Breakthroughs In Treatment Options For Women With Uterine Fibroids
Prevention and Treatment Though approximately 70 percent of Canadian women have uterine fibroids, for most, the condition will never have a major impact on their daily lives. Unfortunately, some women face a very different reality.
Uterine fibroids are benign tumours that grow along the wall of the uterus and usually have little to no effect on a woman’s health. In fact, many who have the tumours will never know it. That’s because the majority of the growths are benign (only approximately 1 in 500 become cancerous) and remain small enough that they never cause symptoms.
However, for about 30 percent of sufferers, these non-malignant fibroids pack a decidedly unfriendly punch. Heavy menstrual bleeding, bladder pressure, bloating and in rare cases, problems with fertility and pregnancy, are just some of the issues that can severely affect women with uterine growths.
Improving quality of life for sufferers
“Most uterine fibroids are asymptomatic and require no treatment, but about a third cause symptoms. It depends on their on size, number and location,” explains Dr. George Vilos, Professor of Obstetrics and Gynecology at Western University. “They can interfere with a woman’s quality of life because of things like the constant pressure on the bladder, or bowel, or the fatigue associated with heavy periods.
In fact, fibroids are the number one cause of anemia—chronic iron deficiency. It’s not just the heavy bleeding that’s a concern; it’s also the bleeding-in between periods that’s an issue with uterine fibroids.”
Until recently, there were only two main treatment options available to women suffering from uterine fibroids. For those who were not planning to get pregnant, the birth control pill or IUD offered a measured solution. While the contraceptives could not decrease the size of the fibroids, they could inhibit their growth and would at least help control bleeding during a menstrual cycle.
"For other women—especially for individuals afflicted with large or very numerous fibroids—surgery, such as a full or partial hysterectomy or a myomectomy, was often the only choice."
For other women—especially for individuals afflicted with large or very numerous fibroids—surgery, such as a full or partial hysterectomy or a myomectomy, was often the only choice. But surgery, of course has its own risks and complications. Dr. Vilos notes that, for example, a hysterectomy, which is the most effective treatment for fibroids, is a major surgical procedure and has a mortality rate of roughly 1 in 2000.
A new medication on the market
But a breakthrough occurred just a little over two years ago when a new medication was approved by Health Canada to treat fibroids. “This medication does two things,” explains Dr. Vilos, “it reduces bleeding and reduces fibroid volume. Most women—up to 90 percent—stop bleeding within a week of treatment. After three months or so, fibroids shrink considerably, by about 40 to 50 percent.”
The promise of this new pill was underscored in February, when the Society of Obstetricians and Gynecologists of Canada—the leading authority in Women’s Health in the country—published their new clinical practice guidelines and listed the medication as the first and only approved medical treatment for uterine fibroids.
Dr. Vilos emphasizes that the significance of this medical development is not only as a treatment for fibroids but also as a pre-surgical aid for sufferers who must undergo surgery. “We can give patients three months of treatment before the surgery to help stop bleeding and shrink the fibroids.
If we shrink fibroids, the surgery becomes easier and safer. There’s less chance of bleeding and the doctor has smaller fibroids to deal with. With smaller fibroids, a surgeon may even be able to perform a minimally invasive procedure that has a shorter recovery time. So that’s the huge advantage of this medication, it helps suffers not just with bleeding but by shrinking fibroids so surgical procedures can be safer and less invasive.”