Fibroids? What Now??

There's no one, right way to treat uterine fibroids. There are many treatment options available. But perhaps the best way to handle things is to take a wait and see approach.

Many women with fibroids never have symptoms at all. If this is your situation, doctors prefer to employ expectant management, which means your doctor will monitor your situation and see if and how it develops. It's perfectly safe to choose this approach if there are no symptoms. After all, fibroids aren't cancerous and don't often interfere with pregnancy. Fibroid growth tends to be very slow and they usually shrink after menopause kicks in and estrogen levels drop. In most cases of uterine fibroids, monitoring is all that is necessary.

Regulating Hormones

Should your fibroids require treatment, one approach is to try to regulate the hormones that control the menstrual cycle. The idea here is to bring heavy periods and pelvic pressure under control. These medications won't get rid of the fibroids but may shrink them. Among these medications are:

*Gonadotropin-releasing hormone (Gn-RH) agonists. Each month, your hypothalamus produces Gn-RH to trigger menstruation. Gn-RH then makes its way to your pituitary gland where it prods your ovaries to manufacture estrogen and progesterone.

Gn-RH agonists produce the opposite effect, and cause hormone levels to dip. This means that menstruation ceases, fibroids become smaller, and your body has a chance to rebound from the chronic anemia resulting from heavy, prolonged menstruation.

Symptom Relief

*Progestin-releasing intrauterine device (Mirena IUD). As long as your fibroids don't distort the shape of the inside of your uterine cavity, the insertion of a Mirena IUD should alleviate the pain and heavy bleeding so often caused by fibroids. However, keep in mind that the progestin released by this IUD only gives symptom relief and will not shrink or get rid of your fibroids.

*Androgens. Male hormones called androgens are released by the ovaries and adrenal glands. When given as a therapeutic measure for uterine fibroids, androgens often alleviate the symptoms of fibroids.

*Danazol. This drug is a synthesized form of testosterone and can help fibroids by stopping menstruation which in turn can correct anemia and shrink the fibroids. But there can be some nasty side effects, for instance, mood changes, weight gain, unsightly hair growth, and lowering of the voice. Some women would rather not take their chances with this drug.

The Pill

*Oral contraceptives. The pill will help regulate your period but won't reduce the size of your fibroids.

*Nonsteroidal anti-inflammatory drugs (NSAIDs) are known to reduce heavy vaginal bleeding that is not caused by fibroids, but they won't do a thing for the heavy bleeding that accompanies fibroids. Still, they may relieve your pain.

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