Medicine can be used to help relieve uterine fibroid problems. The goals of medicine treatment are to:
- Relieve severe pain or other symptoms caused by fibroids.
- Correct anemia caused by heavy bleeding.
- Shrink fibroids before fibroid removal (myomectomy) or uterus removal (hysterectomy).
- Avoid hysterectomy.
When treatment is stopped, symptoms usually return.
The following medicines are used to relieve heavy menstrual bleeding, anemia, or painful periods-they do not shrink fibroids:
- Nonsteroidal anti-inflammatory drug (NSAID) therapy relieves menstrual cramping and greatly reduces heavy menstrual bleeding for many women.
- Birth control hormones (pill, patch, or ring) reduce heavy menstrual periods and pain while preventing pregnancy. But they usually do not affect the size of uterine fibroids.
- An intrauterine device (IUD) that releases small amounts of a certain hormone (levonorgestrel) into the uterus may reduce heavy menstrual bleeding.
- A progestin shot (Depo-Provera) every 3 months may lighten your bleeding. It also prevents pregnancy. Based on studies, progestin may improve fibroids or may make them grow.2 This might be different for each woman.
- Iron supplements, available without a prescription, are an important part of correcting anemia caused by fibroid blood loss.
The following medicine is used to shrink fibroids before surgery and to temporarily relieve symptoms:
- Gonadotropin-releasing hormone analogue (GnRH-a) therapy puts the body in a state like menopause, which shrinks the uterus and fibroids. GnRH-a therapy is used for only a few months, because it can weaken the bones. It may also cause unpleasant menopausal symptoms. Fibroids grow back after GnRH-a therapy is stopped.4
Ulipristal (Fibristal) is used to treat moderate to severe symptoms of fibroids in women who are planning to have surgery. This medicine should not be used for more than 3 months.
What to think about
If you have pain or heavy menstrual bleeding, it may be from a bleeding uterine fibroid. But it may also be linked to a menstrual cycle problem that can be improved with birth control hormones and/or NSAID therapy. For more information, see the topic Abnormal Uterine Bleeding.
GnRH-a therapy is sometimes used to stop bleeding and improve anemia. But taking iron supplements can also improve anemia and does not cause the troublesome side effects and bone weakening that can happen with GnRH-a therapy.