Reporter's File: A Growing Array of Options for Fibroids

Excerpts taken from article By Leslie Berger, NY Times

Not so long ago, women typically had babies in their 20s, developed fibroids in their 30s and underwent hysterectomies in their 40s. For most, at least, that was the typical progression. But these days, as more women hold demanding jobs, many delay childbearing — and most expect more say in their health care. Hysterectomy is just one choice in a growing menu of treatments for uterine fibroids, one of the most common and least discussed of female afflictions. Several procedures, each new one less invasive than the last, have become available in the last decade, enabling women to avoid major surgery, protect their fertility and return to work within days rather than weeks.

With myomectomy, for example, doctors cut out the fibroids but leave the uterus intact. A technique called uterine artery embolization shrinks fibroids by blocking their blood supply. And with M.R.I.-guided ultrasound, tightly focused ultrasound beams zap fibroids, using magnetic resonance imaging to guide the process.

Moreover, new medicines are in development, including a class of drugs called progesterone receptor modulators that may shrink fibroids without inducing menopause and bone loss, as existing medications do. All the new treatments, as well as more sophisticated diagnostic techniques, are part of a growing interest in a condition long considered too unpleasant and embarrassing to talk about, even though nearly three-quarters of women are affected.

Fibroids, which are abnormal, multishaped growths of tissue and fat, appear in only one place in the body: the uterus. The tumors are almost always benign but can grow to the size of a football and cause menstrual bleeding and pelvic pain so severe that some women plan their schedules around their monthly periods. The excessive bleeding is not only disruptive but can also lead to anemia. Depending on their size and location, fibroids can also reduce fertility by as much as 70 percent and and cause several obstetric complications, including premature birth.

Bonnie - I have had clients do the embolization as well as ultrasound with much success and are much safer.