Vertigo Causes

Vertigo Causes

Vertigo Basics

Let’s first begin with the question: what is vertigo? Alfred Hitchcock’s 1958 movie “Vertigo” is the first thing that comes to mind for many of us. It’s a film about a private investigator with acrophobia, a pathological fear of heights.

Patients will feel a “dizzying sensation” when the condition effects them. It can also feel like “tilting within stable surroundings” according to Dictionary.com. Vertigo causes vary greatly from person to person. They range from problems with the inner ear to food allergies.

Different Types and Vertigo Causes

We will start with benign paroxysmal positional vertigo. This condition happens because of an abrupt shift in head position. Tiny crystalline structures break off in the inner ear touching reactive nerve endings.

The next possible cause of is acute labyrinthitis, also called vestibular neuritis. It’s an inflammation of the balance apparatus of the inner ear, caused by a viral infection.

Ménière’s disease, is another possible cause of vertigo. This condition may cause “repeated episodes of dizziness”. It will also cause with ringing in the ear and progressive low-frequency hearing loss.

Ménière’s disease happens when a change in the volume of fluid inside the inner ear occurs. The reason for this change is unknown but scientists suspect a few causes. The cause could be loud noise or viral infections. According to Drugs.com “biologic factors inside the ear itself” may cause it as well.

Allergies and Vertigo

Allergy induced vertigo is another category of physical disturbance that causes vertigo or dizziness. Allergens are particles present in the air we breathe and in our food can effect vertigo symptoms.

Dust, pet dander and pollen tends to trigger the body’s immune response. Histamine release can occur producing symptoms we associate with allergies. Most common are watery eyes, sneezing, wheezing but also vertigo symptoms.

The disturbed functioning of the Eustachian tube produces a sense of vertigo. It’s primary function of equalizing pressure between the inner ear and outside air. It’s what helps us feel balanced.

A change in air pressure can our sense of equilibrium and produce vertigo symptoms.

Often we can attribute our vertigo to Mucus can clog this tube in the middle ear, causing dizziness. The terms vertigo and light headed do not mean the same thing. If you are light headed you may feel that you are losing consciousness or feeling faint.

Treatments

After diagnosis, how is vertigo treated? There many treatments for vertigo that can help. Traditional medicine or natural treatments are popular and effective.

Vestibular rehabilitation exercises are a great form of treatment. The patient must lie down on a table on one side. They must wait for the vertigo to fade, then flip onto the other side. This process repeats until the vertigo disappears completely.

Doctors prescribe medications like Valium for IV, skin patch or in pill form. Sometimes, middle ear bacterial infection is the cause of vertigo. In that case, doctors will prescribe antibiotics. Surgery is also an option but only in the worst cases.

Over the Counter treatments may help as well. They promise relief from a range of symptoms, including dizziness.

Many OTC remedies carry the risk of liver damage and unknowing abuse by users. Herbal remedies are much more safe and gentle on the body.

Often home remedies have as a good a chance as OTC options at providing some measure of relief. Massage therapy focused on the head and neck area seems to ease the symptoms of vertigo as well.

Symptom relief can come from gentler sources like diet and exercise adjustments. These methods are better for the body.

They are also better than relying on products made by pharmaceutical companies. For example, here are some nutritional guidelines that may some value in reducing vertigo.

Lifestyle and Natural Options

Lowering your sodium intake, avoiding caffeinated beverages and eating more protein will help. Eat more protein, more fruits and vegetables.

Strawberry yogurt with almonds and milk is a yummy treat that some claim can help. According to some, it’s shown a more than anecdotal effectiveness in relieving vertigo symptoms.

Remember to eat fruit first thing in the morning on an empty stomach. Stop consuming alcoholic beverages.

These are great guidelines for any healthy lifestyle. Most noteworthy, they should also prove helpful in reducing vertigo.

There are some other considerations by way of supplements. Ginger root can reduce nausea, a symptom of vertigo. What makes ginger unique is that it works fast. A few slices ingested and the vertigo fades away. So, be sure to consider ginger as a fast, reliable remedy for vertigo.

Another great option is ginkgo biloba. This Chinese herb has a long history of ameliorating the symptoms of vertigo. Its action on the body is to stimulate blood flow within the arteries and brain.

It is effective in countering the effects of narrowing or hardening arteries. Most noteworthy for vertigo sufferers, it has been shown to dissipate vertigo symptoms.

 

Vertigo is a spinning feeling that doesn’t stop even if you lie down. Vertigo can be disturbing but there are natural ways that you can help fight symptoms.

 

 

Hernias: A Cause for Concern?

Hernias: A Cause for Concern?

Should Hernias be a Cause for Concern?

Hernias are a medical ailment that many people suffer from. They come in many different forms and sizes. A common type of hernia people suffer from is fascial hernias. This type of hernia allows a flexed muscle to protrude out of the fascia.

Some are painful; while others are going to be painless not visible. If you are suffering from a painful hernia, you will want to find relief soon. There are no surgeries to put the muscle back in the correct spot. Even so, there are procedures that can help to ease the pain.

There are many different kinds of hernias. It’s not easy to figure out which one you’re suffering from on your own. After consulting with your doctor, you can work on a plan to get your life back to normal.

You don’t need to give up your normal physical activities forever. Hernias happen, but you should always be able to bounce back.

 

Sports Hernia

A sports hernia is a specific injury that occurs in athletes. These hernias usually occur within the lower abdomen, or even the groin.

Without proper treatment, this type of hernia could turn into an inguinal hernia. These hernias create a visible bulge in your muscle. In abdominal hernias, the organs in your body push on the bulging muscle -weakening it in the process.

 

Watch out for your obliques and pubis area, as these are prime locations for a sports hernia to pop up. If you’re going to compete and be active, it’s always a good idea to stretch beforehand.

Many athletes ignore the importance of stretching. It’s an important part protecting your body while playing sports.

How Can I Fix Them?

For people who love physical activity, hernias are hard to take in stride. Many athletes have to deal with hernias but they happen to ordinary people too.

The older you get, the more prone to hernias you’re going to be – that’s just typical wear and tear. The human body isn’t actually designed to be accomplishing the amazing feats that we do, day in and day out.

Things that can help:

  • RICE (Rest, Ice, Compression, Elevation)
  • Compression gear when you’re being active
  • Massages
  • And plenty of other things – like better diet and supplements

You can’t lose hope, especially when it comes to those painful hernias. Most of us have been there, and when the going gets tough, the tough get going!

Making a Diagnosis

There are many different kinds of hernias to suffer from. You are going to need a doctor when it comes to making a diagnosis. This is crucial or ensuring that you can get better soon. If you feel something is wrong, you should call your doctor.

Other Types of Hernia:

 

  • Femoral (the outer groin)
  • Hiatal (the upper stomach)
  • Umbilical (the belly button)
  • Incisional (as a result of surgical incision)
  • Inguinal (the inner groin)

 

What Causes Them?

The most likely cause for this ailment is from exerting yourself. If you push your body too far when you engage in serious physical activity, the muscle walls can give out.

Even things like coughing or sneezing could have you develop a rather serious hernia! As a result, you might think it’s no big deal. The pain may be easy to ignore at first, but seeking care is key.

Hernias you leave to linger have a higher risk of becoming painful. You could exert yourself a little too much again, and apply too much pressure to the exact same area.

Stretching on a consistent basis could help you out in the end. Practicing a healthier lifestyle all around will help prevent future hernias as well.

Hernia – definition, cause and health effects

Hernia – definition, cause and health effects

How Is a Hernia Condition Defined?

‘Hernia” is the term used by health care professionals to identify “a medical condition characterized by a bulge caused by an organ or tissue pushing through an area of weakness in the partition or the wall of muscle that is intended to confine it.”  A hernia occurs when some contents of a body cavity bulge out of the area where they are normally held.  These contents, usually portions of intestine or abdominal fatty tissue, are enclosed within the thin membrane that naturally lines the inside of the cavity.   Hernias can develop at any number of locations in the human body but most often involve a portion of the gastrointestinal tract bulging through the abdominal/pelvic wall.

Hernias by themselves may be asymptomatic (produce no symptoms at all) or may cause slight to severe pain. Nearly all, though, carry the potential risk of eventually having their blood supply cut off (becoming strangulated).  When the content of the hernia bulges out, it can apply enough pressure that blood vessels in the hernia may eventually be constricted to the point where circulation is completely cut off resulting in a medical/surgical emergency.  Depending on the nature and severity of the hernia involved, surgical repair of the opening may be required, but it is always advisable to see a qualified medical caregiver for diagnosis and treatment advice when symptoms of a hernia develop.

What Causes a Hernia?

A hernia occurs when some part of an organ or fatty tissue squeezes through a hole or a weakened spot in the surrounding muscle or the fascia (connective tissue).  Hernias that develop over time are often caused by a combination of muscle weakness within the abdominal wall and increased stress from pressure within the abdominal cavity (e.g., straining from heavy lifting), which allow parts of the abdominal cavity to protrude or herniate.  Alternatively some hernias are congenital with defects in the muscular diaphragm or abdominal wall discovered at birth or early in life.  In some cases it is possible for the bulge associated with a hernia to come and go, but the defect in the tissue will persist.

The actual cause of the hernia can vary depending on each individual situation.  Often there is no one, clear cause even though some hernias are documented to have occurred as the consequence of a single instance of heavy lifting, straining while using the toilet or some other activity that acutely increases pressure inside the belly.  At the most basic level, though, all hernias are caused by a combination of pressure and a pre-existing opening or weakness of muscle or fascia with the pressure pushing an organ or tissue through the opening or weak spot.  Sometimes the muscle weakness can be present at birth involving pathways formed during fetal development, existing openings in the abdominal cavity or areas of abdominal wall weakness; more often, though, it occurs later in life.  A hernia can develop quickly or over a long period of time, depending on its cause.

In fact any activity or medical problem that increases pressure on tissue in the belly wall and muscles or within the abdominal cavity also has the potential to cause stress at weak points, which then might subsequently contribute to the formation or worsening of a hernia.  Increased pressure within the abdomen may occur with a variety of chronic situations including persistent, hard coughing or sneezing bouts (chronic lung disease), incorrect posture, increased fluid within the abdominal cavity (ascites), peritoneal dialysis (used to treat kidney failure) and growth of tumors or masses in the abdomen. The pressure also may increase in acute situations caused by improper lifting of excess weight without stabilizing the abdominal muscles, by straining to have a bowel movement or to urinate (e.g., diarrhea, constipation, enlarged prostate) or from physical trauma such as sharp blows to the abdomen.

Pregnancy, undescended testicles or excess abdominal weight and girth are other factors that can lead to a hernia.  Also, if muscles are weakened because of prior injury or surgery, congenital defect (failure of the abdominal wall to close properly in the womb), poor nutrition, aging, smoking or overexertion, then hernias are more likely to occur.  In addition a family history of hernias may predispose to development of some hernias.

Babies and children can develop hernias when there is pre-existing weakness in the belly wall.  In the U. S. typically about five out of 100 children are diagnosed with an inguinal hernia. The condition is more common in boys.  Occasionally children do not exhibit symptoms until they are on their way to adulthood because, although some hernias can be present at birth, others develop later, or the bulge itself simply may not be noticeable until later in life.

There is also a physiological school of thought which contends that the risk of hernia is the result of a physiological difference between patients who suffer hernia and those who do not, namely the presence of aponeurotic extensions from the transversus abdominis aponeurotic arch.

What Health Effects, Signs and Symptoms?

 If you think you might have a hernia, you certainly would not be alone, nor would you be the first such case.  The earliest known description of a hernia dates all the way back to at least 1550 BC in the Ebers Papyrus from Egypt, and currently at least five million people in the U.S. develop hernias every year.  In your case you very well may have a hernia if you can feel a soft lump in your belly or groin or even within an old scar where you may have had surgery in the past.  You might find that such a lump will go away when you press on it or lie down.  In many hernia cases, though, there are no apparent symptoms at all; consequently the condition may not even be detected and diagnosed until a routine physical exam is conducted by a health care professional for some unrelated situation.  Other cases, however, may present with discomfort or pain which can become worse when standing, bending over, coughing, straining or lifting heavy objects.

Over time the most common hernia complaint involves a bump or bulging protrusion that feels sore and may be growing.  Initially, however, the signs and symptoms of a hernia can range anywhere from simply noticing a painless lump all the way up to confronting a potentially life-threatening, severely painful, tender, swollen protrusion of tissue that is impossible to push back into the abdomen.  When a hernia gets bigger, in some instances it may even get stuck inside the hole and lose its blood supply (an incarcerated strangulated hernia).

Symptoms and signs may vary depending on the type of hernia.  With groin hernias, for example, symptoms typically are present in about 66% of people and may include a bulging area that produces pain or discomfort especially with coughing, exercise or going to the toilet (sometimes accompanied by constipationor blood in the stool).  Often such pain gets worse throughout the day but improves when lying down.  Groin hernias occur more often on the right side than on the left side.  A femoral hernia, in contrast, usually results in a bulge just below the groin (found more commonly in women) while an inguinal hernia (more common in men) typically produces a bulge in the groin that may reach all the way to the scrotum.  For inguinal hernias, most patients notice a feeling of fullness or a lump in the groin area with pain and burning.  Femoral or obturator hernias may present with symptoms of recurrent inguinal or pelvic pain without obvious physical findings and may, therefore, eventually require a CT scan in order to establish a definitive diagnosis.  Umbilical hernias are generally easier to diagnose and locate with the typical bulging of the belly button itself.  Hiatal hernias often result in heartburn and belching but may also cause upper abdominal or chest pain along with difficulty in swallowing or a feeling of fullness or discomfort with eating.

Alternate Therapies to Manage Fibroids

Alternate Therapies to Manage Fibroids

Alternate Therapies — Options To Consider for Treatment of Uterine Fibroids

Advances in medicines and technologies for fibroid treatment have been astounding. In contrast, though, a number of  alternate therapies, included among critical elements of overall wellbeing, can be quite basic and holistic.  Healthcare professionals recognize that important aspects of a woman’s life can interrelate closely with other factors, including, but not limited to stress, diet/nutrition, exercise and sleep.

Unraveling these relationships may change how discomfort from fibroids is perceived and accommodated by various women. Some individuals, especially those with mild symptoms who are on watchful waiting or those who prefer holistic approaches, may well opt to evaluate alternative therapies alongside conventional medical and/or surgical treatment options.  By modifying lifestyle factors in combination with nutrition and lifestyle counseling, vitamin and herbal supplements, homeopathy and bodywork therapies, some fibroid sufferers may be able to diminish or even eliminate some of their troublesome symptoms.

An Example of Coordinating Alternate Therapies

Some women may be able to improve their fibroid situation without medical intervention when they undertake nutritional modifications such as a decrease in their intake of inflammatory foods (e.g., caffeine, alcohol, processed/junk foods) and environmental hormones (e.g., red meats and dairy products with estrogens) along with an increase in their consumption of anti-inflammatory foods, high-fiber/whole grain products and organic fruits and vegetables. This approach, along with the use of herbal supplements and/or procedures like acupuncture, can sometimes eliminate or diminish fibroid-related symptoms enough to offset the need for medical, surgical or radiological therapies. In other scenarios these alternative approaches might be used in a complementary fashion alongside traditional allopathic medical and surgical approaches including watchful waiting, MRgFUS, UFE and robotic surgery.

With the choice of any alternative therapy, it is very important to find a suitable and competent practitioner to help you address these needs. Of course the decision to accept or decline any form of treatment is an individual one. It is important, however, for you to know there are alternative treatment methods and physicians who may be able to help you find a gentler, more natural approach to manage uterine fibroid tumors.

Among the many online sources of more in-depth information about alternate therapies for uterine fibroid tumors, the following websites provide a variety of viewpoints:

http://drtorihudson.com/articles/uterine-fibroids-womens-health-update/
http://www.top10homeremedies.com/home-remedies/home-remedies-fibroids.html
http://www.healthy.net/Health/Article/Healing_Fibroids_Naturally/8110
http://www.itmonline.org/arts/fibroids.htm 

For more comprehensive information about advantages and limitations for other approaches to treatment for uterine fibroid tumors, please visit the Vitamin Insider website and select the topic:  “Pros and Cons of Fibroid Treatment Options.”  

Note also in Vitamin Insider that a wider variety of subjects about fibroid tumors — everything from causes and risk factors to  diagnosis and prognosis – can be found among the topics there.

Surgical Treatment for Fibroid Tumors

Surgical Treatment for Fibroid Tumors

Surgical Procedures: The Final Treatment for Uterine Fibroid Tumors

Surgery to treat uterine fibroid tumors is necessary under certain conditions. Symptoms include heavy bleeding that is persistent and causes severe anemia.

If the severe bleeding does not respond to less drastic treatment. Surgery is usually the next step.

Surgical Treatment: Abdominal Myomectomy

This treatment consists of the surgical removal of only the fibroid. Afterward, there is reconstruction and repair of the intact uterus.

The “bikini” is the most common type of incision used. It is a four to six-inch  incision on the abdomen, just below the pubic hairline.

The procedure starts with an inspection to find number and position of all fibroids. Next, doctors administer Pitressin to the uterus, which limits bleeding during the surgery.

An incision opens the covering of the uterus that overlays the fibroid. The fibroids are then separated and removed from the the normal uterine muscle.

The procedure can take one to two hours to complete, depending on the severity of fibroids. Following surgery, patients may need to recover in the hospital for two to three days.

Is Abdominal Myomectomy Right for You?

Pros:

The surgeon can see pelvic organs and to remove all fibroid tumors with this method. Removal of fibroids that might otherwise be hard to find is possible with this procedure.

Consequently, this method is best for large or many fibroid tumors.

As a result, this procedure results in high patient satisfaction with significant symptomatic improvement. More than 75% of women who undergo this procedure feel relief from symptoms .

During myomectomy there may be a lower risk of complications. Also there would be less blood loss than during hysterectomy.

Myomectomy can be performed in some women during Cesarean section delivery. After myomectomy, chances of pregnancy are better, but conception Surgical Treatment for Fibroid Tumorsisn’t guaranteed.

Cons:

Abdominal myomectomy requires a larger incision, general anesthesia, and more time to perform. Blood loss, pain and infection are some of the risk factors associated abdominal surgery.

Longer recovery time is a factor as well with hospital stays ranging from one to three days.

Postoperative recovery time is generally two to six weeks. As a result of surgery, there may be significant discomfort in the following days.

Also, there is the risk of bleeding from the uterus during surgery. So, some doctors and organizations won’t perform abdominal myomectomy under certain circumstances.

Other Factors to Consider

For example, if the uterus is bigger than a three-month pregnancy that is a red flag. Replacement blood transfusion might be necessary in some cases. Infection of the uterus, fallopian tubes or ovaries (pelvic infection) may occur.

Surgery can cause scarring that might result in infertility. Fibroids can return after surgery in 10 to 50 out of 100 women. These odds change depending on specifics of the original fibroid problem.

Fibroids that were larger and more abundant are more likely to reoccur.

If surgery reveals the uterus is too overgrown with fibroids, doctors may recommend hysterectomy. After myomectomy, patients will often need Cesarean delivery with all pregnancy.

Surgical Treatment: Hysterectomy

Hysterectomy is the surgical removal of all or part of the uterus. It can include the removal of other pelvic organs through an incision in the abdomen.

The doctor may also remove the Fallopian tubes, ovaries, or the cervix. Most women undergoing hysterectomy do not need to have their ovaries removed. Most won’t experience early menopausal symptoms because of surgery.

Hysterectomies are the last option for uterine fibroids. This procedure only occurs after all other methods have failed.

Weighing the Benefits vs Risks

Pros:

It has high patient satisfaction rate with symptomatic improvement. Surgical removal of the uterus is one treatment that guarantees a cure from fibroids. The hospital stay can last from one to three days, and full recovery is two to six weeks.

Cons:

There is no chance for pregnancy after this procedure. Because of invasiveness of the procedure, this treatment requires general anesthesia. There are major abdominal surgery risk factors associated with the procedure.

These include blood loss, pain, infection and longer recovery. As a result, a post-operative stay in the hospital of a few days is typical. and can need as much as four to six weeks of further recovery at home.  There are significant risks of various complications, but the surgery .

The mortality rate from the procedure is low at  0.4%. The rate of severe complications is approximately 3%. The rate of complications during the course of all treaments is 20% or higher.

Other Factors to Consider

The most common complications during the course of treatment infections or hematomas. This includes wound infection, vaginal cuff infection or bleeding and urinary tract infection.

Even as much as ten years after hysterectomy, there is risk of urinary incontinence. Other long-term adverse outcomes vary.

Pelvic organ prolapse/fistula, anal incontinence, bowel dysfunction, and renal cell carcinoma may occur. The patient should know all treatments and get advise from their doctor beforehand.

 

Click here for more comprehensive information about different treatment options.  

Minimally Invasive Techniques for Fibroids

Minimally Invasive Techniques for Fibroids

Minimally Invasive Techniques To Treat Fibroid Tumors

Women who undergo minimally invasive fibroid treatment procedures generally experience shorter hospital stays, less pain, faster recovery times and less scarring with a quicker return to normal activities than women who have traditional surgery. Such treatment is performed with the intention of enabling a woman to preserve her uterus and possibly, in some cases, to give her the opportunity to bear children in the future. Sometimes, however, fibroid removal may leave a woman’s ability to conceive and bear children impaired.

With minimally invasive surgery fibroid sufferers have reported the following advantages:

• Significantly less pain
• Less blood loss and need for transfusion
• Lower  risk of infection
• Shorter hospital stay
• Quicker recovery and return to normal activities
• Small incisions for minimal scarring
• Better outcomes and greater patient satisfaction in many cases

Minimally Invasive: uterine artery embolization/uterine fibroid embolization 

This procedure, known as UAE or UFE, is a non-surgical technique that shrinks fibroids without removing them. It is generally performed in the radiology department of a hospital. With this procedure you will not require general anesthesia, but sedating medications (conscious sedation) will be given by vein to help you relax during the procedure, which is generally one to two hours in duration. A local anesthetic will be applied to the skin around your groin to numb the area so that you do not feel discomfort. A small (one-inch or less) incision is made in the groin directly over the artery carrying blood to the leg. In most cases UAE will be done in both the left and the right uterine arteries. While monitoring the process by X-ray, the doctor, an interventional radiologist by training, guides a long thin catheter tube into the blood vessels that supply the uterus. Small plastic or gelatin particles are pushed through the catheter until they form a block to blood flowing to the uterus. After the procedure you will be asked to lie flat for four to six hours to recover.

Fibroids have only a limited supply of blood vessels; therefore, with the blood flow blocked, the fibroid cells soon start to die off. The surrounding normal uterine muscle, which has a better blood supply, is able to survive the procedure. Deprived of blood, nutrition and oxygen, fibroids then shrink for the next three to six months following minimally invasive embolization, during which time symptoms caused by the fibroids often lessen as well.

pros:

does not require general anesthetic and is associated with a shorter hospital stay and a more rapid recovery time compared to conventional surgical procedures. After UAE most women are able to go home the next day and, once released from the hospital, need to take only oral pain and anti-inflammatory medications for the next few days. As with all medical procedures, the recovery varies from woman to woman. Most women, though, feel back to normal within a few days and return to regular activity within a week or so. Fibroid size reduction of 40 to 60% commonly occurs within four months; menorrhagia improvement is reported in up to 85% of all cases. Uterine artery embolization provides excellent relief for abnormal bleeding, pelvic pain and bulk-related symptoms. Early reports show that uterine artery embolization subsequently can result in normal reproductive and obstetric functions. Studies suggest that for many women fibroids are not likely to grow back after embolization. In fact over 85% of patients report significant improvement in symptoms, even up to five years after treatment. More extended research is needed though to establish definitive, long-term results.

cons:

some interventional radiologists do not recommend uterine artery embolization for very large fibroids because of concern that the procedure is not likely to be completely successful.  Women with submucosal fibroids are not good candidates for this minimally invasive procedure since treatment failure is high and there is some risk of developing a serious infection.   Also patients who have a large subserosal fibroid on a narrow stalk (pedunculated fibroid) are not good candidates. After embolization blocks the blood supply to the fibroids, the cells of the fibroid start to die off immediately. The dying cells release toxins that irritate the surrounding tissue and cause pain and inflammation. Almost all women experience moderate to severe pain along with nausea or vomiting for the first day or so after uterine artery embolization and are, therefore, usually kept in the hospital for a day or even longer if necessary. Hospitalization assures that the woman can be given narcotic pain medication when needed. Pelvic cramps, especially common for the first 24 hours after the procedure, can be severe and may last more than six hours at a time for as long as two weeks. After the procedure anti-inflammatory medications (NSAIDs) are administered to minimize inflammation in the uterus. Tylenol, too, may be given for the fever that commonly follows this procedure.  Some women experience pain or discomfort that persists for more than a week; consequently such individuals might not get back to normal activity for a few weeks or, rarely, even months. The treated fibroid tissue may pass out of the body through the vagina. Research has shown that up to 30% of women who undergo the UAE procedure subsequently need to have it repeated within one or two years and/or have a hysterectomy performed within five years after the procedure. With this technique, too, there may be some risk for early onset of menopause, but more study is needed for a final conclusion about such jeopardy. Women who may want to become pregnant in the future probably should not undergo this procedure because obstetric complications, including abnormalities of the placenta attaching to the uterus, may be increased. The full effects on subsequent fertility are not yet clear.

***

Minimally Invasive: myolysis 

A needle is inserted into the fibroids, usually guided by laparoscopy, and electric current or freezing is used to destroy the fibroids. In myolysis, which is minimally invasive, surgical instruments are inserted through a tiny, laparoscopic incision in the abdomen; then a high frequency electrical current is administered directly to the fibroid. The electrical current causes blood vessels to constrict or close down, cutting off blood flow to the fibroids. The fibroids remain in place and are not surgically removed. Without a blood supply, the fibroids eventually die and shrink just as they would with uterine artery embolization.

Cryomyolysis is a similar minimally invasive procedure, except that it “freezes to death” the fibroids. Instead of an electric current, liquid nitrogen (at -180 degrees C) is applied through a cryoprobe while a doctor monitors the freezing process using ultrasound.

In order to maximize the potential shrinkage that results from this procedure, the patient is generally requested to undergo GnRH therapy for three to six months as a precursor to treatment. Hopefully the medication will cause fibroids shrink somewhere in the 50% range, thus making the procedure easier to perform and maximizing subsequent shrinkage of fibroids with the myolysis/cryomyolysis procedure.

pros: 

advantage over myomectomy is that here no suturing is required. It is generally easier to do than a myomectomy, and recovery from this minimally invasive procedure is usually rapid with fibroid shrinkage up to 70% by 12 months. The procedure itself takes only about one hour. Afterwards the patient is observed in a recovery room for approximately another three hours and then discharged directly to home. Total recovery from this procedure usually takes about one week.

cons:

general anesthetic is required. Fibroids that are too large, too small or too numerous could complicate the procedure. Neither myolysis nor cryomyolysis can be performed on very large fibroids (anything over 10 cm pre-administration of GnRH agonists is considered “very large”), nor can either one be performed if there are more than four fibroids, each with a volume of up to 5 cm. Also, any fibroid less than 3 cm in size is too small to qualify for this procedure. Only those doctors who are thoroughly experienced laparoscopical operators should attempt this procedure because both extensive skill and special equipment are required for success. Pre-treatment with Lupron GnRH agonist is also somewhat controversial because of its possible side effects. Fibrous pelvic adhesions may occur after treatment. Destruction of the fibroid can result in formation of significant scar tissue and a possibly weakened uterine wall. There is conflicting opinion on the issue of fertility after myolysis with some experts cautioning against subsequent conception because of the unknown strength of the uterine wall after myolysis and the possible presence of scar tissue formed around the uterus. Both of these situations could pose serious risk of the uterus tearing during labor.

***

Minimally Invasive: laparoscopic or robotic myomectomy 

Both laparoscopic myomectomy and robotic myomectomy are considered minimally invasive surgery. They both are performed through small (approximately 1/2 inch) incisions as an outpatient procedure with a short recovery time (typically about 14 days). During laparoscopic myomectomy the surgeon uses special instruments to remove the fibroids and then sutures the uterus. The robotic procedure uses similar instruments, but in this case the instruments are remotely controlled by the surgeon who sits at a console a few feet away from the operating table.

pros:

usually performed as minimally invasive out-patient surgery under general anesthesia with only a short hospital stay and quick recovery. The procedure is considered safe and effective when performed by a properly trained physician. The technique continues to evolve as new instruments are developed to allow a more precise removal of the fibroids.  It may cause fewer adhesions than abdominal surgery. Following laparoscopic myomectomy, most women are able to leave the hospital the same day as surgery. Because the incisions are small, recuperation is usually associated with minimal discomfort. Since the abdominal cavity is not opened to air, bacteria are less likely to reach the area of surgery; therefore, the risk of infection is very low. The intestines are not exposed to the drying effect of air or to irritation from the sterile gauze sponges used to hold the bowel out of the way during abdominal surgery. As a result the intestines usually begin to work normally again immediately after laparoscopic surgery allowing you to avoid the one- or two-day delay before you are able to eat that would otherwise result from conventional abdominal surgery. Laparoscopic myomectomy is associated with faster postoperative recovery and also could potentially reduce the risk of postoperative adhesions when compared with laparotomy. After laparoscopic myomectomy most women can walk the day of surgery, drive in about one week and return to normal activity, work and exercise within two weeks.  Procedure generally results in high patient satisfaction with the symptomatic improvement.

cons:

laparoscopic or robotic myomectomy may not be possible if the fibroid is so large that there is insufficient room to fit the necessary instruments into the abdomen. The size, number and position of the fibroid(s) must be carefully considered; the skill and experience of the surgeon may also limit the use of this technique.  Spontaneous uterine rupture, although uncommon after laparoscopic myomectomy, is still a concern. The risk of recurrence seems to be higher after laparoscopic myomectomy than after myomectomy performed by laparotomy. Without the proper experience, a physician might find this procedure harder to perform than abdominal surgery because it takes more skill and training.  Laparoscopic suturing with small instruments, in particular, requires special training and expertise. If future fertility is desired, the procedure is controversial. Since a myomectomy may result in a buildup of scar tissue, fertility may be impaired even though infertility is sometimes helped with the procedure. Further study is needed to clarify this issue. Future pregnancy, if it does occur, often requires Cesarean delivery.

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Minimally Invasive: hysteroscopic myomectomy

A minimally invasive surgical procedure to remove fibroids without removing the healthy tissue of the uterus, myomectomy has traditionally been performed through a large abdominal incision. Advances in technology, however, now allow this less invasive alternative using a vaginal approach. Such a procedure may be more time consuming for the surgeon, but it affords patients an opportunity to remain fertile.

A hysteroscopic myomectomy removes fibroids through the vagina. It is a technique that can be performed when fibroids are located within or bulging into the uterine cavity (submucosal). Anesthesia is needed because the surgery may take one to two hours and would otherwise be very uncomfortable. A small telescopic instrument, the hysteroscope, is passed through the cervix so that the inside of the uterine cavity can be seen. A small camera, attached to the telescope, projects the image onto a video monitor. This technique allows magnification of the picture and also enables the doctor to perform surgery while sitting in a comfortable position. Electricity passes through the thin wire attachment at the end of the hysteroscope so that the instrument can cut easily through the fibroid. As the tissue is shaved out, heat from the instrument sears blood vessels.

pros:

often the best procedure for women who wish to have children after treatment or who wish to keep their uterus for other reasons. The blood loss is usually minimal. Submucous or intracavitary myomas are easily visualized and can be resected or removed using a wire loop or similar device. This procedure is performed as outpatient surgery without any incisions and virtually no postoperative discomfort. Women usually go home the same day, and recovery is remarkably fast. The hospital stay can last from 30 minutes to two hours with most patients being able to go back to normal activity, work and exercise within one or two days. When fibroids are the cause of infertility, pregnancy rates following hysreroscopic myomectomy have been about 50%. When performed for heavy bleeding, nearly 90% of women have a return of normal menstrual flow.

cons:

general anesthetic is required. Only fibroids that are small and accessible through the cavity can be treated this way; therefore, effectiveness may be mostly limited to treatment of submucosal fibroids.

***

Minimally Invasive: endometrial ablation 

An outpatient treatment for uterine fibroids, especially effective to stop or decrease bleeding from the uterus. The traditional method of performing endometrial ablation uses electrical energy passed into the uterine cavity at the end of a telescope in order to cauterize and destroy the lining of the uterus. An alternative minimally invasive procedure, called Hydrothermal Ablation (HTA), uses hot water circulated inside the uterus to destroy the lining cells. The fibroids remain inside the uterus but shrink in size.

pros:

technique is very effective and destroys fibroid tissue without harming surrounding normal uterine tissue. With HTA the ablation device is specially engineered to keep the water at a low pressure so that it cannot escape through the tubes. If the device senses a leak, it automatically shuts off. Because the water circulates freely throughout the entire uterine cavity, the shape of the cavity does not affect the results; consequently this technique is very effective for the fibroid sufferer who has an enlarged uterine cavity. Hydrothermal Ablation takes only about ten minutes and results are almost always excellent. Procedure is performed as outpatient surgery. Patients usually go home the same day once they have recovered from anesthesia and typically return to work within three to five days. It varies woman to woman as to when results are seen; however, symptomatic relief of pelvic pain and pressure is typically seen shortly after the procedure is performed. Heavy bleeding is noticeably improved within three to six months, sometimes as soon as the first subsequent menstrual period. After endometrial ablation the ovaries continue to make normal amounts of hormone for the rest of the body, but without uterine lining cells, bleeding cannot occur. Generally a woman treated with endometrial ablation can look forward to the rest of her life without the fatigue and inconvenience associated with heavy bleeding.

cons:

requires special training and skill on the part of the doctor. Many doctors who never learned how to perform endometrial ablation do not offer the procedure to their patients as a minimally invasive alternative to hysterectomy. Endometrial ablation should only be performed for women who do not wish to have more children. Because the lining cells of the uterus are destroyed, there is no safe place for a developing fetus to attach. Even so, it is still strongly recommended to use some form of contraception after the procedure because there does exist, even if only rarely, the possibility of an unplanned, excessively risky pregnancy.

For more comprehensive information about advantages and limitations for other approaches to treatment for uterine fibroid tumors, please visit the Vitamin Insider website and select the topic:  “Pros and Cons of Fibroid Treatment Options.”  

http://vitamininsider.com/

Note also in Vitamin Insider that a wider variety of subjects about fibroid tumors — everything from causes and risk factors to  diagnosis and prognosis — can be found among the topics there.

 

 

Noninvasive Options To Treat Fibroids

Noninvasive Procedures for Treatment of Uterine Fibroids

 

As an approach significantly less invasive than traditional, conventional hysterectomy, there are alternative procedures that can now offer important advantages for some fibroid sufferers. With noninvasive technology there is no cutting, suturing or removal of the uterus itself, and general anesthesia is not required.  In most cases overnight hospital stay will not be necessary. These noninvasive procedures are generally considered safe. They can be expected to reduce the risk of complications and side effects that might otherwise result from more drastic surgical intervention. You can expect to return to your livelihood and social activities quickly because of the short recovery time.

CAUTION: not all women may be good candidates for the treatments listed below. Consult with your healthcare team to determine whether your condition is likely to benefit from noninvasive interventions.

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Noninvasive: progestin-releasing intrauterine device (IUD) 

Women who have a uterus with fibroids smaller than 12-weeks size and a normal-size uterine cavity may achieve relief from heavy bleeding by using a progestin-releasing intrauterine device.

 

pros:

drug in synthetic form very similar to progesterone in this type of IUD thins the uterine lining cells so that the cells bleed less. It can help to lower the amount of blood lost during menstruation and thereby help prevent anemia. One study showed that by three months 85% of women returned to normal bleeding. Heavy bleeding and anemia were cured in virtually all women at the end of one year.  In some cases this treatment may somewhat lessen the associated cramping as well. After being inserted into the uterus, the IUD can remain there for up to five years. 

 

cons:  

is suitable for treating only fibroids that are not very big. Larger fibroids may block the uterine cavity, making it impossible to insert an IUD. Because it will have a contraceptive effect, the IUD is probably not a good idea for fibroid sufferers who are trying to conceive. This noninvasive treatment cannot reduce the size of fibroids, nor can it make them disappear; therefore, it generally will not totally eliminate pain and cramps. IUDs may cause nausea, acne, weight gain and breast tenderness. These side effects are more commonly noted during the first few months of treatment than later on. Overall, they affect about 10 out of 100 women who use IUDs. Intrauterine devices are rejected by the body in about that same number of women. Using any IUD carries a certain level of risk — it is estimated that damage to the uterus is caused when fitting the device in about one to ten of every 10,000 women.

***

 

Noninvasive: MRI-guided focused ultrasound (MRgFUS) 

This technology utilizes high-frequency energy in the form of sound waves. Precisely pinpointed, high-intensity ultrasound can be successfully used to “burn away” fibroids without harming normal surrounding tissues since the energy can be focused on a single point inside a woman’s body (e.g., on a troublesome fibroid). Heat created by the energy actually destroys fibroid cells, but the ultrasound energy itself can pass through the rest of the body without harm until it gets to the focal point in the fibroid. Magnetic Resonance Imaging (MRI) is used to focus the ultrasound waves and leads to the term "MRgFUS (Magnetic Resonance guided Focused Ultrasound)." 

The "knifeless surgery" is performed as an outpatient intervention, during which you will remain conscious but sedated and feeling no pain. During the procedure you can expect to be positioned on your stomach on top of a patient table that fits into the standard MRI scanner. MRI is an advanced diagnostic technology, which provides 3-D imaging of internal organs thereby avoiding exposure to radiation. Without the need for any incision, this treatment uses magnetic resonance images to identify the exact location of the fibroid and the portion that is being targeted. It also provides real time feedback about temperature changes of the treated fibroid to make sure that the fibrotic tissue has been successfully ablated (destroyed).

Initially your doctor will identify the fibroid(s) on MR images taken of your pelvic region. Then, after detailed planning, (s)he will direct high energy focused ultrasound waves to heat a small spot in the uterine fibroid to a temperature of up to 85°C. During the pulse or sonication, which lasts about 15 to 20 seconds, the doctor monitors progress and reviews temperature-sensitive images. Since each sonication treats only a very small volume, this process will be repeated until the required volume is treated (typically about 50 to 100 times). Depending upon the size and number of fibroids to be treated, the procedure activity generally lasts from two to three hours. Following the treatment your body gradually sloughs off the treated tissue over a period of months to provide symptom relief.

Showing promise, but still being further developed and refined, this procedure is a non-invasive alternative that can be selected to treat some women with fibroids.

 

pros:

keeps the uterus intact and offers the option of same-day, non-surgical treatment for smaller or medium-sized fibroids with low risk and very rapid recovery.  It does not require general anesthesia, and recovery time is significantly reduced compared to surgical alternatives. Most women can return to normal activity after only one to three days of home recovery. Symptomatic improvement up to 71% within three months, fibroid size reduction up to 30% – increased in proportion to treated fibroid volume. Treatment effects are usually sustained up to 24 months with low rates of secondary or repeat procedures.


cons:

the procedure is controversial for women wishing future fertility because the safety of pregnancy after MRgFUS has not yet been well established. Procedure may not be appropriate for women with very large fibroids. Other patients who may not be well suited for this procedure are women with submucous fibroids, multiple fibroids or fibroids near the bowel or bladder. Magnetic resonance guided focused ultrasound can also be a very expensive procedure.

***

 

For more comprehensive information about advantages and limitations for other approaches to treatment for uterine fibroid tumors, please visit the Vitamin Insider website and select the topic:  "Pros and Cons of Fibroid Treatment Options."  

http://vitamininsider.com/

Note also in Vitamin Insider that a wider variety of subjects about fibroid tumors — everything from causes and risk factors to  diagnosis and prognosis — can be found among the topics there.

 

Medication Options for Fibroid Treatment

Which Medications Might Be Considered for Treatment of Fibroids?

 

 

Unfortunately there are no medications currently available that are able to prevent the formation of fibroids or to shrink them permanently once they are present. While medical treatments do not remove or cure a uterine fibroid, they can shrink it and thus may be effective at temporarily diminishing some of the symptoms of pain, pressure and bleeding that are often associated with fibroids. Once medication is stopped, the fibroid most likely will grow again, albeit slowly. Oral medications can be used to manage the condition without compromising the function of a woman's reproductive system. 

Since they cannot permanently eradicate fibroids, medicines are sometimes prescribed more so to buy time while they reduce symptoms. For some women medication can initially allow the luxury of a more relaxed interval to prepare emotionally and physically before undergoing any more intense treatment. With fibroid sufferers who are approaching the age of menopause, this “bought time” may even  be sufficient to propel them right into menopause, when the natural loss of estrogen and progesterone is likely to shrink the fibroids spontaneously. In other cases medication may be prescribed specifically to reduce the size of fibroids temporarily — just enough to allow for less invasive surgical procedures with a quicker recovery. 

***


Gonadotropin-releasing hormone (Gn-RH) agonists 

Pharmaceuticals in this category work by temporarily shutting off the ability of your ovaries to make estrogen and progesterone; therefore, symptoms will abate as long as you continue to take the medication. Your menstrual periods, too, will temporarily cease while you are taking the medicine.

 

pros:

since estrogen and progesterone are needed for fibroids to grow, the temporary  lack of these hormones will usually cause fibroids to shrink. Medications in this category generally take about two weeks to begin shrinking the fibroids, and the full effect is seen after three months. By then most fibroids will have decreased in size by about 35% of their pre-treatment volume. The shrinking effect will be maintained for as long as you use the medication, but there is rarely any further shrinkage after the third month of treatment. Heavy bleeding goes away in almost all women by about the sixth month. Some surgeons prescribe a Gn-RH agonist to be taken before a hysterectomy to shrink the uterus so that the surgery might possibly be performed through a vaginal incision rather than the more drastic abdominal incision.


cons:

when this medication intake is discontinued, the ovaries begin to produce hormones again; consequently the fibroids typically grow back to their original size, and bleeding returns within three to six months. Because this type of medication has no permanent effect, it is used primarily to reduce symptoms and allow time to bring the blood count back to normal while further treatment is being planned. In addition long-term use of this type of medication is further limited by side effects and the risk of osteoporosis. Side-effects occur in 95% of women (78% experience hot flushes, 32% complain of vaginal dryness and 55% suffer from occasional headaches for a few weeks). Muscle or joint pain, trouble sleeping, fluid retention, fragile emotions, depression and decreased libido have also been reported but less commonly so. Of greater concern is the significant bone loss which can occur if treatment continues beyond six months. In addition treatment of this type can turn into an expensive proposition — $2,000 per year or more — and is usually not covered by medical insurance.

***

 

Progesterone-blocking medication 

Treatment with progesterone-blocking medication stops heavy bleeding in most women. Progesterone has been known both to increase and to decrease the size of fibroids depending on the dosage. Higher doses of progesterone appear to cause growth in these tumors; therefore, treatment recommendations are for the lowest possible effective dose.

 

pros:

The American Society for Reproductive Medicine (ASRM) states that progesterone can effectively control the bleeding caused by fibroids. It is still uncertain, however, whether this treatment actually shrinks fibroids. In one recent research study using this type of medication, mean uterine volume shrank by nearly 50%, symptoms improved and few side effects were noted. Further study with a larger sample size is needed, though, to assess long-term safety and efficacy.


cons:

ASRM cautions that such treatment may not affect the size of the tumors. It does appear to cause over-growth of the uterine lining cells (endometrial hyperplasia) in about one quarter of women. There is some concern that this over-growth could lead to pre-cancer or cancer of the lining cells; however, preliminary studies do not show strong evidence of it. The FDA is currently reviewing data from recent clinical trials.

***

 

Oral contraceptives or progestins 

Birth control pills (oral contraceptives) can be used to treat the bleeding symptoms and menstrual cramps caused by uterine fibroids. Because they decrease the production of female hormones and prevent ovulation, such medication can minimize the flow of blood, making them an option for women whose main symptom is heavy menstrual bleeding. 

 

pros:

today's lower-dosage birth control pills will help control heavy bleeding and cramping without initiating further fibroid growth. 


cons:

can have side effects including headache, nausea, fluid retention and breast tenderness. They can also increase the risk of blood clots (thrombosis), especially in older women and women who smoke. This approach may not be effective if any of the fibroids are near or bulging into the uterine cavity. These medications do not shrink fibroids. It is not completely clear how effective the pill is in relieving fibroid symptoms nor whether it is significantly more effective than other treatments. In fact there has not yet been enough high-quality research conducted on the use of birth control pills to treat fibroid symptoms to be conclusive. 

***

 

Alternative/herbal remedies 

There are few scientific studies of alternative (herbal) treatments for fibroids; however, increased interest in Traditional Chinese Medicine has recently prompted research that shows promise in the early stages. 

 

pros:

this treatment approach may work for women with small fibroids who wish to prevent the fibroids from growing and causing more symptoms. One recent small study compared fibroid growth in women treated with Traditional Chinese Medicine, body therapy and guided imagery measured against women treated with non-steroidal anti-inflammatory medications (NSAIDs), progestins or oral contraceptive pills. After six months ultrasounds showed that fibroids stopped growing or shrank in 59% of the women treated with the combination of alternative treatments but in only 8% of the other group. Another study reported treatment of 110 women with fibroids smaller than 10 cm (4.5 inches) with Traditional Chinese Medicine (Kuei-chih-fu-ling-wan). Fifteen of the women (14%) eventually requested and had hysterectomy surgery performed during this study. In the remaining 95 study subjects fibroids went away in 19%, got smaller in 43%, did not change in 34% and grew in 4%. Heavy bleeding improved in 95%, and severe cramping improved in 94%.


cons:

some Traditional Chinese Medicine specialists report success with small fibroids (less than two inches) but not with fibroids larger than that. It is important, too, to work with a reputable alternative medicine practitioner who can properly direct your care.

***

 

For more comprehensive information about advantages and limitations for other approaches to treatment for uterine fibroid tumors, please visit the Vitamin Insider website and select the topic:  "Pros and Cons of Fibroid Treatment Options."  

http://vitamininsider.com/

Note also in Vitamin Insider that a wider variety of subjects about fibroid tumors — everything from causes and risk factors to  diagnosis and prognosis — can be found among the topics there.

Watchful Waiting for Fibroid Care

Watchful Waiting (or Expectant Management) for Uterine Fibroids

 

 If you are like most women with uterine fibroids, you experience only minimal symptoms or, perhaps, none at all. In this situation watchful waiting (also known as "expectant management") could be the best course, especially at the outset. With this approach no active treatment will be undertaken, but during the watchful waiting time you do need to be evaluated periodically by your doctor. Followup visits should include questions about any change in your symptoms along with abdominal and pelvic examinations to assess any difference in size and/or number of fibroids.

The reasoning is that, since some fibroids will disappear on their own or will cause only minimal symptoms, it may be better not to undergo active treatment until/unless it becomes unavoidable. Many fibroid treatments come with the risk of significant side effects as well as a lengthy recovery time for the more invasive procedures. Consequently, as long as symptoms are not debilitating, it may be best just to wait and see what happens as time goes by.

The good news is that, while you are in the watchful waiting phase, there are some important things you can do on your own that might possibly reduce or eliminate some fibroid symptoms. You can experiment with natural treatment options, which are typically more beneficial when the fibroids are smaller and/or less problematic. You can also make lifestyle and diet adjustments. In addition, during watchful waiting, you can educate yourself about available treatment options in case you eventually get to the point of needing intervention. The more aware you are of various options, the more empowered you will be as you work with your healthcare team to find the right resolution for your specific fibroid situation.

 

pros:   

probably the best initial option for a large majority of women with uterine fibroids.  Remember: some fibroids don’t grow at all, and some even shrink on their own before menopause. After menopause most fibroids will shrink and bleeding will stop spontaneously when estrogen and progesterone hormone levels decrease. Avoiding the cost and aftereffects of prescription medication and/or surgical intervention is a convincing argument in favor of watchful waiting. For most women "doing nothing" makes excellent sense unless/until fibroid symptoms become excessively bothersome.


cons:  

approach is best managed in partnership with a gynecology specialist who has specific experience with treating fibroids on a regular basis, who can help with the “watching” and who is experienced at various treatment options in case more intensive intervention becomes necessary over time.  May require an office visit every three to six months with close monitoring of blood count test results. Symptoms may intensify over time so that additional intervention may eventually become necessary.

***

 

For more comprehensive information about advantages and limitations for other approaches to treatment for uterine fibroid tumors, please visit the Vitamin Insider website and select the topic:  "Pros and Cons of Fibroid Treatment Options."  

http://vitamininsider.com/

Note also in Vitamin Insider that a wider variety of subjects about fibroid tumors — everything from causes and risk factors to  diagnosis and prognosis — can be found among the topics there.

Pros and Cons of Fibroid Treatment Options

Pros and Cons of  Frequently Recommended Treatments for Uterine Fibroids

 

Uterine fibroids are the most common gynecologic tumor among women of reproductive age. Fibroid-related morbidity has a significant economic impact on health care: the cost of health care for women with fibroids is more than double that of women without this condition. Annual expenses related to the diagnosis of fibroids have reached significantly more than $2 billion in the United States alone.

At any given time, by using a sensitive MRI diagnostic technique, more than 75 percent of all women can be found to have small fibroids. Of those, only about 30 percent, though, will ever experience uterine fibroids large enough to be noted during a pelvic exam. The vast majority of these women — in fact more than 80 percent — will never develop troublesome symptoms and will not require treatment. Even for that rare woman who does experience significant problems, there may be a number of gentle, but still sound and effective, treatment options available. There are advantages and disadvantages — pro and cons — associated with each approach. In many cases the rush to hysterectomy surgery may not be inevitable if you take the time to seek out viable alternatives.

Your choice(s) of treatment should be determined by the medical problems your fibroids are causing, your desire to conceive and your feelings or thoughts about your body, surgery and other options. In order to weigh the pros vs. the cons for each treatment, it is important for you to be informed about the benefits as well as the risks of all possible interventions. Even if some treatments do not seem to apply to your situation at the current time, your condition or symptoms eventually might change. If you understand the potential for future symptoms and problems, along with the various alternative means of treatment available, much of the fear and mystery of fibroids can be eliminated.

Each form of treatment for uterine fibroid tumors has its own specific set of pros and cons.  As you have seen in previous Vitamin Insider posts for this topic, every woman's condition is unique, which means logically there is no one, single "best" intervention for all fibroid sufferers. When you and your healthcare team are making decisions about the proper option for managing/treating your own particular situation, you would be wise to consider both the positive and the negative potential outcomes associated with each approach.

 

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Please click on each link below to learn more about the pros and cons of various treatment approaches.

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WATCHFUL WAITING –  If you are like most women with uterine fibroids, you experience only minimal symptoms or, perhaps, none at all. In this situation watchful waiting (also known as "expectant management") could be the best course, especially at the outset. With this approach no active treatment will be undertaken, but during the watchful waiting time you do need to be evaluated periodically by your doctor. Followup visits should include questions about changes in your fibroid symptoms along with abdominal and pelvic examinations to assess any change in size and/or number of fibroids.

 http://vitamininsider.com/watchful-waiting-fibroid-care/

***

 

MEDICATION –  Unfortunately there are no medications currently available that are able to prevent the formation of fibroids or to shrink them permanently once they are present. While medical treatments do not remove or cure a uterine fibroid, they can shrink it and thus may be effective at temporarily diminishing some of the symptoms of pain, pressure and bleeding that are often associated with fibroids. Once medication is stopped, the fibroid most likely will grow again, albeit slowly. Oral medications can be used to manage the condition without compromising the function of a woman's reproductive system. 

Since they cannot permanently eradicate fibroids, medicines are sometimes prescribed more so to buy time while they reduce symptoms. For some women medication can initially allow the luxury of a more relaxed interval to prepare emotionally and physically before undergoing any more intense treatment. With fibroid sufferers who are approaching the age of menopause, this “bought time” may even  be sufficient to propel them right into menopause, when the natural loss of estrogen and progesterone is likely to shrink the fibroids spontaneously. In other cases medication may be prescribed specifically to reduce the size of fibroids temporarily — just enough to allow for less invasive surgical procedures with a quicker recovery.

Among the medications most frequently prescribed are those from the following categories:

Gonadotropin-releasing hormone (Gn-RH) agonists
Progesterone-blocking medication
Oral contraceptives or progestins
Alternative/herbal remedies 

http://vitamininsider.com/medication-options-fibroid-treatment/

***

 

NONINVASIVE PROCEDURES –  As an approach less drastic than hysterectomy, there are alternative procedures that can offer significant advantages for some fibroid sufferers. With noninvasive technology there is no cutting, suturing or removal of the uterus itself. General anesthesia is not required.  In most cases there will be no overnight hospital stay. These procedures are generally safe and reduce the risk of complications and side effects.  You can expect to return to your livelihood and social activities quickly because of the short recovery time.

caution: not all women may be good candidates for the treatments listed below. Consult with your healthcare team to determine whether your condition is likely to benefit from noninvasive intervention of the following types:

Progestin-releasing intrauterine device (IUD) 

MRI-guided ficused ultrasound (MRgFUS)

http://vitamininsider.com/noninvasive-options-treat-fibroids/

***

 

MINIMALLY INVASIVE PROCEDURES –  Women who undergo minimally invasive procedures generally experience shorter hospital stays, less pain, faster recovery times and less scarring with a quicker return to normal activities than women who have traditional surgery. Such treatment is performed with the intention of enabling a woman to preserve her uterus and possibly, in some cases, to give her the opportunity to bear children in the future. Sometimes, however, fibroid removal may leave a woman's ability to conceive and bear children impaired. 

Among minimally invasive techniques the following procedures are most frequently recommended:

Uterine artery embolization/uterine fibroid embolization

Myolysis

Laparoscopic or robotic myomectomy

Hysteroscopic myomectomy 

Endometrial Ablation

http://vitamininsider.com/fibroid-treatment-minimally-invasive-techniques/

***


SURGICAL PROCEDURES –  Surgery may be indicated to treat uterine fibroid tumors if the woman experiences heavy bleeding that is persistent, causes severe anemia and/or does not respond to less drastic treatment. After other options have been exhausted without success, a surgical procedure may eventually become the final resolution.

The choice of surgery most often weighs relative advantages of the following two procedures:

Abdominal myomectomy
Hysterectomy 

http://vitamininsider.com/surgical-treatment-fibroid-tumors/

***

 

ALTERNATIVE THERAPY –  Recent advances in the medicine and technology for fibroid treatment have been astounding. In contrast, though, a number of critical elements of overall wellbeing are quite basic and holistic.  Healthcare professionals recognize that important aspects of a woman's life will interrelate with other factors, including, but not limited to:

  • stress 
  • diet and nutrition
  • exercise
  • sleep

Unraveling these relationships may change how discomfort from fibroids is perceived and accommodated by individual women. Some fibroid sufferers, especially those with mild symptoms who are on watchful waiting or those who prefer holistic approaches, may well opt to evaluate the pros and cons of alternative therapies alongside conventional medical and/or surgical treatment options.  By modifying lifestyle factors in combination with nutrition and lifestyle counseling, vitamin and herbal supplements, homeopathy and bodywork therapies, some fibroid sufferers may be able to diminish or even eliminate some of their symptoms without conventional intervention.

http://vitamininsider.com/alternate-therapies-manage-fibroids/

***

 

The final analysis: understand your options and make a treatment choice that is comfortable for you. Do not hesitate to ask your healthcare professionals to clarify any questionable recommendations and even to provide additional information about the pros and cons of each treatment as you undertake your due diligence. Seeking a second opinion is another viable option you might choose before undergoing treatment for fibroids. In most cases you have time to consider the alternatives. Do not rush to action without exercising your right to be fully informed in advance.