Uterine Fibroids Treatment Summarised!

The treatment of fibroids depends on the symptoms, the size and location of the fibroids, the age and fertility of the woman, and her personal preference. Some women may not need any treatment if they have no symptoms or if their symptoms are mild and manageable. Some women may choose to wait and see if their fibroids shrink or disappear after menopause¹.
For women who have symptoms that affect their quality of life, there are several options available, including medication, surgery, and other procedures. The aim of the treatment is to relieve the symptoms, shrink or remove the fibroids, and preserve or improve fertility if desired¹.
Medication for fibroids can be used to reduce heavy bleeding, pain, or the size of the fibroids. Some of the medicines that may be prescribed are¹:
- levonorgestrel intrauterine system (LNG-IUS) - a small, plastic device that is inserted into the womb and releases a hormone that thins the lining of the womb and reduces bleeding. It also acts as a contraceptive, but does not affect fertility after it is removed.
- tranexamic acid - tablets that are taken during the period to help the blood clot and reduce bleeding. They are not a contraceptive and do not affect fertility.
- non-steroidal anti-inflammatory drugs (NSAIDs) - tablets such as ibuprofen or mefenamic acid that are taken during the period to reduce the production of a substance that causes heavy bleeding and pain. They are also painkillers, but are not a contraceptive and do not affect fertility.
- oral progestogen - tablets that are taken for part of the menstrual cycle to mimic the effect of progesterone, a hormone that opposes oestrogen and reduces the growth of the womb lining and the fibroids. They are not a contraceptive and do not affect fertility.
- gonadotrophin-releasing hormone (GnRH) analogues - injections or nasal sprays that are taken for a few months to temporarily stop the production of oestrogen and progesterone, causing a temporary menopause and shrinking the fibroids. They are not a contraceptive and do not affect fertility, but they can cause side effects such as hot flushes, vaginal dryness, and bone loss.
Surgery for fibroids can be used to remove the fibroids or the entire womb. The type of surgery depends on the size, number, and location of the fibroids, as well as the woman's age, fertility, and preference. Some of the surgical options are¹:
- hysteroscopy - a procedure that involves inserting a thin, telescope-like instrument through the vagina and cervix into the womb, and using a wire loop or a laser to cut or vaporise the fibroids. This is suitable for submucosal or pedunculated fibroids that protrude into the womb cavity.
- laparoscopy - a procedure that involves making small cuts in the abdomen and inserting a thin, telescope-like instrument and other surgical tools to remove the fibroids. This is suitable for subserosal or pedunculated fibroids that grow outside the womb wall or into the pelvis.
- laparotomy - a procedure that involves making a larger cut in the abdomen and removing the fibroids through the opening. This is suitable for larger or multiple fibroids that cannot be removed by laparoscopy.
- hysterectomy - a procedure that involves removing the entire womb, either through the vagina or the abdomen. This is suitable for women who have very large or numerous fibroids that cause severe symptoms and who do not wish to have children in the future. It is the only definitive cure for fibroids, but it has risks and complications, such as infection, bleeding, and early menopause.
Other procedures for fibroids are less invasive than surgery and aim to destroy the fibroids without removing them. They may be suitable for women who have smaller or fewer fibroids and who want to avoid surgery or preserve their fertility. Some of the alternative procedures are¹:
- uterine artery embolisation (UAE) - a procedure that involves injecting tiny particles into the blood vessels that supply the fibroids, blocking the blood flow and causing the fibroids to shrink and die. This is done under local anaesthetic, using a thin tube that is inserted through a small cut in the groin and guided by X-ray images.
- high-intensity focused ultrasound (HIFU) - a procedure that involves using an ultrasound probe to deliver high-energy sound waves to the fibroids, heating them up and destroying them. This is done under local or general anaesthetic, using an MRI scanner to locate the fibroids and monitor the treatment.
- radiofrequency ablation (RFA) - a procedure that involves inserting a needle-like device into the fibroids and delivering an electric current that heats and destroys them. This is done under local or general anaesthetic, using an ultrasound or MRI scanner to guide the device and monitor the treatment.

[@harrietxo2310]

Omg she’s gorgeous! and im loving the further awareness of gynaecological conditions!