Fibroids are benign tumors of the uterus that cause pain, bleeding and pressure. Treatment options depend on your symptoms. Hysterectomy, myomectomy (removal of the fibroids), or uterine ablation are the surgical options. A procedure called uterine artery embolization and MRI directed focused ultrasound ablation also can shrink fibroids but they are still procedures with potential complications. Medical therapy can control bleeding in some women. This is limited to birth control pills and progesterones such as Depo-Provera and Mirena IUD. They don’t really help with pain or pressure because the fibroids do not shrink.

Although many herbal products claim to shrink fibroids, most studies show they are no more effective than placebo. Lupron is a GNRH agonist and does shrink fibroids quite nicely, but it is an injectable medication and limited to short term therapy.

Fibroids do naturally shrink when you get to menopause. The problem is living with the symptoms until you get to menopause. Thankfully, there are some new medications that may soon be approved for use that can be used for a longer time period to help avoid surgery or procedures.

Estrogen & Progesterone promote fibroid growth; lowering these levels can shrink fibroids. This can be accomplished with two new classes of medications. A selective progesterone receptor modulator (SPRM) is an agent that acts on the progesterone receptor. GNRH antagonists are medications that tell the brain, “enough is enough-stop making Estrogen and Progesterone.” The data so far is very good for shrinking fibroids, reducing bleeding, pain, and pressure. One medication has already been approved in Europe.

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