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Treatment Options for Uterine Fibroids

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Until very recently, women with uterine fibroids had limited treatment options. The most common way to treat fibroids has typically been hysterectomy, or removal of the uterus.

While the number of hysterectomies has decreased greatly over the years, it is still a common procedure for fibroid treatment, and the second most frequently performed surgery in the United States: approximately 150,000 hysterectomies are performed each year to treat fibroids. 

But treating this benign condition with surgery is no longer a woman’s only option. Today’s medical advances offer more choices and alternatives to manage symptoms from fibroids, and Magee-Womens Hospital of UPMC offers a variety of treatment options including:

Watchful Waiting

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

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

Hormonal Therapy

Various hormone medications are available to control fibroid symptoms. Birth control pills are frequently prescribed to regulate the natural hormone balance and reduce bleeding symptoms. Progesterone also reduces the effects of the monthly cycle on the fibroid. Lupron may be prescribed to create a "false" menopause, causing the fibroids to shrink.

Unfortunately, the effect of these medications is limited. Fibroid symptoms usually come back when the medications are stopped. In addition, the medications can cause side effects such as hot flashes or bloating in some women.

Uterine Fibroid Embolization

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 often premenopausal women experiencing symptoms from fibroid tumors. Most frequently these symptoms include irregular or heavy bleeding, pain, pelvic pressure or fullness. The effects of UFE on fertility are not yet known, therefore the procedure is not recommended for women that may wish to experience pregnancy in the future.

The Uterine Fibroid Embolization program at Magee 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.