Hormonal Treatments for Uterine Fibroids
Uterine Fibroids Symptoms and Hormone LevelsUterine fibroid symptoms vary from nothing to heavy bleeding, pelvic or abdominal pressure, frequent urination and abdominal swelling. The etiology of this benign but troublesome condition may be attributed to an imbalance of different hormone levels more specifically sex hormones such as estrogen. Some scientists believe that uterine fibroids arise due to the excess of estrogen in the body. Since estrogen is related to the proliferation of uterine tissue, this model is widely endorsed.
Hormone therapy is just one of the many options for treating uterine fibroids. The foundation of hormone therapy for uterine fibroids is based on using medications that lower the level of estrogen in the body. When there is a low level of estrogen in the body often fibroids will stop growing growth will stop and may even shrink.
Hormone Therapy for Treating Uterine Fibroids IncludeGonadotropin-Releasing Hormone (GnRH) Agonists and Antagonists
GnRH agonists or antagonists are typically given before surgery to make fibroids smaller and more controllable during surgery and reduce blood loss. Therapy using GnRH agonists and antagonist drugs results in decreased estrogen and progesterone levels, leading to a decrease in the size of the fibroid.
There is also cessation of menstruation, allowing women with anemia due to uterine bleeding to increase their iron stores. The side effects of using these medications are similar to the symptoms experienced as a result of hormonal changes during and after menopause. These include hot flashes, vaginal dryness, mood swings, changes in metabolism and infertility.
GnRH treatments are not to be used during pregnancy due to potential pregnancy complications, nor in the long term since they can significantly decrease bone density leading to osteoporosis. Currently, GnRH agonists are used more frequently than GnRH antagonists.
GnRH agonist drugs include: Lupron, Synarel, Zoladex, among others. Recent research, however, suggests that GnRH antagonists work more quickly and the side effects are less severe than those of GnRH agonists.
Progestins can partially suppress estrogen stimulation of uterine fibroid growth. They also reduce bleeding and provide contraception. Side effects of progestins may include weight gain depression, and irregular bleeding. For some women, however, fibroids tend to grow while on progestin therapy. Examples of progestins are: medroxyprogesterone acetate, depomedroxyprogesterone acetate, and norethindrone.
Progestin-Releasing Intrauterine Device (IUD)
A progestin-releasing IUD can only provide relief for the symptoms associated with fibroids such as heavy bleeding and pain but it cannot shrink fibroids or make them disappear.
Based on recent studies, it has been found that drugs that oppose the other major female hormone, progesterone, seem to be effective in treating uterine fibroids as well. The most popular anti-progestin drug Mifepristone, also known as RU 486, has showed in small studies that it induces uterine shrinkage and stops menstrual periods in women with fibroids. However, this drug is not readily available and studies regarding its effectiveness are still in the early stages.
The ovaries and adrenal glands produce androgens, also known as male hormones. Androgens can help to relieve fibroid symptoms. Currently, there are synthetic drugs similar to testosterone called Danazol and Gestrinone that may effectively stop menstruation, cure anemia, shrink fibroid tumors and reduce fibroid size. Side effects in taking this drug may include weight gain, dysphoria (feeling depressed, anxious or uneasy), acne, headaches, unwanted hair growth and a deeper voice.
Selective Estrogen Receptor Modulators (SERMS)
SERMs may help reduce fibroid growth. Based on animal studies, it acts as an anti-estrogen on uterine smooth muscle and may be capable of shrinking fibroids even though estrogen is still present. However, its efficiency on humans compared to other drugs is still unclear. An example of a SERM drug is Raloxifene.
Luteinizing Hormone Releasing Factor
Lupron® and other luteinizing hormone releasing factor medications are frequently used to decrease the size of uterine fibroids by about 50% over 3 months of use. However, Lupron®, is very expensive and does not seem suitable for long term treatment of fibroids. It reduces the size of fibroids and decreases blood flow to the fibroids prior to surgery.
Oral contraceptives also alter the natural hormone levels in the body, thus, slowing or stopping fibroid growth. They work by altering the estrogen and progesterone levels in the body which results in a low enough estrogen level to control fibroid growth.
The side effects of oral contraceptives are similar to those associated with GnRH agonists and antagonists, but are less severe. One advantage of oral contraceptives overto GnRH therapies is that they can be used for a long period of time without endangering fertility or causing severe enough side effects to require discontinuation of therapy.
Efficacy of Hormone Therapy for Uterine FibroidsIn almost all cases once hormone therapy has been stopped, fibroids tend to grow back, possibly reaching their original size again. This often occurs if the use of hormone therapy is not accompanied by another treatment.
It is always best to consult a medical professional to seek advice on which drug regimens and treatments are most suitable based on the details of your case
Read about the different clinical treatments for uterine fibroids
Alternative Treatments for Uterine Fibroids (Myomas). Retrieved from http://www.uterine-fibroids.org/alternative-treatments.html. December 26, 2010.
Center for Uterine Fibroids. About Fibroids. Retrieved from http://www.fibroids.net/aboutfibroids.html#medical. December 26, 2010.
Cornforth, Tracee. Treatment for Fibroids. Retrieved from http://womenshealth.about.com/cs/fibroidtumors/a/fibroidtreatmnt.htm. December 25, 2010.
Cowan, Bryan. Uterine Fibroids(Leiomyomas; Myomas; Fibromyomas). The Merck Manuals Online Medical Library. Retrieved from http://www.merckmanuals.com/professional/sec18/ch248/ch248a.html. December 25, 2010.
Jelovsek, Frederick R. How Will Taking ERT Affect Fibroids? Retrieved from http://www.wdxcyber.com/nbleed14.htm. December 26, 2010.
Jelovsek, Frederick R. Non Hysterectomy Fibroid Treatments Including Embolization. Retrieved from http://www.wdxcyber.com/nbleed2.htm. December 25, 2010.
Mayo Clinic. Uterine Fibroids: Treatment and Drugs. Retrieved from http://www.mayoclinic.com/health/uterine-fibroids/DS00078/DSECTION=treatments-and-drugs. December 26, 2010.
Medline Plus. Uterine Fibroids. http://www.nlm.nih.gov/medlineplus/ency/article/000914.htm. December 26, 2010.
Smith, Jonathan. Hormonal Therapies. Retrieved from
http://www.uterus1.com/care/uterusprocedure20.cfm?bulletinid=2. December 25, 2010.