Tag: Uterine Fibroids

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Fibroids

Messages from Body Language

Fibroid pain can affect how we sit, stand, and carry ourselves in life. It can also affect the message this body language sends to others.

Fibroid pain and discomfort can affect how we sit, how we stand we stand, and how we carry ourselves in life. It can also affect the message this body language sends to others.

The pain and the unpredictability of fibroid symptoms such as heavy bleeding, bleeding between periods, as well as acute cramping, can not only adversely how we feel about our bodies, but it can also affect the way we present ourselves to others.

Let’s face it, it’s hard to stand tall, and walk with confidence when your uterus is throbbing, or acute pains are causing you to want to curl up in a little ball in your bed.

In fact, according to a study published in the European Journal of Social Psychology, sitting up and standing up straight increases positive thoughts and as a result, self-confidence.

In the study, 71 students that were participants were told that they would be taking part in two separate studies at the same time, one organized by the business school and one by the art school.

The participants were then told that the study of the arts was going to examine their ability to maintain a specific posture while engaging in a study conducted by the business school.

The participants were then seated at a computer terminal and instructed to either sit down with their backs erect and push their chest out (confident posture) or slouched forward with their backs curved and their faces looking at their knees (doubtful posture).

While in their assigned posture positions, the students then were told that they would be participating in another study that investigated factors contributing to job satisfaction and professional performance.

Still holding their assigned posture, the students were then asked to write down either three positive or three negative personal traits as they related to future job performance.

For the final task of the experiment, the participants were asked to take a survey where they rated how well they think they would perform as future employees.

In our next article, we will take a look at the results of this study and how it can relate to women with uterine fibroids.

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Fibroids

UFE Consultation

Setting up a consultation to see if UFE can help you, is an excellent first step towards better health and wellness.

It’s a new year, and why not make it a year without the pain and discomfort that comes with having uterine fibroids by setting up a UFE consultation?

Sound good?

Great!

So let’s get started by scheduling your initial consultation here at MidAtlantic Vascular and Interventional to determine the treatment method that would be best for you.

During this consultation, our expert staff will go over your full medical history.

One way to speed up this process is to arrive early to fill out your medical history form completely. In doing so, please be sure to write down all medications you are taking.

Once you’ve completed the paperwork, you will meet with our nurse practitioner or physician assistant who will complete your medical history and conduct a basic physical examination as well as check your vitals.

Following this, you will meet with our expert interventional radiologist to discuss the procedure and determine if you could be a good candidate for uterine fibroid embolization.

During the consultation with the doctor, he will take the time to learn more about your specific situation and symptoms in order to deliver the best care possible.

If it is decided that you could be a good candidate for Uterine Fibroid Embolization, the next step will be to order a pelvic MRI.

The pelvic MRI imaging process will assess in more detail the appearance, location, size, and vascularity of your fibroids- all of which can help determine if uterine fibroid embolization is right for you.

Once the MRI is reviewed the doctor will be able to determine if you could benefit from UFE.

If UFE is right for you, the next step will be to schedule the procedure, putting your well on your way to living a life free of the painful and life-interrupting symptoms of uterine fibroids.

To schedule your initial consultation please call us at 301-622-5360.

While many women are definite candidates for UFE, others may fall somewhere in the middle, or in some cases might benefit from another type of fibroid treatment.

In our next article, we will take a look at what makes for a good candidate for UFE.

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Fibroids

Making it Through the Holidays with Fibroids

Making it Through the Holidays with Uterine Fibroids

If you have decided to take action and do something about your uterine fibroids- Congratulations on making your health and your body a priority!

This is wonderful news. As you deserve to live a life free of the many uncomfortable, life-interrupting, and painful symptoms that can come with having uterine fibroids.

However, for those of us traveling during the holidays, or having family and friends in town, chances are that the fibroid procedure that you and your doctor have chosen for you isn’t scheduled until after the holidays.

So what can be done in the meantime? Do you just have to grin and bear it? Or load up on NSAIDs and other pain-relieving medicines?

Not necessarily.

In fact, there are actually several things you can do to help reduce your fibroid pain and the stress that it can bring this holiday season so that you can enjoy this special time of year as much as possible.

So let’s take a look at some of the things you can do to reduce fibroid symptoms and pain:


Add more iron-rich foods to your diet.

The holidays are full of yummy treats. Cookies, cakes, casseroles, ham, turkey, stuffing- you name it, and you’ll probably come across it.

However, given that fibroids can cause heavy bleeding that leads to anemia, it’s important to make sure that you are eating iron-rich foods to help reduce the feelings of weakness and lethargy that come from anemia.

This means adding in foods that are rich in iron, like green leafy vegetables, dried fruits, beans, or lean red meat.

Sometimes it’s helpful to add iron to your morning smoothies, or, if you are prescribed iron supplements by your physician, make sure they are part of your diet as well.


Get plenty of rest.

Though the holiday season can be a busy time of year, it doesn’t have to be busy the entire time. In fact, in order to keep fibroid symptoms at bay, it’s important that make sure to have periods of downtime where you can give your body a rest.

If your body isn’t given time to rest and recoup, the stress being put on it can impact your blood and hormone levels, which can increase fibroid pain and symptoms.

Therefore, it’s important to remind yourself that it’s ok to skip a holiday party or an event to take care of yourself and your body. And it’s ok to go to bed early, ask for some help cleaning up, and so on.

By taking better care of yourself, you can reduce fibroid symptoms and as a result, have a much more enjoyable holiday season.


Be prepared when traveling

Traveling with fibroids can be extra stressful, frustrating, and downright uncomfortable.

Therefore, in order to reduce this stress, it’s important to make sure that you pack the right supplies to reduce, treat, and control your fibroid-related symptoms.

Some of the items you may wish to have with you are:

  • Plenty of pads and tampons
  • Flushable wipes
  • Extra underwear
  • A change of clothing
  • Pain-relieving medications
  • Non-perishable snacks
  • A refillable water bottle (look for filling stations at the airport)
  • Relaxing music and other forms of entertainment
  • A heating pad (many planes now offer individual power outlets)
  • A small pillow and throw blanket

If you have an upcoming fibroid treatment procedure scheduled, it can also be helpful to remind yourself that you are taking action to relieve your fibroid symptoms soon and that this pain and discomfort will not last forever.

The Bottom Line: Is that by taking care of yourself and using some of the tips above, one day at a time, you can have a holiday season that’s a little easier, and more enjoyable even with uterine fibroids.

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Fibroids

Fibroid Symptom: Menorrhagia

One of the most common and frustrating symptoms of uterine fibroids is heavy bleeding, also known as menorrhagia.

What do heavy menstrual cycles, fatigue, dizziness, pelvic pressure and bloating, enlargement of the abdomen, constipation, increased urinary frequency, heavy bleeding (menorrhagia), pain during sex, and even infertility all have in common?

If you guessed “symptoms caused by uterine fibroids.”

You’re right!

Although fibroids are non-cancerous, due to the many painful, uncomfortable, and life-limiting side effects, many women choose to have them removed.

One of the most common and frustrating symptoms of uterine fibroids is heavy bleeding, also known as menorrhagia.

It is estimated that as many as 35 percent of women in their reproductive years experience menorrhagia, and fibroids can be a leading cause of this.

In fact, fibroids have been found in more than 10% of women with menorrhagia overall and in 40% of women with severe menorrhagia.

According to the National Library of Medicine (NLM), an estimated 26 million women between 15 and 50 have uterine fibroids. Of those, nearly 15 million women experience associated symptoms or linked health-related problems, such as heavy menstrual bleeding.

So what is considered to be heavy bleeding, and how do fibroids contribute to this?

Most gynecologists and physicians agree that heavy bleeding can be defined as:

–  Bleeding that lasts for longer than eight days.

–  Bleeding that requires frequent sanitary pad or tampon changes, approximately every hour or more.

Why do fibroids cause heavy bleeding?

While there is no one reason that heavy bleeding occurs with fibroids, there are several factors that contribute to this symptom, including:

–  Added pressure on the uterus from the fibroids

–  Irregular contractions of the uterus

–  Blood vessel growth stimulation caused by fibroids increases the amount and frequency of bleeding and spotting between periods

–  Elevated hormone levels

Fortunately, there are several treatment options for women with fibroids, which can help reduce or resolve completely, the symptom of heavy bleeding.

The most common treatment methods for fibroid-related menorrhagia include medication and major surgery such as a hysterectomy or a myomectomy. As well as, a procedure that has been rapidly gaining in popularity for its effectiveness and shorter recovery time, which is called Uterine Fibroid Embolization.

Since 1995, Uterine Fibroid Embolization, which is a non-invasive procedure performed either solely or primarily through the uterine artery, has been helping women who suffer health issues related to uterine fibroids. Furthermore, as UFE continues to grow in popularity as a treatment method for uterine fibroids, a plethora of research continues to document its promising results.

The goal of this procedure is to relieve symptoms by blocking the artery that is supplying blood to the fibroids, which causes them to shrink and die.

So how effective is this procedure in relieving the symptoms of fibroid-related heavy bleeding?

It is very effective.

In fact, multiple studies show that fibroid embolization is at least 90% effective when it comes to reducing fibroid-related bleeding and pain.

Not only that, but time and time again, women are reporting that they are experiencing a significant change in their fibroid symptoms within days following the procedure.

This is incredible, especially considering that other treatment methods can take months to show signs of improvement.

One of the earliest studies of the effectiveness of UFE was published in The Journal of the American Association of Gynecologic Laparoscopists.

The study followed up with 305 women who were treated with the procedure, up to a year after treatment, and what they found was quite promising.

They found that the symptom of heavy bleeding was controlled in 86% of patients at 3 months and 92% at 12 months. And, they also found that the bulk of fibroid symptoms was controlled in 64% of patients at 3 months and 92% at 12 months.

Another study, which was published in the medical journal Radiology reported the results of following up with 80 consecutive patients treated with UFE for menorrhagia caused by fibroids.

Researchers followed up with this group of women for a minimum of 2 years and discovered that menorrhagia was controlled in over 90% of these women!

These are just a few of the studies regarding the impact that Uterine Fibroid Embolization can have on relieving the fibroid symptom of heavy bleeding. A simple google search will bring up study after study where the findings are similar to those stated above.

But wait…there’s more…much more.

In our next article, we will look at what the research says regarding the impact that Uterine Fibroid Embolization can have on some of the other common symptoms of uterine fibroids such as pelvic pressure and pain.

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Fibroids

It’s Time to Take Action

Uterine Fibroid Embolization has a success rate of over 90%. Women report alleviation of symptoms and improvement in their quality of life.

If you have decided it’s time to take action against the heavy bleeding, pelvic pressure, urinary issues, and sexual problems that are common symptoms of uterine fibroids- Congratulations!

And, if you’ve chosen to treat the fibroid condition through a non-invasive procedure, Uterine Fibroid Embolization- Double those congratulations!

As you’ve chosen a treatment procedure that has a success rate of over 90%, with the vast majority of women reporting not only an alleviation of symptoms but a significant improvement in their quality of life.

Gone are the days of heavy bleeding, pressure, pain, and missing out on activities due to these and other symptoms of fibroids.

The process of experiencing relief from fibroid symptoms post UFE takes time, but not nearly as much time as other procedures to remove uterine fibroids such as a hysterectomy or a myomectomy, which can have a recovery time of several weeks and even months. Whereas the minimally invasive procedure of Uterine Fibroid Embolization allows for a much faster healing process and must faster result.

It is not uncommon for women to experience almost immediate relief after the procedure. In fact, many women have reported that they noticed that their first menstrual cycle following the procedure didn’t include severe pain or heavy bleeding. While for others it may take a little more time for all of these symptoms to resolve themselves.

The time it takes for the elimination of uterine fibroids symptoms, really comes down to how quickly the body responds to the UFE treatment, as well as the size of the fibroid or multiple fibroids.

The procedure itself begins with the insertion of a tiny catheter into the groin or wrist. Then, with the help of moving X-ray technology (fluoroscopy), the radiologist will then guide the catheter through the blood vessels until it reaches the artery that supplies blood to the fibroids.

Once the catheter reaches the artery that supplies blood to the fibroids, tiny gelatin beads are released through it, which travel into the artery, creating a blockage. This blockage cuts off the blood supply to the fibroids. And, without the fibroids being able to receive vital nutrients through the blood, they cannot survive and they begin to shrink.

So how long does it take for the fibroids to shrink?

Amazingly, uterine fibroids can begin to shrink immediately following the Uterine Fibroid Embolization procedure and will continue to shrink throughout the next year.

The majority of fibroid shrinkage usually takes place in the first six months following the procedure. However, it can take up to a year for the fibroids to shrink to their fullest capacity, with most women experiencing significant relief from their symptoms during this time.

Usually, patients will return to their radiologist for a follow-up appointment around two months after the procedure to access the amount of shrinkage of the fibroids.

You may be wondering:  How can you tell if the procedure was effective and the fibroids are shrinking?

Good question.

Though many women note improvement in their bleeding symptoms immediately following the procedure, it can take up to 3 months for fibroids to shrink enough for women to notice major symptom improvements.

Therefore, one of the best ways to track the progress of the fibroids shrinking is by paying attention to your symptoms both before and after Uterine Fibroid Embolization.

In fact, it can be very helpful to keep a journal or a list of symptoms and rank the severity of these symptoms with 1 being barely noticeable and 10 being the most severe.

Then following the procedure, continue to keep track of the changes happening.

Some of the symptoms you may be keeping track of could be:

• Unusually heavy period
• Long than normal periods
• Bleeding in between periods
• Pressure and pain in the pelvis
• Frequent urination
• Lower back pain
• Pain during intercourse

By keeping track of the severity of these symptoms before and after UFE you may be surprised by how quickly these changes are happening, as you watch your symptoms continue to improve over the next six to twelve weeks.

To learn more about Uterine Fibroid Embolization and to find out if this procedure could help you, please give us a call today at MidAtlantic Vascular and Interventional, and set up your initial consolation.

In our next article, we will take a look at what the research says regarding the effectiveness of Uterine Fibroids Embolization in shrinking fibroids and eliminating symptoms.

 

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Fibroids

UFE: An Alternative to Surgery

Uterine Fibroid Embolization is a very effective, minimally-invasive procedure to remove uterine fibroids. UFE also has a shorter recovery.

Uterine Fibroid Embolization is a very effective, minimally-invasive procedure to remove uterine fibroids. It can also be an alternative to a major surgery such as a hysterectomy or a myomectomy, and has a much shorter recovery time. 

Unlike major surgery to remove fibroids which can require a few nights in the hospital and several weeks or even months to fully recover- UFE is an outpatient procedure, with a much shorter recovery time.

During UFE, a tiny catheter is inserted through a blood vessel in the leg or wrist, which is then guided to the blood vessels that feed the fibroids. Once it reaches that point, small particles are injected into the vessel to block the artery and cut off the blood flow to the fibroids.  Then, following the procedure, the patient will return to their home, where over the next few weeks and months, the fibroids will gradually shrink.

One of the many benefits of Uterine Fibroid Embolization is that it targets all fibroids in the uterus. This makes it an excellent treatment option for individuals with only a few fibroids as well as those who have many fibroids, regardless of fibroid size.

In fact, uterine fibroid embolization is so effective that most individuals who undergo the procedure have a dramatic improvement in their symptoms that is experienced when they return to their normal activities a mere 8 to 10 days after the treatment.

So what does it feel like? Does it hurt?

Good question, and we’ll do our best to answer that.

The UFE procedure itself is not painful, however light sedation medications will be administered through an IV in order to prevent any discomfort.  Some women report experiencing a feeling in their pelvis similar to menstrual cramping or heaviness. This is completely normal and is due to the decreased blood supply to the uterus.

Following the procedure, it is also normal to experience low energy, intermittent nausea, and possibly fever- as a result of the dying fibroid tissue.

These symptoms typically last a few days at most, and gradually decrease in severity. Most women report that by the fourth or fifth day following the procedure, they feel back to normal, while some might have a few more days of cramping. Fortunately, most of this discomfort can be easily ameliorated with the help of over-the-counter pain medication.

Since UFE is an outpatient procedure, it’s important to have an area in your home where you can relax and heal after.

You may wish to set up your bed with extra pillows, and your favorite blanket, and if there’s a tv in your relaxation location, having the remote control nearby can be helpful as well.

While resting at home, some cramping can be expected in the lower abdominal region for about 24 hours but will subside quickly. However, most physicians do recommend that patients plan to stay home or at least limit their activities for at least one week following uterine fibroid embolization.

Other restrictions that your doctor may ask you to follow are:

– No bathing for 2 weeks. Shower as normal.

– No tampons for at least one full cycle.

– Abstain from sex for 2 weeks.

– No heavy lifting until your strength fully returns.

– Flights and travel are not recommended for at least 2 weeks.

– Refrain from taking aspirin for at least the first week.

Though recovery times may vary, most patients can return to all normal activities after 2 weeks. Even better, they can expect to experience significant improvements in their pre-op fibroid symptoms, over the course of one to three months. This means no more heavy periods, pelvic pain and pressure, urinary incontinence, or pain during sexual intercourse.

In our next article, we will take a look at the results of the embolization, and the experience and time it usually takes for the fibroids to shrink.

In the meantime, if you are considering Uterine Fibroid Embolization treatment for uterine fibroids, or have any questions about the UFE procedure, please call us at 301-622-5360 and request an appointment at MidAtlantic Vascular and Interventional today!

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Fibroids

Risks and Side Effects of a Myomectomy

There are several ways to remove fibroids. A myomectomy is a surgical procedure to remove uterine fibroids while keeping the uterus intact.

When fibroids are causing troublesome symptoms, and pain, and interfere with your normal activities, it is important to be aware that there are many treatment options available to relieve this burden. These treatment options can result in a decrease in symptoms, and in the case of a hysterectomy or a myomectomy, remove the fibroids completely.

Unlike a hysterectomy, which removes the fibroids by removing the entire uterus that contains them, a myomectomy is a surgical procedure to remove uterine fibroids, while keeping the uterus intact. Though it is actually more invasive than a hysterectomy, a myomectomy is an alternative to a hysterectomy for women that plan to bear children, or whose fibroids may be the cause of fertility issues.

As with all major surgeries, a myomectomy procedure does come with its own set of side effects and risks.

Some of which are:


Blood Loss:

Many women who undergo a myomectomy report an improvement in fibroid symptoms such as pelvis pressure and heavy bleeding. However, a myomectomy is still major surgery, and though it has a relatively low complication rate, the procedure still comes with its own unique set of challenges and risks.

One of the biggest risks involved in a myomectomy is the risk of excessive blood loss.

Many women with fibroids already have low blood counts and even anemia due to the fibroid symptoms of abnormally heavy menstrual bleeding. This, therefore, puts them at a much higher risk of problems due to blood loss.


Scar Tissue:

Due to the incisions that are done inside the uterus in order to remove fibroids, there is a risk of developing bands of scar tissue after surgery.


Pregnancy and Childbirth Complications:

Women of childbearing years may opt to have a myomectomy, especially over the option of a hysterectomy. However, a myomectomy can cause an increase in some risks during the delivery of a child. Though this is rare, it does happen and may result in a cesarean delivery to avoid rupturing the uterus during labor.


Increased Chance of a Hysterectomy:

Depending on the size, number, and location of fibroids, sometimes the surgeon may have to remove the uterus completely. Though this rarely happens, if the bleeding during a myomectomy becomes uncontrollable or there are additional abnormalities found in the uterus, sometimes the uterus needs to be removed as well.


Spread of Cancer:

During a myomectomy surgery, there is a very rare chance of a cancerous tumor being mistaken for a fibroid. As a result of trying to remove an unknown to be cancerous fibroid, there is the risk that it could lead to the spread of cancer.


Other potential risks and complications of a myomectomy are:

  • Hemorrhage
  • Injury to the uterus
  • Damage to the nearby organs of the urinary system
  • Infection
  • Blood clots
  • Eventual re-growth of fibroids

Though these risks and complications may be rare, they do happen. Therefore it’s important to be aware of them before deciding on any treatment plan.

In the end, you may find that both a hysterectomy and a myomectomy come with too many side effects and risks, and you may wish to learn more about a much less invasive procedure to remove fibroids, such as Uterine Fibroid Embolization, which we specialize in here at MidAtlantic Vascular and Interventional.

In our next article, we will look at some of the things that can be done to help prevent possible surgical complications before choosing to have a myomectomy to remove uterine fibroids.

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Fibroids

Hysterectomy: Is This Treatment Option Right For You?

Depending on the severity of the fibroids and fibroid-related symptoms, some women may still opt to have a hysterectomy.

Though hysterectomy surgery was once common practice for women with fibroids, today there are many different options. However, depending on the severity of the fibroids and fibroid-related symptoms, some women may still opt to have a hysterectomy.

Therefore, today let’s dive deeper into this surgical procedure, and cover the different types of hysterectomies, as well as reasons why some women might elect to have this operation.

There are three different types of hysterectomies, and they are:

  • Supracervical hysterectomy: During this procedure, surgeons remove the uterus but not the cervix. A doctor may also refer to this procedure as subtotal or partial hysterectomy, it is most often used to treat conditions such as endometriosis.
  • Radical hysterectomy: This surgery removes the uterus, cervix, and surrounding support tissue. Doctors often recommend this type of hysterectomy for people with cancer.
  • Total hysterectomy: This surgery involves the complete removal of the uterus and cervix. This can be used to treat many conditions, such as heavy menstrual bleeding, and uterine fibroids.

It’s also important to note that depending on the circumstances surrounding the need for a hysterectomy, the surgeon may also remove the ovaries (oophorectomy) and the fallopian tubes (salpingectomy).

Though there are some promising medications available, such as the Gonadotropin-releasing hormone (GnRH) agonists Lupron, Synarel, and Zoladex which can shrink fibroids and reduce fibroid-related heavy bleeding- some women would prefer a permanent surgical procedure such as a hysterectomy, so as to avoid having to take these medications due to their side effects and risks.

In fact, it is estimated that 40% of women taking GnRH agonists experience side effects such as:

  • hot flashes
  • mood changes
  • increased sweating
  • muscle stiffness
  • vaginal dryness

And the most concerning side effect of GnRH agonist therapy,  osteoporosis.

Other medications that are used to treat fibroids are:

  • Birth control: Birth control can also be used to help with symptoms of fibroids — specifically heavy bleeding during and between periods and menstrual cramps.
    – Given that some of the most commonly prescribed birth control pills can increase estrogen and therefore increase the size of fibroids, birth control is not always the best solution.
  • Progesterone-containing agents: Pills, implants, injections, or an intrauterine device (IUD) — may also control bleeding.
    – If the fibroids are small, and the symptoms are mild, a progesterone-containing birth control pill may be beneficial in reducing symptoms. However, they come with their own set of side effects, and they can sometimes mask the severity of fibroids and other underlying conditions.
  • Elagolix: A combination of a GnRH agonist, estradiol, and norethindrone that has proven to be effective at reducing fibroid symptoms with a lower risk of adverse problems that can come from GnRH agonists alone.
    – Elagolix interacts with several other medications, and if taken long-term can cause permanent bone loss.
  • Tranexamic acid: An antifibrinolytic oral drug that’s indicated for the treatment of cyclic heavy menstrual bleeding in women with uterine fibroids.
    – Though it is a nonhormonal option to reduce menstrual blood loss, it does not affect or address the underlying cause of the bleeding- which is the fibroids themselves. It is also expensive.

Medications can be effective at managing fibroid symptoms, however, they do so, as a temporary solution. Medications do not fix the problem and sometimes they can even make things worse.

Therefore the main benefit of having a hysterectomy is that it doesn’t just manage fibroid symptoms, but by surgically removing the uterus, it removes the fibroids completely.

Not only does a hysterectomy remove fibroids and eliminate any possibility of them returning, but it also eliminates any possibility of having children.

For women that would like to have children, medication may be a good option to help manage fibroid symptoms allowing them to postpone a hysterectomy.  Or they may opt to have a uterine-sparing procedure done such as a myomectomy or Uterine Fibroid Embolization, which we specialize in here at MidAtlantic Vascular and Interventional.

The Bottom Line: For women with severe fibroids, fibroids that keep coming back, and fibroids that haven’t responded well to medication or other procedures, a hysterectomy may be an option worth considering. That being said, just like with medications, having a hysterectomy isn’t without its own set of side effects and risks. In our next article, we will take a look at what those are.

 

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Fibroids

Oriahnn: A New Combination Oral Therapy

A combination therapy that was recently approved by the FDA for the treatment of heavy bleeding caused by uterine fibroids called Oriahnn.

In the previous weeks, we’ve dug deeper into the use of Gonadotropin-releasing hormone (GnRH) agonists, and birth control in treating fibroid symptoms. This week, we’re going to look at a combination therapy that was recently approved by the FDA for the treatment of heavy bleeding caused by uterine fibroids called Oriahnn.

Oriahnn is a prescription drug, that has been created by combining three different oral therapies. These include a gonadotropin-releasing hormone (GnRH) agonist and two hormones: estradiol (a form of estrogen), and norethindrone acetate (a form of progestin).

The GnRH agonist in Oriahnn is elagolix, which causes a decrease in estrogen and progesterone levels in the body. The decrease in these hormones causes a temporary menopause-like state which reduces the size of the fibroids and the size of the uterus. It also inhibits menstruation, thus enabling women with bleeding-induced anemia, to increase their stores of iron. GnRH agonists can also improve fibroid-related symptoms such as frequent urination and constipation.

One of the problems with GnRH agonists is that the decrease in estrogen caused by them can lead to an increased risk of osteoporosis.  Osteoporosis is a disease that weakens the bones, thus putting them at a greater risk for sudden and unexpected bone fractures. Since estrogens play a central role in the homeostasis of the skeleton, estrogen deficiency seems to be primarily responsible for the adverse skeletal effects of GnRH agonists. As a result of the estrogen decrease caused by GnRH therapy, bone turnover can increase while bone mineral density can decrease, thereby increasing the risk of fractures.

This is where the addition of estradiol and norethindrone comes in.

Estradiol is a type of estrogen hormone used by women to help reduce the symptoms of menopause. And, in the case of treating fibroids, it helps to prevent the bone loss that can be caused by using a GnRH agonist alone.

Norethindrone is a progestin hormone. The addition of this hormone helps to inhibit estrogen-related fibroid growth and therefore helps to keep the fibroids from growing.

Studies have found that Oriahnn is effective in reducing fibroid-related heavy menstrual periods. The combination of GnRH agonist, estradiol, and norethindrone has proven to be effective with a lower risk of adverse problems than can come from GnRH agonists alone. However, when it comes to eliminating fibroids completely- this medication can not achieve that outcome.

Here are some of the pros and cons associated with this new medication:

Pros:

Works to lighten heavy periods for a majority (7 out of 10) of women

Can reduce period bleeding by 50% after 1 month

Non-surgical treatment option for uterine fibroids

Can take with or without food

Cons:

Treatment is limited to 24 months because of the risk of permanent bone loss

Unknown if it’s safe or works for children under 18 years of age

Interacts with many medications

No generic available,  so it might be expensive

Needs to be taken twice a day

The bottom line:  The FDA’s most recent approval of the medication Oriahnn to control heavy bleeding in women with uterine fibroids, is potentially a better medicine than a GnRH agonist alone- but it is not without its problems. Oriahnn is not recommended for long-term use and it doesn’t eliminate fibroids. In order to shrink or eliminate fibroids, a non-invasive procedure such as Uterine Fibroid Embolization, or sometimes surgery is usually the best choice.

Next week we will wrap up our look at oral therapies used to treat uterine fibroid symptoms, by looking at the use of Tranexamic Acid to reduce fibroid-related bleeding.

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Fibroids

Treatment Options for Uterine Fibroids

It's important to discuss the various treatment options for your fibroids.

Over the next few weeks, we’re going to take a deeper look at all of the treatment options available for women with uterine fibroids.

We will look at what those options are and how they work. As well as discuss the advantages and disadvantages of each treatment.
Some of the treatment methods we will cover are:

Medications:

  • Gonadotropin-releasing hormone (GnRH) agonists. These medications can be taken via a nasal spray or injection and they work by shrinking your fibroids.
  • Birth control: Birth control can also be used to help with symptoms of fibroids — specifically heavy bleeding during and between periods and menstrual cramps.
  • Progesterone-containing agents — pills, implants, injections, or an intrauterine device (IUD) — may also control bleeding.

Oral therapies:

  • Elagolix is a new oral therapy indicated for the management of heavy uterine bleeding in premenopausal women with symptomatic uterine fibroids.
  • Tranexamic acid is an antifibrinolytic oral drug that’s indicated for the treatment of cyclic heavy menstrual bleeding in women with uterine fibroids.

Non-Uterine Sparing Surgical Treatment:

  • Hysterectomy- During this surgery, your uterus is removed. By removing your uterus completely, the fibroids can’t come back and your symptoms should go away.

Uterine-Sparing Surgery and Non-invasive outpatient procedures:

  • Abdominal Myomectomy: Open abdominal surgery to resect symptomatic uterine fibroids
  • Laparoscopic myomectomy: Laparoscopic removal of uterine fibroids
  • Laparoscopic myolysis: Uses a laser probe to heat coagulate uterine fibroid
  • Uterine Fibroid Embolization: Small particles are injected into the arteries supplying the uterus, cutting off blood flow to fibroids, causing them to shrink and die.

Ultimately your treatment plan will depend on a few factors, including:

  • The number of fibroids you have.
  • The size of your fibroids.
  • Where your fibroids are located.
  • What symptoms you are experiencing related to fibroids.
  • Your desire for pregnancy.
  • Your desire for uterine preservation.

Another deciding factor regarding the best treatment option for you will also depend on your future fertility goals. If you want to have children in the future, some treatment options are better than others. We will cover this in future articles as well.

In the meantime, talk to your healthcare provider about your thoughts, feelings, and concerns when discussing treatment options. And check back next week, as we dive deeper into the first of many treatment options, medication.