Medical Review Provided by Antoinette Marengo, M.D., FACOG

Uterine fibroids are extremely prevalent and often go undetected without symptoms. While some people with fibroids don’t require treatment, others can experience complications including heavy menstrual bleeding, pelvic pain, anemia and pregnancy complications. If fibroids are disrupting your life there are various treatment options to explore.

Medication and procedures to alleviate your symptoms
Over-the-counter pain relief medication may provide temporary relief. Heavy bleeding can result in iron deficiency anemia (IDA). Supplementing with iron may treat symptoms associated with anemia.
Hormonal birth control methods, including intrauterine devices (IUDs), may help reduce heavy menstrual bleeding. Tranexamic acid tablets may also be prescribed, which stop blood clots from disintegrating and thus reduce heavy periods.
Gonadotropin-releasing hormone (GnRH) antagonists with hormonal therapy may help to minimize menstrual bleeding.
GnRH agonists with or without hormonal therapy, taken as either nasal sprays or injections, can reduce bleeding and shrink fibroids while you take the medication; when you stop taking it however, fibroids may return – therefore these medications should only be used before surgery is scheduled, not as long-term treatments.
Endometrial ablation surgery is used to reduce heavy menstrual bleeding by destroying the endometrium, the lining of the uterus. This process typically involves inserting a tool through the vagina and using extreme cold, heated fluids, microwave energy or high-frequency radio frequencies with extreme temperatures – although pregnancy after this procedure may still be possible and even advised. Pregnancy should not be undertaken afterward because of risks to both you and your unborn baby.

Procedures that won’t impact fertility
Surgery to remove fibroids might be necessary in some instances. A myomectomy is one form of such procedure; there are three varieties.

Hysteroscopy, or non-incisional surgery, involves your healthcare provider using a thin and flexible scope (similar to an endoscope in other surgeries) to pass through your vagina and cervical canal and into the uterus, in order to cut away and remove fibroids from inside it.
Laparoscopy, in which your provider inserts a scope into your abdomen to remove fibroids through several small incisions. Laparotomy, in which they cut larger holes to do this job.


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