What other medical treatments are available for uterine fibroids?
It is important to remember that fibroids only require treatment if they cause bleeding or pain. There are several medical treatments available for fibroids. Birth control pills (oral contraceptives) can provide many benefits for women with fibroids. They decrease the amount of uterine bleeding by about 50% and decrease cramping pain during menstruation. They also may decrease the risk of fibroids.
Other medical treatments include the use of drugs that turn off the production of estrogen from the ovaries (GnRH analogs). These medications are given for three to six months. When successful, they can shrink the fibroids by as much as 50%.
Mifepristone (RU-486) is an antiprogestin drug that can shrink fibroids to an extent comparable to treatment with the GnRH analogs. This drug, sometimes known as the “morning-after pill,” is also used to terminate early pregnancy. Treatment with mifepristone also reduces the bleeding associated with fibroids, but this treatment can be associated with adverse side effects such as overgrowth (hyperplasia) of the endometrium (uterine lining).
Danazol (Danocrine) is an androgenic steroid hormone that has been used to reduce bleeding in women with fibroids since this drug causes menstruation to cease. However, danazol does not appear to shrink the size of fibroids.
Letrozole (Femara), an aromatase inhibitor blocks the conversion of testosterone to estrogen and is used to treat some women with breast cancer. Preliminary studies have shown a potential role for aromatase inhibitors in the management of fibroids, but more research is needed.
The administration of raloxifene (Evista) (a drug used to prevent and treat osteoporosis in postmenopausal women) has been shown to decrease the size of fibroids in postmenopausal women, but the results of this therapy in premenopausal women have been conflicting.
Fibroids themselves do not require treatment, but women with fibroids can develop complications as a result of fibroids, including bleeding and pelvic pain (as discussed previously). It is because of symptoms that doctors may suggest treatment for a fibroid. Only 20% to 50% of women with fibroids have symptoms due to the condition, primarily bleeding or pelvic pressure.
In addition to bleeding and pelvic pressure, fibroids can cause recurrent miscarriage, infertility, premature labor, and labor complications. However, a substantial majority of women with fibroids can have successful pregnancies unless the uterine cavity is unusually distorted.
What other medical treatments are available for uterine fibroids?