Fibroids are benign (non-cancerous) uterine growths common in women of reproductive age. Even though fibroids are non-cancerous, they can cause a whole host of problems, including heavy menstrual bleeding, anemia, fertility issues, and much more. Many women live with persistent symptoms, not knowing there is a diverse range of treatment options depending on the size, location, and symptoms of the fibroids, as well as the individual’s overall health and fertility goals.

 

Understanding that you have options and being given enough information to make an informed decision is the goal of the Fibroid Freedom Workshop. Suppose your fibroid diagnosis goes anything like mine did. In that case, you may feel pushed into a hysterectomy even though there is a diverse range of treatment options available to manage fibroids, from watchful waiting to holistic approaches, minimally invasive techniques, and surgical solutions. Informed decision-making means you know all the options available to you. Keep in mind that only some options may work for you.

 

1. Watchful Waiting

Often, the first approach, especially for asymptomatic fibroids, is watchful waiting. This involves regular monitoring, typically through ultrasound, to track the growth and development of the fibroids. It is also essential to check lab values to ensure you do not become anemic. This approach is particularly suitable for women who are nearing menopause, as fibroids tend to shrink post-menopause.

 

2. Holistic and Lifestyle Approaches

Holistic treatments focus on managing symptoms and preventing fibroid growth through lifestyle modifications. A growing body of knowledge shows that changing your lifestyle can improve your health.

  • Dietary Adjustments: A diet rich in green vegetables, fruits, whole grains, and low in red meat can be beneficial. Soy-based products containing phytoestrogens might also help in managing symptoms.
  • Herbal Remedies: Herbs like Vitex, green tea extract, and turmeric are known for their anti-inflammatory properties and may aid in hormonal balance.
  • Physical Activity: Regular exercise can help maintain a healthy weight, which is crucial as obesity can increase fibroid risk.
  • Stress Management: Since stress can exacerbate symptoms, yoga, meditation, and tai chi can be effective.
  • Reducing toxin exposure: Reducing your exposure to toxins like phylates could help.1

3. Medication

Medication is a standard first-line treatment for symptom management. There are a range of medication options, with new therapies added often2. Many of these medications affect your hormones, so be sure to ask your provider about potential side effects and long-term effects.

  • Gonadotropin-releasing hormone (GnRH) Agonists: These drugs can shrink fibroids and are often used before surgery to reduce bleeding.
  • Tranexamic Acid: This medication is used to reduce heavy menstrual bleeding.
  • Progestin-Releasing Intrauterine Device (IUD): Can provide relief from heavy bleeding.
  • Sex hormone combinations: Provide relief from heavy bleeding from fibroids.

4. Non-Invasive and Minimally Invasive Procedures

These procedures are often preferred due to lower risks and shorter recovery times:

  • Uterine Fibroid Embolization (UFE): Particularly effective for reducing heavy menstrual bleeding and relieving pelvic pressure.
  • MRI-Guided Focused Ultrasound (MRgFUS): This non-invasive, outpatient procedure uses high-frequency ultrasound waves to destroy fibroid tissue.
  • Endometrial Ablation: This procedure destroys the lining of the uterus to reduce menstrual bleeding, but it isn’t suitable for women who wish to conceive.

5. Surgical Options

Surgery is typically considered when fibroids are large, symptoms are severe, or when other treatments haven’t worked:

  • Myomectomy: This surgery involves the removal of fibroids while leaving the uterus intact, suitable for women who wish to conceive in the future.
  • Hysterectomy: The most definitive treatment for fibroids, it’s a major surgery with risks and a lengthy recovery period. Many women feel pressured into this option. Keep in mind that this is an irreversible option, and you will not be able to conceive in the future.

6. Emerging Treatments and Research

Advancements in medical research are continually shaping the landscape of fibroid treatment. One such area is the development of selective progesterone receptor modulators (SPRMs), which offer a non-surgical approach to shrinking fibroids3. Clinical trials and studies investigating gene therapy and other novel treatments.

In conclusion, the journey of treating fibroids is highly personal and varies from one individual to another. It’s essential to research and think of your individual needs so that your health, desires, and comfort are at the forefront of your treatment plan. The Fibroid Freedom Workshop empowers you to make an informed decision about managing your fibroids. Kidan said the workshop made her “empowered to choose the healthiest interventions.”

 

References:

  1. Samuelson, Kristin. Uterine fibroid growth activated by chemicals found in everyday products. Northwestern Now. Published November 14, 2022. Accessed January 29, 2024. https://news.northwestern.edu/stories/2022/11/uterine-fibroid-growth-activated-by-chemicals-found-in-everyday-products/#:~:text=For%20the%20first%20time%2C%20scientists%20at%20Northwestern%20Medicine,uterine%20fibroids%2C%20the%20most%20common%20tumors%20among%20women.
  2. List of 7 Uterine Fibroids Medications Compared. Drugs.com. Accessed January 29, 2024. https://www.drugs.com/condition/uterine-fibroids.html
  3. Islam MS, Afrin S, Jones SI, Segars J. Selective Progesterone Receptor Modulators—Mechanisms and Therapeutic Utility. Endocr Rev. 2020;41(5):bnaa012. doi:10.1210/endrev/bnaa012

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