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Uterine Fibroids (cont.)

Medications

Observation: Your doctor will follow the size and growth of your fibroids over time to make sure no indicators of cancer are present. If you do not have symptoms such as vaginal bleeding or pelvic pain, and if the fibroid is not growing rapidly, no treatment may be needed. You may, however, require more frequent pelvic exams, such as every 6 months, to check on changes.

Medication: You may be given nonsteroidal anti-inflammatory drugs, oral contraceptives (birth control pills), gonadotropin releasing hormone agonists, or RU-486.

Nonsteroidal anti-inflammatory agents, such as ibuprofen (Advil is one example), have been shown to relieve pelvic pain associated with fibroids.
Oral contraceptive pills are also commonly used in women with fibroids. Although the hormones (including estrogen) in such birth control pills may increase the size of the fibroid, they often decrease your perceived menstrual blood flow and help with pelvic pain.
Gonadotropin releasing hormone (GnRH) agonists are medications that act on the pituitary gland to decrease estrogen produced by your body. A decrease in estrogen causes fibroids to decrease in size. This type of medication often is used prior to surgery to shrink the fibroid, to decrease the amount of blood loss during surgery, or to improve your preoperation blood count. The size of the fibroid can be reduced by 50% in 3 months of this type of therapy. But fibroids regrow once treatment is stopped. Long-term therapy with these medications is limited by the side effects of low estrogen (much like menopause caused by drugs), which include decreased bone density, hot flashes, and vaginal dryness.
The antihormonal drug RU-486 (mifepristone) has also been shown to reduce fibroids by about half. This drug has also been shown to reduce pelvic pain, bladder pressure, and lower back pain. Low doses of this drug may reduce the size of fibroids in preparation for surgery to remove them. It may also help you avoid surgery entirely by shrinking the fibroids and the problems they are causing. Side effects related to low estrogen, seen with GnRH analogs, may be less common. RU-486 can induce miscarriage, so this medication should be used with caution if you wish to become pregnant.