Hormonal medications. Among hormonal medications that are effective on fibroids are birth control pills and progesterone, both of which can regulate your natural hormone balance and reduce bleeding symptoms. There is also the Lupron depot, which creates a "false" menopause, shrinking fibroids like true menopause. A hormonal IUD releases levonorgestrel, a form of the hormone progestin, and can also be effective in shrinking fibroids.
Non-hormonal medications. Doctors sometimes prescribe tranexamic acid, which can help moderate bleeding.
The effect of these medications is limited; fibroid symptoms usually come back when the medications are stopped. In addition, they can cause side effects, like hot flashes or bloating, in some women.
MRI-guided high-intensity focused ultrasound (HiFU). HiFU is a noninvasive, nonsurgical procedure which provides similar results to uterine artery embolization without incisions or significant patient downtime and side effects. OHSU is the only provider in the region using HiFU to treat uterine fibroids for those patients who qualify to participate in our clinical trial.
Uterine fibroid embolization (UFE). This is a minimally invasive treatment (also sometimes known as uterine artery embolization or UAE) that cuts off supply to fibroids so that they shrink on their own.
Endometrial ablation. This procedure destroys the endometrium — the lining of the uterus — with the goal of reducing menstrual flow. No incisions are needed for endometrial ablation. The doctor inserts tools through the cervix to do the procedure.
Laparoscopic myomectomy. This procedure is the surgical removal of a fibroid, leaving the uterus in place. In many women, myomectomy can be done through a series of small incisions (about a half-inch long) on the abdominal wall. About 10-15% of women grow more fibroids, and may need another operation.
Hysteroscopic myomectomy. This procedure, also known as hysteroscopy, can remove fibroids growing in the uterine cavity. A camera and tiny surgical instruments are introduced into the uterus through the vagina, and fibroids can be cut or "shaved" away from the inside of the uterine wall. This procedure is sometimes combined with endometrial ablation. This procedure is an excellent choice for women with submucosal fibroids located at least 50 percent inside the uterus.
Hysterectomy. The uterus is removed through an abdominal incision or through the vagina. It can take several weeks for a woman to recover from a hysterectomy, but there will be no recurrence of fibroids and no chance of uterine cancers. Hysterectomies can often be done laproscopically or vaginally; in rare cases, an abdominal incision may be necessary.
As a regional and national leader in women’s health, we offer multiple opportunities for patients to participate in clinical trials, which currently include MRI-guided high-intensity focused ultrasound (HiFU). Future trials may include fibroid medications. To learn about our current clinical trials, please call 503 418-4500.