October 4, 2019

What fibroid treatments are best for you?

By uclahealth

Fibroids are non-cancerous tumors that develop in the uterus and can range in size from that of a pea to as large as a watermelon. Having fibroids is quite common: 70 to 80 percent of women will develop uterine fibroids during their lifetimes — and the likelihood of developing fibroids increases as a woman nears menopause.

What are uterine fibroids

Many women will not have any symptoms or know they have fibroids until a provider finds them during a routine pelvic exam. Symptoms of larger or multiple uterine fibroids include:

  • Problem periods: Heavy or prolonged periods or spotting between periods.
  • Pain: Low back pain, pain with intercourse, or pelvic pain and pressure.
  • Urination: Increased frequency of needing to use the bathroom or difficulty emptying the bladder.
  • Conception concerns: Difficulty getting pregnant.

Preventing and managing fibroids

Doctors usually recommend watchful waiting for women who don’t have symptoms or whose symptoms don’t affect their quality of life. This approach means your doctor will monitor you to determine if there are changes that require more aggressive treatment.

While you cannot totally prevent fibroids, your doctor may suggest modifying your diet, which might help slow fibroid growth or ease fibroid symptoms. Foods to eat if you’ve been diagnosed with fibroids include:

  • Fiber-rich foods such as fruits, vegetables, oats and barley
  • Potassium-rich foods such as avocado, tomatoes and bananas
  • Foods rich in calcium, phosphorus and magnesium like fortified milk
  • Antioxidant-rich green tea

Avoid these foods, which may lead to weight gain and fibroid growth:

  • High-sugar foods like fruit juice
  • Highly processed foods like white bread or energy bars
  • Phytoestrogens that mimic estrogen in the body, such as alcohol, red meat and chocolate

Fibroid treatment options

If fibroids are large or bothersome, you should talk with your doctor about the pros and cons of the different fibroid treatment options, which include:

Medical therapy

Providers usually use noninvasive options first for treating fibroids. While medicines aren’t meant to cure fibroids, they can lessen the symptoms. Medical therapy includes:

  • Hormonal medicines: A hormone-releasing intrauterine device (IUD) can relieve heavy bleeding or pelvic pain and pressure. Gonadotropin-releasing hormone (GnRH) is a naturally occurring hormone that stimulates the production of the hormones estrogen and progesterone. Anti-GnRH medicines can be used to stop the production of those hormones and cause menstruation to cease for a few months.
  • Non-hormonal medicines: Anti-inflammatory medicines can help alleviate fibroid pain when used for a short time. Other medicines can be used temporarily to increase blood clotting and decrease the amount of bleeding with periods.

Fibroid surgery

There are two surgical approaches for fibroids:

  • Fibroid removal: Known as myomectomy, this approach removes the fibroid while leaving the healthy uterine tissue in place. This can often be done with minimally invasive procedures.
  • Hysterectomy: The removal of the uterus to treat fibroids is usually a last resort. As with myomectomy, there are many minimally invasive approaches to removing the uterus.

MR-guided focused ultrasound

Magnetic resonance (MR)-guided high-intensity focused ultrasound (HIFU) is a noninvasive procedure performed in an outpatient setting. The procedure targets the fibroid with high-temperature ultrasound energy to kill the fibroid cells without affecting nearby tissues. MR-HIFU is the only U.S. Food and Drug Administration (FDA)-approved interventional procedure for the treatment of fibroids in premenopausal women.

Uterine artery embolization (UAE)

UAE is a minimally invasive alternative to surgery for the treatment of fibroids. A small tube is threaded through the skin into an artery that supplies the fibroid with blood. The provider injects small particles into the tube. They travel to the fibroid and bunch together to block the blood supply, causing the fibroid to shrink. 

UCLA Health provides comprehensive care for fibroids. Learn more about fibroids or request an appointment with an OB/GYN provider. If you already have a provider and are interested in UAE or MR-HIFU, please call 310-481-7545 or request an appointment.

Tags: female pelvic medicine, fibroids, News & Insights, OBGYN, Obstetrics & Gynecology, pelvic exam, UCLA Fibroid Treatment Program, uterine fibroids, women's health

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