Conservative Treatment
When fibroids are not causing severe symptoms, many doctors choose “conservative” treatment. This can include the use of nonsteroidal anti-inflammatory drugs (such as Tylenol or Advil), intrauterine devices (IUDs), progestin shots and iron supplements.
Conservative treatments are meant to “manage” fibroid symptoms but are not a cure. Their goal is to help you feel better and reduce the impact that fibroids have on your quality of life.
Hormone Therapy
Gonadotropin-releasing hormone analogue (GnRH-a) is a medication used to decrease fibroid tumor size and reduce menstrual bleeding. While this can control fibroid symptoms in the short term, it is not recommended for long term use. Furthermore, hormone therapy can result in menopause-like symptoms and bone loss. When the hormone therapy is discontinued, the fibroids will return.
Endometrial Ablation
This approach removes the lining of the uterus to control bleeding. Because it doesn’t require uterus removal, patients may still become pregnant. However, endometrial ablation can only be performed in women with submucosal fibroids less than one inch in diameter. The procedure may also result in abnormal bleeding, which can require another treatment or surgery.
Myomectomy
A myomectomy is surgery to remove fibroids from within the uterus. The advantage of this approach is that the uterus is preserved, as is the ability to have children in the future. This disadvantage is that it is a surgery requiring general anesthesia and with similar surgical risks to a hysterectomy. But perhaps the biggest drawback to this treatment is that it doesn’t last. Fibroids will likely return, and in as little as 24 months.
