Most women with fibroids don’t have symptoms severe enough to warrant treatment. For those who do, there are a variety of therapies, which are usually selected based on a woman’s age, medical history and whether she may want to get pregnant at some point; other factors include the size and location of the fibroids. Here is a brief description of some of the most common treatments. More information is available on the National Institute of Child Health and Human Development website.
o Watchful waiting: Many fibroids shrink with time, and most shrink or disappear after menopause. This approach is commonly used by women whose symptoms aren’t severe and whose fibroids aren’t interfering with their urinary system or fertility.
o Hormonal therapies: These are temporary measures to control symptoms; they don’t permanently eliminate the fibroids, and symptoms usually resume when the medications are stopped. Observational studies suggest that hormone-releasing intrauterine devices (such as Mirena) and some oral contraceptives can reduce symptoms. Injections of leuprolide (Lupron) create a temporary menopauselike state by significantly reducing the body’s estrogen production. These medications are mainly used to shrink fibroids before surgery. Their side effects include hot flashes and other menopausal symptoms, and they can cause osteoporosis when used long-term. Antiprogestins, such as mifepristone (RU-486, in doses that are a tiny fraction of the dose used for medical abortions) and ulipristal acetate (Ella, in doses that are a fraction of the dose used for emergency contraception), have shown promise in improving fibroid symptoms, with fewer side effects than leuprolide. Neither is approved for fibroid treatment by the Food and Drug Administration, though both are approved for this indication in Europe.
o Clotting agents: Tranexamic acid (Lysteda) can reduce the heaviness of menstrual bleeding, but it also has the potential to cause clots elsewhere in the body.
