Uterine fibroids treatment

If uterine fibroids do not have any particularly obvious clinical manifestations, no treatment measures are required, and there will be no malignant changes. However, you must go to the hospital regularly for relevant examinations. When your symptoms become very obvious, you must take some medication for treatment. The most typical drug is mifepristone, which can be used to treat diseases such as uterine fibroids.

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.