Fibroid treatment, explained
Years ago, removing your entire uterus was the only way to take care of uterine fibroids. Nowadays, there are many options for uterine fibroid treatment. If you have fibroids, take some time to decide on the best uterine fibroid treatment for you.
The benign, non-cancerous overgrowths of the muscle cells in the uterus aren’t malignant, so there’s no need to panic, says Janice Newsome, MD, associate division director of interventional radiology and image-guided medicine at Emory University Hospital in Atlanta.
Your options are based on your uterine fibroid symptoms. Not everyone with fibroids has symptoms, and whether or not you do usually depends on how big the fibroids are, how many there are, and where they’re located. Signs of uterine fibroids include heavy bleeding, pelvic pressure, having to urinate a lot, back pain, and constipation or diarrhea.
When deciding on a fibroid treatment option, you and your doctor will also take into consideration “the desire for future fertility,” says Jenny M. Jaque, MD, chief of obstetrics and gynecology at the University of Southern California’s Keck School of Medicine. Unlike hysterectomies, many other uterine fibroid treatments allow you to still get pregnant later on.
Diet and lifestyle changes
“Because we actually don’t understand what causes fibroids to form, it’s difficult to say what you should do to prevent them,” says Dr. Newsome. We do know that fibroids are sensitive to hormones, especially estrogen, and that lifestyle modifications that affect hormone production may alleviate some symptoms.
In fact, diet and exercise may be the two main things you can do at home to treat uterine fibroids.
Estrogen affects fibroids, and fat cells produce estrogen, says Dr. Newsome. Shedding some excess body fat could therefore improve fibroid symptoms, she says. While there are no large studies on diet or foods that can shrink fibroids, there is some anecdotal evidence, she adds, that women who follow a plant-based diet have improved fibroid symptoms.
Exercise may also help ease some uterine fibroid symptoms, but there are no known ways to get rid of fibroids naturally, says Dr. Newsome.
GnRH agonists
If watchful waiting and lifestyle changes aren’t options for you, doctors may move on to hormonal medications to control symptoms and even shrink the fibroids.
Several of these medications, like leuprolide (Lupron), are gonadotropin-releasing hormone (GnRH) agonists. They work by blocking hormone production. This causes the fibroids to shrink, which relieves uterine fibroid symptoms like heavy bleeding, pelvic pain, or needing to urinate all the time. Reducing bleeding is especially important to lower a woman’s risk of anemia.
But halting hormone production means you may also end up with menopausal symptoms like hot flashes. Some doctors prescribe “add back” medications–low doses of hormones–to counter that effect without decreasing how well the GnRH agonist works.
GnRH agonists, available in pill, nasal spray, and injection forms, are typically used for a short period of time. They can be helpful in reducing the size of a fibroid before surgery, for example. Fibroids will grow back after these medications are stopped.
Hormonal meds
Hormonal contraceptives are another option to treat uterine fibroid symptoms. They won’t necessarily reduce the size of uterine fibroids, but they may regulate periods or reduce heavy bleeding. This could be the pill or a progestin-releasing IUD, as long as the location of the fibroids doesn’t interfere with inserting one safely, says Dr. Jaque.
Androgens, so-called male hormones, like danazol (a synthetic drug that mimics testosterone), can stop periods and shrink fibroids. However, this treatment might also result in weight gain, a lower voice, and unwanted hair.