What should I do if I have uterine fibroids?

Having uterine fibroids is a sad thing, but it is irreversible. If we still just feel sad, it is useless. What we can do is to try our best to help ourselves recover as soon as possible. Only in this way can we really be healthy. So, after knowing that we have uterine fibroids, what should we do?

Western medicine treatment of uterine fibroids

Treatment must be comprehensively considered based on the patient's age, fertility requirements, symptoms, size of the fibroids, etc.

1. Follow-up observation

If the fibroids are small and asymptomatic, usually no treatment is required, especially for patients near menopause. Estrogen levels are low and the fibroids may shrink or disappear naturally. Follow-up is required every 3-6 months. If the fibroids are found to be larger or the symptoms are obvious during the follow-up period, further treatment should be considered.

2. Drug treatment

For patients whose fibroids are smaller than the size of a 2-month pregnant uterus, whose symptoms are mild or not obvious, and whose patients are near menopause and whose general condition cannot allow surgery, symptomatic drug treatment can be given.

(1) Androgens: They can counteract estrogen, causing the endometrium to shrink, and directly act on smooth muscles to cause them to contract and reduce bleeding, and can also cause premature menopause in perimenopausal patients. Commonly used drugs: testosterone propionate 25 mg intramuscular injection, once every 5 days, 25 mg intramuscular injection during menstruation, once a day for a total of 3 times, the total amount per month should not exceed 300 mg to avoid virilization.

(2) Luteinizing hormone-releasing hormone analog (LHRHα): It can inhibit pituitary and ovarian function and reduce estrogen levels. It is suitable for the treatment of small fibroids (≤2 months of uterine size), heavy menstrual flow or shortened menstrual cycle, and menopausal or peri-menopausal patients. LHRHα is injected intramuscularly 150 mg daily for 3 to 6 months. After using the drug, the patient's menstrual volume decreases or becomes amenorrhea, anemia is gradually corrected, and the fibroids shrink, but they gradually increase again after stopping the drug and return to their original size. Side effects include symptoms of perimenopausal syndrome, such as hot flashes, sweating, vaginal dryness, etc. LHRHα should not be used continuously for a long time, as long-term use can cause estrogen deficiency and lead to osteoporosis.

3. Surgical treatment

If the fibroid is larger than the size of a 2.5-month gestational uterus or the symptoms are obvious and cause secondary anemia, surgical treatment is often required. The surgical methods include:

(1) Myomectomy: Suitable for unmarried patients under 35 years old or married patients without children who wish to preserve their fertility. Myomas are usually removed abdominally or laparoscopically. Submucosal fibroids protruding from the cervix or vagina can be removed vaginally or hysteroscopically. The base of the pedicle can be sutured with intestinal thread or clamped with a vascular clamp for 24 to 48 hours and then the clamp can be removed, or it can be directly removed.

(2) Hysterectomy: If the fibroids are large, the symptoms are obvious, drug treatment is ineffective, there is no need to preserve fertility, or there is suspected malignant transformation, subtotal hysterectomy or total hysterectomy can be performed. Women under 50 years old with normal-looking ovaries can keep their ovaries.

We are not doctors and don’t know how to prescribe the right medicine for ourselves, but we can adjust our mindset correctly. Keeping our mentality healthy is also a sign of health. Therefore, after knowing that we have uterine fibroids, we should not give up, but be positive and make ourselves live happier.