What Are Uterine Fibroids?

Uterine fibroids are noncancerous growths that develop in the uterus, affecting millions of women globally. These benign tumours vary in size and often cause symptoms like heavy menstrual bleeding, pelvic pain, and pressure. While the exact cause remains unclear, hormonal factors, genetic predisposition, and environmental influences play roles. 

Treatments range from surgical interventions like hysterectomy to non-surgical approaches such as hormonal therapies. Hormonal therapies work by regulating reproductive hormones like oestrogen and progesterone, controlling fibroid growth and symptoms. Understanding fibroids is essential for personalised treatment plans tailored to alleviate symptoms and improve quality of life.

What Is the Medical Treatment for Fibroids?

Traditionally, surgical interventions such as hysterectomy (removal of the uterus) and myomectomy (removal of fibroids) have been primary treatment options for uterine fibroids. Yet, progress in medical research has resulted in the creation of non-surgical methods, like hormonal therapies, to ease symptoms and decrease fibroid size. Medical Treatment for Uterine Fibroids include:

Medical Therapy

• Hormonal Therapies:
• GnRH agonists
• Selective progesterone receptor modulators (SPRMs)
• Combined oral contraceptives
• Progestin-releasing intrauterine devices (IUDs)
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Provide pain relief and reduce menstrual bleeding.
• Tranexamic Acid: Helps in reducing heavy menstrual bleeding associated with fibroids.
• Iron Supplements: Address anaemia caused by excessive menstrual bleeding.

Minimally Invasive Surgeries 

• Ultrasound-Guided Focused Ultrasound Surgery (FUS): Non-invasive procedure that uses ultrasound waves to destroy fibroids.
• Endometrial Ablation: Destroys the lining of the uterus to reduce menstrual bleeding.

Uterus Spring

• Myomectomy: Surgical removal of fibroids while preserving the uterus.

• Hysterectomy: Surgical removal of the uterus, often considered for severe cases or when fertility is not a concern.
• Lifestyle Modifications: Including exercise, dietary changes, and stress management to alleviate symptoms.
• Watchful Waiting: Monitoring fibroids without immediate intervention, particularly for asymptomatic cases.

Each treatment option carries its benefits, risks, and considerations, and the choice depends on factors such as the severity of symptoms, the size and location of fibroids, and the patient's reproductive goals. Consulting with a healthcare provider is crucial for determining the most suitable treatment approach for individual needs.

Hormonal Therapies for Uterine Fibroid Treatment

Hormonal therapies for uterine fibroids target the hormonal imbalances that contribute to fibroid growth and symptoms. These therapies work by regulating the levels of reproductive hormones, such as oestrogen and progesterone, which play a key role in the development and maintenance of uterine fibroids. Hormonal therapies for uterine fibroid treatment involve several steps:

1. Assessment and Diagnosis:

• A healthcare provider evaluates the patient's medical history, symptoms, and performs a physical examination, often including imaging tests such as ultrasound or MRI to diagnose uterine fibroids.

1. Discussion of Treatment Options:

• The healthcare provider discusses various treatment options, including hormonal therapies, with the patient. They explain the mechanisms of hormonal therapies, their potential benefits, and any associated risks or side effects.

1. Selection of Hormonal Therapy:

• Based on the patient's symptoms, fibroid characteristics, and medical history, the healthcare provider recommends a specific hormonal therapy. This decision considers factors such as the size and location of fibroids, the severity of symptoms, and the patient's reproductive goals.

1. Initiation of Treatment:

• Once the patient and healthcare provider agree on a treatment plan, hormonal therapy is initiated. This may involve prescribing medications such as GnRH agonists, selective progesterone receptor modulators (SPRMs), combined oral contraceptives, or progestin-releasing intrauterine devices (IUDs), depending on the chosen therapy.

1. Monitoring and Follow-Up:

• Throughout the course of treatment, the patient is monitored closely for response to therapy and any potential side effects or complications. Follow-up appointments allow for adjustments to the treatment plan as needed based on the patient's progress and symptoms.

Common Hormonal Therapies

Several hormonal therapies are used in the management of uterine fibroids, each with its own mechanism of action and potential side effects. GnRH agonists, such as leuprolide acetate and goserelin, work by suppressing the production of oestrogen and progesterone, leading to a temporary reduction in fibroid size and symptoms. 

Selective progesterone receptor modulators (SPRMs), such as ulipristal acetate, target progesterone receptors in the uterus, inhibiting fibroid growth and alleviating symptoms.

Combined oral contraceptives, which contain both oestrogen and progestin, are also used to regulate menstrual cycles and reduce menstrual bleeding associated with uterine fibroids. Progestin-releasing intrauterine devices (IUDs) offer a localised hormonal treatment option, releasing progestin directly into the uterus to inhibit fibroid growth and decrease menstrual bleeding.

Conclusion

Uterine fibroids are noncancerous growths that develop in the uterus, affecting millions of women globally. These benign tumours vary in size and often cause symptoms like heavy menstrual bleeding, pelvic pain, and pressure. While the exact cause remains unclear, hormonal factors, genetic predisposition, and environmental influences play roles. 

Treatments range from surgical interventions like hysterectomy to non-surgical approaches such as hormonal therapies. Hormonal therapies work by regulating reproductive hormones like oestrogen and progesterone, controlling fibroid growth and symptoms. Understanding fibroids is essential for personalised treatment plans tailored to alleviate symptoms and improve quality of life.