn't yet known, UFE is usually recommended only for women who are no longer fertile or who aren't planning to become pregnant.
Lifestyle changes
Nutritionists recommend a low-fat, high-fibre diet to help ward off a host of health woes, and it's good advice for lighting fibroids too. Research suggests that a steady diet of fats and red meat stimulates fibroid growth, whereas eating plenty of fruit and vegetables checks their development. Fibre-rich whole grains may also ease fibroid-related bowel difficulties. To pump up your iron stores and help prevent anaemia related to excessively heavy periods, talk to your doctor taking an iron supplement.
If your fibroids are causing heavy, painful periods, regular doses of nonsteroidal anti-inflammatory drugs (NSAIDs) may bring relief. They reduce discomfort and curb the activity of prostaglandins, chemicals that stimulate uterine contractions. Good choices include ibuprofen (Nurofen) and naproxen (Naprogesic). If you're truly plagued by heavy periods, oral contraceptives (Nordette, Microgynon, Brevinor) may help control the bleeding.
Because of the direct link between oestrogen and fibroids, drugs that block this hormone can reduce bleeding and shrink fibroid growth. Gonadotropin-releasing hormone (GnRH) agonists accomplish this by releasing reproductive hormones, which signal ovaries to stop producing oestrogen. The drugs come in a variety of forms, including leuprolide injections (Lucrin Depot), nafarelin acetate nasal spray (Synarel), and goserelin acetate implants (Zoladex). These medications are generally prescribed only for shortterm use, usually to shrink fibroids by about 50 percent before
surgery. The downside: GnRH agonists can cause unpleasant side effects that mimic menopausal symptoms (hot flushes, vaginal dryness, irritability) and, if taken for more than six months, can increase osteoporosis risk (strong bones need oestrogen). And fibroids usually grow back once the drug treatment ends.
PROMISING DEVELOPMENTS
- Two experimental techniques appear to wipe out fibroids. With cryomyolysis, a probe is passed through a small abdominal incision and freezes fibroids into submission. With radiofrequency ablation, a needle electrode is inserted to 'cook' the growth with heat.
- Studies suggest the progesterone antagonist drug mifepristone (RU 486) shrinks fibroids and stops periods, but it isn't currently available in Australia and New Zealand. Also under scrunity is a new drug, pirfenidone, which blocks growth factors that can affect fibroids.
If you've been told that the only surgery to cure fibroids is a hysterectomy (see below), it's time to become acquainted with other possibilities, especially because hysterectomy acquainted with other possibilities, especially because hysterectomy means you'll no longer be able to bear children. Although fibroids remain a top reason for a hysterectomy, other options do exist. But only hysterectomy offers a certain cure. Fibroids may eventually return following other procedures.
HYSTERECTOMY: IS IT RIGHT FOR YOU?
Until recently, hysterectomy was an almost automatic solution for fibroid problems--surgically removing the uterus guarantees and end to fibroids. Today the operation is contraversial, with many questioning its medical necessity when other options don't affect fertility. Still fibroid treatment accounts for more than 7000 of the hysterectomies performed on Australian and New Zealand women each year.
Additional reasons for a hysterectomy include cancer of the endometrium, cervix or ovary; chronic pelvic pain; severe endometriosis, chronic vaginal bleeding; and a prolapsed uterus.
There are two types of hysterectomy that are usually used for fibroids. One is partial hysterectomy, which removes the uterus through an abdominal incision, but leaves the crevix, fallopian tubes and ovaries in place.
The other is total hysterectomy which removes the uterus and cervix, fallopian tubes, and ovaries, either by vaginal incision (if the fibroids are small) or by abdominal incision (if they're large). This procedure is often recommended for premenopasual women; removing the ovaries eliminates the possibility of ovarian cancer.
a hysterectomy requires a hosptial stay of several days. You can sometimes recover in just two weeks (particularly from a vaginal procedure, which is faster and less painful) or it may take up two months.
You'll need to discuss the pros and cons of each possible treatment with your doctor, and be sure to seek a second opinion if hysterectomy is presented as your best--or only--option.
If you hope for a future pregnancy, you might choose a myomectomy. This surgical procedure removes individual fibroids either through your cervix (hysteroscopic myomectomy), in which case no incision is needed, or through your abdomen (laproscopic myomectomy), and sometimes through both (abdominal myomectomy). All require general aneathesia. Recovery from abdominal myomectomy takes up to six weeks, but you may bounce back from the hysteroscopic and laparoscopic procedures within two.
A newer, nonsurgical technique called uterine fibroid embolization (UFE), also called uterine artery embolization, works by stopping blood flow to fibroids so they wither away (see illustration previous). A specially
trained interventional radiologist makes a tiny cut in your groin, then inserts a catheter through an artery to the uterus. Next, the doctor injects tiny plastic (or gelatine) particles to block blood supply to the fibroids. General anaesthesia isn't necessary, although an overnight hospital stay is (many women suffer cramps, nausea and fever a few hours after the procedure). However, if you choose to undergo UFE, you should be able to resume your regular activities in about a week. Because its effect on fertility isn't yet known, UFE is usually recommended only for women who are no longer fertile or who aren't planning to become pregnant.
Lifestyle changes
Nutritionists recommend a low-fat, high-fibre diet to help ward off a host of health woes, and it's good advice for lighting fibroids too. Research suggests that a steady diet of fats and red meat stimulates fibroid growth, whereas eating plenty of fruit and vegetables checks their development. Fibre-rich whole grains may also ease fibroid-related bowel difficulties. To pump up your iron stores and help prevent anaemia related to excessively heavy periods, talk to your doctor taking an iron supplement.
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