It wasn’t very long ago that women had babies in their 20’s, developed fibroids in their 30s and underwent hysterectomies in their 40s. This was how health typically progressed for most women, if not for all. But, with today’s demanding jobs, childbearing gets delayed.
This makes hysterectomy to be just one choice from the various treatment options for uterine fibroids, which is one of the most common yet least discussed female troubles.
A woman with no symptoms to affect her day-to-day life may not receive any treatment at all. And when the treatment is necessary, it may be in the form of various medications or surgeries.
What type of treatment you have depends on:
If a woman is close to reaching her menopause, she might want to delay having any treatment for her fibroid. The progression of her condition can be tracked through regular pelvic exams and ultrasounds.
GnRH Agonists- Gonadotropin releasing hormones (GnRH) stop ovulation, and thus the production of oestrogen, and can reduce fibroid size.
Oral Contraceptive Pills- If a woman with fibroid has heavy menstrual periods, she is prescribed hormonal medications to reduce the bleeding and regulate the menstrual cycle.
Intrauterine Devices (IUD)- The bleeding caused by fibroids can be decreased with an IUD that releases a small amount of hormone into the uterine cavity.
LNG-IUS (Levonorgestrel intrauterine system)- It is a plastic device placed inside the uterus and releases progestogen hormone, which stops the lining of the uterus from growing too fast, which effectively reduces bleeding.
A patient, who doesn’t find relief with medications, may have to undergo surgery for fibroids. The following surgical procedures can be done:
Hysterectomy- This involves removing the whole uterus. Very large fibroids or excessive bleeding leave no option but hysterectomy as a treatment option. Recurring fibroids may also lead to a woman getting her uterus removed so that they can be stopped from coming back. Hysterectomy can cause reduced libido and early menopause in the woman.
Myomectomy- A woman, who wants to get pregnant in future, can go for myomectomy because it involves removing the fibroids surgically from the wall of the uterus. However, women with large fibroids, or the ones located in particular parts of the uterus may not be able to benefit from this procedure.
UAE (Uterine Artery Embolization) – This surgical procedure is done to stop the fibroid from getting its blood supply. Women with large fibroids undergo UAE, which effectively shrinks it. For the procedure, a chemical is injected through a catheter into a blood vessel in the leg - it is guided by X-ray scans.
Magnetic-resonance-guided Percutaneous Laser Ablation – After an MRI scan detects the fibroids, very fine needles are inserted through the patient's skin and pushed until they reach the targeted fibroids. Then, with the help of a fibre-optic cable, laser light goes through the body, hits the fibroids and shrinks them.
Magnetic-resonance-guided Focused Ultrasound Surgery- After an MRI scan locates the fibroids, sound waves are aimed at them. This procedure is also used to shrink the fibroids.
Women suffering fibroids should discuss each treatment option with their doctor. Deciding on a particular surgical procedure depends on the location, size, and number of fibroids. Certain procedures to treat the fibroid may affect a woman's fertility and are recommended only for women who are past childbearing age or who do not want to conceive in future.
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