Non-Surgical Treatments for Uterine Fibroids: What Are Your Options?

Uterine fibroids are benign tumours in the uterus that frequently occur in women in their childbearing years. While surgical procedures, such as a hysterectomy, are the primary solution for painful, symptomatic fibroids, some women often have concerns about whether surgery is necessary.

Fortunately, advancements in uterine fibroid management have introduced various non-surgical treatment options, allowing women to effectively manage symptoms without the downtime and risks associated with surgery.

What Should You Consider When Choosing a Fibroid Treatment Option?

Every woman’s experience with fibroids is unique, and the decision on how to treat these benign growths should be tailored to individual circumstances.

The following are key factors to consider when determining the right treatment option for uterine fibroids:

Severity of Symptoms

Some women experience little to no discomfort, which requires conservative treatments. However, those who have severe symptoms, such as heavy bleeding, pelvic pain or pressure on nearby organs, may require a more intensive approach.

Age and Fertility Plans

Younger women who wish to preserve fertility may opt for less invasive treatment options that maintain uterine integrity. On the other hand, post-menopausal women or women who have completed childbearing may consider more definitive treatments.

Size and Location of Fibroids

Some growths may develop deep within the uterine cavity and interfere with fertility, while others may form outside the uterus. Another factor to consider is the fibroid size, since larger growths often necessitate more invasive treatments.

Overall Health Condition

Underlying health conditions, such as high blood pressure, diabetes or heart disease, can affect the safety and suitability of certain treatments. Some procedures may also require good overall health to minimise risks.

What Non-Surgical Treatment Options Are Available for Uterine Fibroids?

There are several ways to manage or shrink uterine fibroids without surgery. In Singapore, common non-surgical treatment options for uterine fibroids include:

Medication

Medications are often the first line of treatment in mild to moderate cases. Although they do not eliminate fibroids, they can help manage symptoms. These medications include:

• Hormonal Therapy: Hormonal treatments, such as birth control pills or progestin-releasing intrauterine devices (IUDs), can regulate menstrual cycles.
• Tranexamic Acid: Typically taken during the menstrual period, this medication helps reduce heavy bleeding but does not affect the fibroid size.
• Nonsteroidal Anti-inflammatory Drugs: NSAIDs can help relieve the pain and inflammation associated with fibroids. While they do not address bleeding or shrink fibroids, they can improve comfort for women with mild pelvic pain.
• Gonadotropin-Releasing Hormone (GnRH) Agonists: These drugs can temporarily shrink fibroids by inducing a menopausal state. However, they are often used intermittently due to side effects, such as hot flashes and bone density loss.

Minimally Invasive Procedures

For women who need relief from severe fibroid symptoms but are not ready for surgery, minimally invasive procedures can be an excellent choice. These options offer effective treatment with less recovery time and fewer complications. Common techniques include:

• Uterine Artery Embolisation (UAE): This procedure involves placing a catheter into a blood vessel in the groin or wrist. Once in place, it releases small embolic particles to cut off the blood supply that feeds the fibroids, causing them to shrink over time.
• MRI-guided Focused Ultrasound (MRgFUS): High-intensity ultrasound waves are used to heat and destroy fibroid tissue, with MRI guidance ensuring precise targeting while sparing surrounding tissues.
• Endometrial Ablation: The uterine lining (endometrium) is treated to reduce heavy menstrual bleeding. While it can significantly decrease bleeding, this procedure may not be suitable for those wishing to maintain fertility.

Are Non-Surgical Treatments Right for You?

Fibroid cases vary from woman to woman and what proves effective for one individual may not bring the same result for another. Having a thorough discussion with your healthcare provider can provide clarity on which treatment aligns with your health goals. For expert advice, schedule a consultation with our gynaecologist to discuss your symptoms, undergo necessary tests, and determine the treatment plan that works best for you.