Treatment Options for Uterine Fibroids

Some patients with uterine fibroids may not require intervention or, at most, limited treatment. For patients with uterine fibroids without symptoms, the best therapy may be careful surveillance and watchful waiting. Some patients never exhibit any symptoms or have any problems associated with fibroids, in which case, no treatment is necessary.

For patients who experience occasional pelvic pain or discomfort, a mild, over-the counter anti-inflammatory or analgesic drug often will be effective. More bothersome cases may require stronger drugs available by prescription.

Hormonal Medications

Hormonal therapy includes most forms of birth control as well as gonadotropin-releasing hormone (GnRH) antagonists/agonists. Birth control options help to reduce the amount of bleeding that occurs during a period. Depending on the type of birth control, some methods may prevent patients from having a period all together. These options do not affect the size or growth of the fibroids. 

GnRH antagonists/agonist medications affect the hormone pathway in a different way than birth control methods by decreasing the body’s estrogen and progesterone levels. This causes a “menopause-like” state. These medications reduce the amount of bleeding that occurs during a period. Depending on the type of GnRH medication that is used, the size of fibroids can decrease as well. Fibroid shrinkage only occurs while taking these medications and fibroids return to their normal size after stopping. These medications are not recommended for long term use. 

Non-hormonal Medications

Tranexamic acid is an oral medication that helps to decrease the amount of bleeding that occurs during a period. This medication does not contain hormones and does not affect the levels of hormones in the body. This medication does not affect the size or growth of fibroids. 

Uterine Fibroid Embolization (UFE), also called Uterine Artery Embolization (UAE) is a minimally invasive procedure performed by an interventional radiologist. Treatment of fibroids by embolization is relatively new; however, uterine embolization has been successfully used for 20 years to treat heavy bleeding after childbirth.

Embolization is a term that means to stop or block the flow of blood. Almost all fibroids receive their blood supply from the uterine arteries. The technique blocks blood flow to fibroids without injury to the uterus that has other blood flow sources.

In UFE, a catheter is inserted into an artery in the groin and threaded into the uterine arteries. Tiny plastic particles are introduced through the catheter to obstruct the blood flow. The lack of blood supply to the fibroids may cause them to shrink by as much as 65 percent. While most women get complete relief or significant improvement in their symptoms, up to 20 percent of women may still have symptoms after embolization.

Candidates for UFE are premenopausal women experiencing symptoms from fibroid tumors. Most frequently these symptoms include irregular or heavy bleeding, pain, pelvic pressure or fullness. 

The UPMC Magee Uterine Fibroid Embolization program combines the expertise of board-certified gynecologists and interventional radiologists with extensive experience in this minimally invasive procedure. These specialists offer consultation services for women seeking information on UFE as a treatment option for uterine fibroids.

For more information on Uterine Fibroid Embolization, please call the UFE program coordinator at the Magee Fibroid Treatment Center: 412-647-3397.

Our UFE Experts:

• Rajoo Dhangana, MD
• Paula M. Novelli, MD