For women with fibroids, heavy bleeding, or endometriosis
If you suffer from symptomatic fibroids, heavy bleeding or endometriosis, you might be able to avoid a hysterectomy with the right medical management and care. For those who cannot avoid hysterectomy, therapeutic and medical care and management can help minimize the impact of surgery. The great news is you have a number of options, including various types of oral contraceptives, progesterone/progestin hormones, and GnRH agonists.
Certain forms of birth control pills have proven to help some women. The progestin component can sometimes offset the stimulating effect of her own estrogen. However, since birth control pills also contain synthetic estrogens, this isn’t always the case.
The Mirena intrauterine system (IUD) is another option to consider. It releases a synthetic progestin inside the uterus. Though it’s available as birth control, it also helps control bleeding issues and can prevent the need for hysterectomy in some women.
At the Women to Women clinic, we try to use natural progesterone products for these purposes whenever possible, such as Prometrium, prescription capsules or custom-compounded micronized progesterone products. If contraception is also desired, birth control pills and the Mirena are appropriate options to consider.
Sometimes women are prescribed Lupron, a type of GnRH agonist, to bring on a sudden, temporary “medical menopause” in an attempt to shrink fibroids or reduce endometrial implants. GnRH agonist drugs are modified versions of the naturally occurring hormone known as gonadotropin releasing hormone, which plays a role in regulating the menstrual cycle. These drugs are normally used preoperatively in order to improve ease of surgery. They may also be used in the treatment of endometriosis. Additionally, Lupron inhibits ovarian function and severely decreases a woman’s estrogen and hormone production as well. This creates some uncomfortable side effects, including instant menopausal symptoms and potentially significant thinning of the bone. Women are usually prescribed the drug for 3–6 months and then evaluated to see how their symptoms have improved. Many of these women do end up having surgery eventually.
It’s important to realize that knowledge is power. As you become more knowledgeable you are able to make the right decisions for you. After all, no one knows your body as well as you do!