Know the Implications of Your Fibroid Treatment Options
Women may not be fully informed about the implications of their treatment decision. Factors include recovery time (return to work and daily living), symptom recurrence rate, need for post-procedure hormone replacement therapy, the risk of early menopause, cost and additional effects on the body.
Non-surgical (Minimally Invasive)
Uterine Fibroid Embolization (UFE)
Uterine fibroid embolization, sometimes called uterine artery embolization, is a non-surgical treatment that involves cutting off the blood supply to fibroids, causing them to shrink. UFE takes about one hour to complete, provides symptom control comparable to surgery, with a significantly shorter recovery time in approximately two weeks. UFE is performed by an interventional radiologist (IR), usually as an outpatient hospital procedure. Uterine fibroid embolization is not intended for women who desire future pregnancy. However, several studies have shown that women actively trying to become pregnant following UFE were able to do so.
High Intensity Focused Ultrasound (HIFU)
This procedure uses high-intensity focused ultrasound to destroy fibroids. HIFU is a relatively new procedure, with limited availability in the United States. HIFU is non-invasive and done as an outpatient procedure, with six-to-eight hours of treatment time. Additionally, many women are not eligible for treatment with HIFU. It is not intended for women who are pregnant or desire future pregnancy. The effects of HIFU on the ability to become pregnant and carry a fetus to term, and on the development of the fetus, have not yet been determined.
A hysterectomy is the surgical removal of the uterus and often times the ovaries. The procedure usually requires a four-to-six week recovery period, and has a perceived association with numerous other long-term physical and psychological effects including incontinence, loss of sexual pleasure and depression. If the ovaries are removed along with the uterus before a woman reaches menopause, her risk of osteoporosis and heart disease increases. She may also need to consider if hormone replacement therapy (HRT) is necessary to control symptoms of surgical menopause. A woman is no longer able to have children after having a hysterectomy.
A myomectomy is the surgical removal of fibroids while leaving the uterus in place. Since the uterus is left in place, a woman undergoing a myomectomy may still be able to have children. Like hysterectomy, a myomectomy is invasive and requires a long recovery period. There is also no guarantee that the fibroids will not return. Some studies have shown that up to 46% of women have recurring fibroid symptoms two years after their myomectomy.
Short-Term Fibroid Reilef Medication
Medications called GnRH agonists offer short-term relief from fibroid symptoms. GnRH agonists induce a temporary chemical menopause by reducing estrogen levels causing the fibroids to decrease in size. However, the fibroids usually grow back to their pre-treatment size when the medication is discontinued.