Uterine Fibroid Drugs
Uterine fibroids are non-cancerous tumors which grow in the uterus. They can cause heavy, painful periods and general discomfort by pressing on the bladder, bowels or back. In some patients, large fibroids might cause infertility by blocking or distorting the fallopian tubes. This may prevent eggs from the ovaries reaching the uterus or sperm from the cervix reaching the fallopian tubes. Uterine fibroids are the most common non-cancerous tumor in humans and many women live quite happily with them without experiencing unpleasant symptoms or infertility. Some sufferers, however, will require medical intervention to relieve their symptoms or to help them to get pregnant.
Medication For Fertility
If you are struggling to conceive because fibroids are growing in your uterus, your doctor is likely to recommend a course of drug treatment before moving on to more radical options such as surgery. Some of the medications prescribed for uterine fibroids may interfere with your ability to get pregnant while you are taking them. However, they may be used as a first step towards helping you to achieve your goal. In other words, you might have to accept doing something which will temporarily stop you getting pregnant so that you will be able to conceive at some point in the future.
Gonadotropin releasing hormone agonist, or GnRHa, is a hormone-based treatment usually administered by injection. It stops you from having periods and thereby reduces the oestrogen levels in your body. (The hormones oestrogen and progesterone encourage the growth of uterine fibroids). The decrease in oestrogen causes the fibroids to shrink. Therefore, if you have fibroids blocking your fallopian tubes, the chances are that the blockage will be cleared. Although GnHRa stops you from having periods, it is not a contraceptive. It does, however, induce some menopause-like side effects in some patients (hot flushes, vaginal dryness, etc.). For that reason, it is often used in combination with HRT (Hormone Replacement Therapy), which combats menopause symptoms. GnRHa treatment is generally not prescribed on a long-term basis and is often used to shrink fibroids prior to surgery. A surgical procedure called a myomectomy, in which the fibroids themselves are removed from the womb, is the most common surgery performed to help a patient conceive. Taking GnRHa will not interfere with your ability to get pregnant, after the treatment has stopped.
Medication For Symptoms
A range of medications are also prescribed to help you manage the symptoms of uterine fibroids, although these will not necessarily help you get pregnant if you are experiencing infertility.
Anti-inflammatory painkillers such as ibuprofen help to ease the severe period pain which sometimes accompanies uterine fibroids. These medications reduce your body's production of prostaglandins, which can aggravate inflammation, cramps and swelling. These medications will not interfere with your ability to get pregnant. They may have certain side effects which will be listed either on the packet or on the information leaflet inside.
Transexamic acid tablets help the blood in the uterus to clot during your period which reduces menstrual bleeding. They are usually taken for four days from the first day of your period. The tablets won't affect your ability to get pregnant once you stop taking them.
The contraceptive pill stops your natural periods (although you do have a monthly bleed during your 7-day break every four weeks) and it sometimes helps to reduce period pain. The pill is not a long-term option for women who want to get pregnant as the purpose of it is to make you temporarily infertile for the time you are taking it. It may leave you unable to conceive for a limited time after you stop taking the tablets.
Levonorgestrel Intrauterine System, or LNG-IUS, is a small, plastic device which is inserted into the womb. It helps to prevent thick growth of the uterine lining by releasing a progestogen hormone called levonorgestrel. The thinner the uterine lining, the less tissue there is to be flushed away at the time of the menstrual period. Periods will therefore be lighter. The treatment does have some side-effects, such as periods stopping altogether (although this is rare), irregular menstrual bleeding, skin problems, headaches and painful breasts.
If The Drugs Don't Work
If drug treatment fails to rectify your problem (be it fertility issues or painful symptoms which you want to get rid of, or both) your doctor may recommend surgery. Several different surgical procedures are used to treat uterine fibroids, some of which will help you to become fertile and some of which leave the patient unable to have children by removing some or all of her reproductive organs. If you decide to opt for surgery, your doctor will want to talk to you in detail about your plans for having children, or not. See our article on uterine fibroid surgery for more information.