Fibroid Tumors: What Every Woman Must Know
Diagnosed with fibroids? Three experts help WebMD explore your treatment options.
Treatment Options: What You Should Know continued...
The reason behind all these problems, says Bartsich, is compromised blood flow to the uterus. "If you are going to do a good job of blocking blood flow to the fibroid, then you are also blocking blood flow to the uterus, and that causes difficulties during pregnancy," Bartsich tells WebMD. While he says some women have gone on to have a healthy pregnancy after embolization, he believes it's "risky."
Option 3: MRI-Guided Ultrasound
What It Is: For this procedure doctors use high focused ultrasound waves that are converted to heat and destroy the tumor. The MRI is used to guide the radio waves to the tumor site.
How It's Done: Patients are sedated and placed inside an MRI machine that is specially equipped with the ultrasound. The procedure can take up to three hours.
What It Accomplishes: Using heat it destroys the fibroids, though frequently two or more sessions may be needed. In the past, similar methods have used lasers or some form of electric current to accomplish the same thing.
Best Suited For: Women who have completed childbearing.
What You Should Know: Although recently approved by the FDA, doctors say there is insufficient data concerning impact on future pregnancy. Bartsich says risks include potential damage to other organs and the presence of "dead" fibroid tissue, which may compromise fertility -- problems akin to what was found in similar procedures that eventually fell out of favor.
Option 4: Medical Management
What It Is: Medications that shrink fibroids by reducing hormonal stimulation, primarily a GnRH angonist known as Lupron.
What It Accomplishes: Turns off the production of steroid hormones without which fibroids shrink. However, they generally return when treatment is stopped.
Best Suited for: Women with very small fibroids or those who wish to shrink tumors prior to surgery. Also frequently used to halt severe bleeding, allowing a woman to build her blood supply for transfusion prior to a myomectomy.
What You Should Know: Though this treatment does shrink tumors, Goldstein says it is unsafe to use for longer than nine months, after which time the fibroids generally return. However, he says it can be the treatment of choice for women who are very close to menopause. "If you can stop the bleeding for a year a woman will have made it to menopause, after which time the fibroids shrink on their own," Goldstein tells WebMD.
Option 5: Medical Monitoring
What It Is: A watchful waiting, checking the size and number of fibroids -- and any resulting symptoms -- at regular intervals. How It's Done: Via vaginal ultrasound exam and a blood test for anemia.What It Accomplishes: It may help carry a woman through to her menopause without treatment, after which time hormone levels drop and fibroids disappear on their own. Best Suited for: Women with minimal symptoms who are nearing menopause and who have completed their childbearing.