Spontaneous healing of multiple uterine fibroids

Multiple uterine fibroids generally refer to uterine fibroids, which are very common benign tumors and one of the most common tumors in the human body. The cause of uterine fibroids is unknown. After the disease occurs, there will be symptoms such as uterine bleeding and abdominal pain. Some patients may not even have any symptoms, so they hope that the disease can heal itself. So, can multiple uterine fibroids heal on their own? Let’s take a look below.

It is currently believed that the occurrence of uterine fibroids is closely related to estrogen. As age increases, patients may experience menopause. After menopause, uterine fibroids are more likely to shrink automatically. For small uterine fibroids that have no symptoms, generally no special treatment is required and regular check-ups are sufficient. However, for large uterine fibroids, which often occur more frequently in patients and do not have fertility requirements, hysterectomy can be considered.

Uterine fibroids treatment

1. Follow-up observation

If the patient has no obvious symptoms and no signs of malignancy, regular follow-up observation can be performed.

2. Medication

(1) Gonadotropin-releasing hormone agonist (GnRH-a) Currently, the commonly used GnRH-a in clinical practice include leuprorelin, goserelin, triptorelin, etc. GnRH-a should not be used continuously for a long time. It is only used for pretreatment before surgery, generally for 3 to 6 months, to avoid causing severe menopausal symptoms caused by low estrogen. A small dose of estrogen can also be supplemented at the same time to counteract this side effect.

(2) Mifepristone is a progesterone antagonist that has been clinically tried in recent years to treat uterine fibroids. It can reduce the size of fibroids, but the fibroids often grow again after discontinuation of the drug.

(3) Danazol is used for preoperative medication or treatment of uterine fibroids that are not suitable for surgery. Uterine fibroids may grow larger after medication is stopped. Danazol can cause liver damage and androgenic side effects (weight gain, acne, dull voice, etc.).

(4) Tamoxifen can inhibit the growth of fibroids. However, long-term use may cause enlargement of uterine fibroids in some patients, and may even induce endometriosis and endometrial cancer, so this should be paid attention to.

(5) Commonly used androgen drugs include methyltestosterone (methyltestosterone) and testosterone propionate (testosterone propionate), which can inhibit the growth of fibroids. The dosage should be used carefully to avoid virilization.

During the bleeding period of patients with uterine fibroids, if the amount of bleeding is heavy, uterine contractants (such as oxytocin, ergot) and hemostatic drugs (such as hemostatic acid, aminobenzoic acid (hemostatic aromatic acid), lizhihemostasis, Panax notoginseng tablets, etc.) can also be used, which can play a certain degree of auxiliary hemostatic effect.

3. Surgery

Surgical treatment of uterine fibroids includes myomectomy and hysterectomy, which can be performed abdominally or vaginally, or endoscopically (hysteroscopy or laparoscopy). The choice of surgical procedure and approach depends on factors such as the patient's age, whether or not they have fertility requirements, the size and location of the fibroids, and medical technology conditions.

(1) Myomectomy is a surgery to remove uterine fibroids while preserving the uterus. It is mainly used for young women under 40 years old who wish to retain their fertility. It is suitable for patients with larger fibroids, heavy menstruation, compression symptoms, infertility due to fibroids, submucosal fibroids, and fast-growing fibroids without malignant transformation.

(2) Hysterectomy is recommended for patients with obvious symptoms, those with malignant fibroids, and those who have no fertility requirements. Hysterectomy can be performed with total hysterectomy or subtotal hysterectomy. For older women, total hysterectomy is more appropriate. The possibility of cervical malignancy must be excluded before surgery.

(3) Uterine artery embolization uses radiological intervention to directly insert an arterial catheter into the uterine artery and inject permanent embolic particles to block the blood supply to the uterine fibroids, thereby causing the fibroids to shrink or even disappear. UAE is currently mainly suitable for uterine fibroids with symptoms such as abnormal uterine bleeding leading to anemia. Caution should be exercised when choosing interventional treatment for uterine fibroids, especially for those with uncontrolled pelvic inflammation, those who wish to retain their fertility, those with arteriosclerosis, and those who have contraindications to angiography, which should be listed as contraindications to this treatment. 5% of patients may experience premature ovarian failure after surgery, and there are also rare reports of pelvic infections.

4. Focused Ultrasound Therapy

By focusing ultrasound waves and raising the temperature locally inside the tumor to over 65°C, the tumor undergoes coagulative necrosis, which in turn has a therapeutic effect. The treatment can cause the fibroids to shrink and relieve symptoms. Indicated for symptomatic uterine fibroids. The advantages are that there are no surgical scars after treatment and recovery is fast. Adverse reactions have been reported including skin burns, adjacent intestinal damage, and hematuria.